Effectiveness of a blended online behavioral parent training program for Vietnamese parents of children with ADHD: A randomized controlled trial with 3-month follow-up

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• Picked for Pediatrics and Child Health (paper of the day, 27 July 2026): Ranked by evidence level and journal quartile

Abstract

BACKGROUND: Behavioral parent training (BPT) is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD); however, evidence from low- and middle-income Asian countries remains scarce. This randomized controlled trial evaluated a culturally adapted blended BPT program for Vietnamese parents of elementary school-aged children with ADHD. METHODS: Eighty-six parents of children (6-11 years) with a clinician-confirmed DSM-5 diagnosis of ADHD were randomized to a blended BPT program (n = 43) or treatment as usual plus psychoeducational materials (n = 43). The intervention comprised six weekly 2-h online group sessions, each followed within the same week by a 1-h individual home-based support session, and 12 weekly support telephone calls across a 3-month maintenance period. Parenting skills (Parenting Skills Assessment Scale), parent-rated child ADHD symptoms (Vanderbilt ADHD Diagnostic Parent Rating Scale), and parenting stress were assessed at baseline (T1), post-intervention (T2), and 3-month follow-up (T3). The analyses included 80 participants with complete data (intervention, n = 37; control, n = 43). RESULTS: Parenting skills improved substantially in the intervention group relative to the control group (group × time interaction: F (2, 156) = 20.75, p < .001, partial η 2  = 0.21; baseline-adjusted between-group d = 1.28 at follow-up). Parent-rated ADHD symptoms decreased significantly within the intervention group (T1→T3: -4.14 points, p < .001), but the baseline-adjusted between-group differences were small and not statistically significant (T2: p = .057; T3: p = .075; adjusted d ≈ 0.28-0.30). Parenting stress declined similarly in both groups. Exploratory mediation analyses indicated a significant indirect effect on follow-up ADHD symptoms through improved parenting skills (ab = -1.86, 95% bootstrap CI [-4.01, -0.37]). CONCLUSION: The culturally adapted blended BPT program was feasible and produced large, sustained improvements in parenting skills among Vietnamese parents. The effects on parent-rated ADHD symptoms were small and require confirmation in adequately powered trials. TRIAL REGISTRATION: Thai Clinical Trials Registry, TCTR20260212003 (retrospectively registered on February 12, 2026). Registration number: TCTR20260212003. Available at: https://www.thaiclinicaltrials.org/show/TCTR20260212003.

Abstract as published, via PubMed.