Online versus telehealth delivery of a parenting program for postdeployed military families: Child internalizing and externalizing symptoms as moderators of response

OBJECTIVE: Families could benefit from remote parent training programs. However, the comparative effectiveness of online self-directed versus facilitator-delivered telehealth for families with varying characteristics remains unclear. This study examined whether baseline child mental health symptoms moderate parental response to two remote delivery formats of a parenting intervention for military families. METHOD: A sample of 149 families with a 4- to 12-year-old child and at least one parent deployed post-9/11 participated in a 14-week After Deployment, Adaptive Parenting Tools parenting intervention. The intervention was delivered postdeployment and focused on strengthening parenting to support child adjustment. Families were randomly assigned to one of two remote formats. Both fathers and mothers were invited to participate and independently reported their child's externalizing and internalizing symptoms at baseline. Observed parenting practices were assessed at baseline and at 1-year follow-up. Separate moderation models were conducted for fathers and mothers. RESULTS: For mothers and fathers, baseline child externalizing behavior moderated the effect of delivery format on parenting practices at 1 year. At high symptom levels, telehealth had a greater impact on parenting practices than the online self-directed format. At low symptom levels, both formats produced similar improvements in parenting practices for fathers, while online self-directed delivery had a greater impact than telehealth format for mothers reporting low child externalizing symptoms. CONCLUSIONS: Parents reporting higher child symptoms benefit most from a facilitator-delivered telehealth parent training, whereas online self-directed training appears adequate for lower child symptoms. These findings suggest that tailoring delivery format based on family needs may optimize the effectiveness of parent programs. (PsycInfo Database Record (c) 2026 APA, all rights reserved).