{"id":{"repo_id":"ku","oai_identifier":"oai:kuscholarworks.ku.edu:1808/37786"},"canonical_url":"https://search.dev.ndltd.org/etd/ku/oai:kuscholarworks.ku.edu:1808/37786","repository":{"repo_id":"ku","name":"University of Kansas","base_url":"https://kuscholarworks.ku.edu/server/oai/request"},"display":{"title":"Barriers to Treatment Engagement Among Minoritized, Low-Income Youth with Developmental Delay Receiving Internet-Delivered Parent-Child Interaction Therapy","abstract":"Objective: Disruptive behavior problems (DBPs) are a top reason for referral to mental health clinics in young children, particularly those with developmental delays (DD). Yet, engagement in treatment is a major concern, especially for minoritized, low-income families. Internet-delivered Parent-Child Interaction Therapy (IPCIT) is effective for DBPs and offers a promising telehealth approach to support engagement. This study examined whether parent acculturation, technological problems, and stress predicted five IPCIT engagement indicators and whether the indicators formed a latent construct. Methods: Participants were 70 children with DD (M age = 34.3 months; 72.9% male) and their parents, primarily low-income and from racial/ethnic minoritized backgrounds (93.3%). Engagement indicators included session attendance, treatment retention, homework completion, therapeutic alliance, and treatment satisfaction. Regression and confirmatory factor analyses assessed predictors and engagement structure. Results: Higher parenting stress predicted lower attendance, weaker alliance, and reduced satisfaction. Lower parent acculturation predicted reduced homework completion. Technology problems were mostly non-significant, with one exception predicting attendance. The latent model of engagement could not be validated. An exploratory composite approach identified stress and acculturation variables as significant negative predictors of overall engagement. Conclusion: Engagement in IPCIT is presently best understood as a multidimensional construct, with stress as a key barrier, followed by acculturation. While most technology issues were non-significant, brief in-session disruptions appeared to hinder attendance. Findings highlight the need for stress-sensitive, culturally responsive strategies, while minimizing technology disruptions, to support engagement among underserved families in telehealth parent training.","abstract_html":"Objective: Disruptive behavior problems (DBPs) are a top reason for referral to mental health clinics in young children, particularly those with developmental delays (DD). Yet, engagement in treatment is a major concern, especially for minoritized, low-income families. Internet-delivered Parent-Child Interaction Therapy (IPCIT) is effective for DBPs and offers a promising telehealth approach to support engagement. This study examined whether parent acculturation, technological problems, and stress predicted five IPCIT engagement indicators and whether the indicators formed a latent construct. Methods: Participants were 70 children with DD (M age = 34.3 months; 72.9% male) and their parents, primarily low-income and from racial/ethnic minoritized backgrounds (93.3%). Engagement indicators included session attendance, treatment retention, homework completion, therapeutic alliance, and treatment satisfaction. Regression and confirmatory factor analyses assessed predictors and engagement structure. Results: Higher parenting stress predicted lower attendance, weaker alliance, and reduced satisfaction. Lower parent acculturation predicted reduced homework completion. Technology problems were mostly non-significant, with one exception predicting attendance. The latent model of engagement could not be validated. An exploratory composite approach identified stress and acculturation variables as significant negative predictors of overall engagement. Conclusion: Engagement in IPCIT is presently best understood as a multidimensional construct, with stress as a key barrier, followed by acculturation. While most technology issues were non-significant, brief in-session disruptions appeared to hinder attendance. Findings highlight the need for stress-sensitive, culturally responsive strategies, while minimizing technology disruptions, to support engagement among underserved families in telehealth parent training.","abstract_has_math":false,"creators":["Golik, Alexandra Michelle"],"institution":"University of Kansas","degree_name":"Ph.D.","degree_level":null,"degree_discipline":"Clinical Child Psychology","degree_department":null,"school":null,"contributors":[],"advisors":["Cushing, Christopher C","Gudiño, Omar G"],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025-01-01","date_published":"2025-01-01","updated_at":"2026-07-24T02:46:05Z","subjects":["barriers","parent training","PCIT","telehealth","treatment engagement"],"languages":["en"],"rights":[],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier.other","label":"Dc Identifier Other","values":["https://www.proquest.com/LegacyDocView/DISSNUM/32240550"],"render_values":[{"text":"https://www.proquest.com/LegacyDocView/DISSNUM/32240550","href":"https://www.proquest.com/LegacyDocView/DISSNUM/32240550","code":true}]}]},"links":{"outbound_url":"https://hdl.handle.net/1808/37786","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Cushing, Christopher C","Gudiño, Omar G"]},{"key":"dc:creator","label":"Author","values":["Golik, Alexandra Michelle"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2026-04-21T19:40:20Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2026-04-21T19:40:20Z"]},{"key":"dc:date.issued","label":"Date","values":["2025-01-01"]},{"key":"dc:publisher","label":"Institution","values":["University of Kansas"]},{"key":"dc:type","label":"Dc Type","values":["Dissertation"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Clinical Child Psychology"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Ph.D."]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["barriers","parent training","PCIT","telehealth","treatment engagement"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.other","label":"Dc Identifier Other","values":["https://www.proquest.com/LegacyDocView/DISSNUM/32240550"]},{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/1808/37786"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Objective: Disruptive behavior problems (DBPs) are a top reason for referral to mental health clinics in young children, particularly those with developmental delays (DD). Yet, engagement in treatment is a major concern, especially for minoritized, low-income families. Internet-delivered Parent-Child Interaction Therapy (IPCIT) is effective for DBPs and offers a promising telehealth approach to support engagement. This study examined whether parent acculturation, technological problems, and stress predicted five IPCIT engagement indicators and whether the indicators formed a latent construct. Methods: Participants were 70 children with DD (M age = 34.3 months; 72.9% male) and their parents, primarily low-income and from racial/ethnic minoritized backgrounds (93.3%). Engagement indicators included session attendance, treatment retention, homework completion, therapeutic alliance, and treatment satisfaction. Regression and confirmatory factor analyses assessed predictors and engagement structure. Results: Higher parenting stress predicted lower attendance, weaker alliance, and reduced satisfaction. Lower parent acculturation predicted reduced homework completion. Technology problems were mostly non-significant, with one exception predicting attendance. The latent model of engagement could not be validated. An exploratory composite approach identified stress and acculturation variables as significant negative predictors of overall engagement. Conclusion: Engagement in IPCIT is presently best understood as a multidimensional construct, with stress as a key barrier, followed by acculturation. While most technology issues were non-significant, brief in-session disruptions appeared to hinder attendance. Findings highlight the need for stress-sensitive, culturally responsive strategies, while minimizing technology disruptions, to support engagement among underserved families in telehealth parent training."]},{"key":"dc:title","label":"Title","values":["Barriers to Treatment Engagement Among Minoritized, Low-Income Youth with Developmental Delay Receiving Internet-Delivered Parent-Child Interaction Therapy"]}]}],"canonical_facts":{"dc:contributor.advisor":["Cushing, Christopher C","Gudiño, Omar G"],"dc:creator":["Golik, Alexandra Michelle"],"dc:date.accessioned":["2026-04-21T19:40:20Z"],"dc:date.available":["2026-04-21T19:40:20Z"],"dc:date.issued":["2025-01-01"],"dc:description.abstract":["Objective: Disruptive behavior problems (DBPs) are a top reason for referral to mental health clinics in young children, particularly those with developmental delays (DD). Yet, engagement in treatment is a major concern, especially for minoritized, low-income families. Internet-delivered Parent-Child Interaction Therapy (IPCIT) is effective for DBPs and offers a promising telehealth approach to support engagement. This study examined whether parent acculturation, technological problems, and stress predicted five IPCIT engagement indicators and whether the indicators formed a latent construct. Methods: Participants were 70 children with DD (M age = 34.3 months; 72.9% male) and their parents, primarily low-income and from racial/ethnic minoritized backgrounds (93.3%). Engagement indicators included session attendance, treatment retention, homework completion, therapeutic alliance, and treatment satisfaction. Regression and confirmatory factor analyses assessed predictors and engagement structure. Results: Higher parenting stress predicted lower attendance, weaker alliance, and reduced satisfaction. Lower parent acculturation predicted reduced homework completion. Technology problems were mostly non-significant, with one exception predicting attendance. The latent model of engagement could not be validated. An exploratory composite approach identified stress and acculturation variables as significant negative predictors of overall engagement. Conclusion: Engagement in IPCIT is presently best understood as a multidimensional construct, with stress as a key barrier, followed by acculturation. While most technology issues were non-significant, brief in-session disruptions appeared to hinder attendance. Findings highlight the need for stress-sensitive, culturally responsive strategies, while minimizing technology disruptions, to support engagement among underserved families in telehealth parent training."],"dc:identifier.other":["https://www.proquest.com/LegacyDocView/DISSNUM/32240550"],"dc:identifier.uri":["https://hdl.handle.net/1808/37786"],"dc:language.iso":["en"],"dc:publisher":["University of Kansas"],"dc:subject":["barriers","parent training","PCIT","telehealth","treatment engagement"],"dc:title":["Barriers to Treatment Engagement Among Minoritized, Low-Income Youth with Developmental Delay Receiving Internet-Delivered Parent-Child Interaction Therapy"],"dc:type":["Dissertation"],"thesis:degree_discipline":["Clinical Child Psychology"],"thesis:degree_name":["Ph.D."]},"updated_at":"2026-07-24T02:46:05Z"}