BRIGHT Coaching to empower caregivers of children with emerging developmental delays on waitlists for services: A randomized controlled trial

AIM: To examine the effectiveness of BRIGHT Coaching, a virtual coaching intervention, to increase parental empowerment in caregivers awaiting developmental services for their child. METHOD: BRIGHT Coaching, a 12-topic program, was developed by experts and parent-partners to address caregivers' knowledge needs. Participants were caregivers of children aged 1 year 6 months to 4 years 6 months with suspected developmental delays, recruited from four Canadian provinces. This was a two-arm, parallel-group, pragmatic, multi-site randomized clinical trial, with intervention (n = 154) and control (n = 152) groups that were comparable at baseline. Participants received either BRIGHT Coaching or usual care over 12 months. Three outcome measures were administered at baseline, posttreatment (8 months), and follow-up (12 months): the Family Empowerment Scale (FES; domains: family, services, community), Parenting Stress Index, and Parenting Sense of Competence Scale. Exit surveys explored participants' perspectives. Intention-to-treat analyses were applied. RESULTS: Participants were predominantly mothers of males, with diverse income, education, and ancestry. In the baseline-adjusted treatment × time mixed model, FES total favored the intervention group at posttreatment (Δ = +0.17, 95% confidence interval 0.04-0.30; interaction p = 0.028) and at follow-up (Δ = +0.18, 95% confidence interval 0.05-0.31; interaction p = 0.020). FES total was the single confirmatory outcome; subscale and secondary-measure findings are exploratory (false-discovery-rate controlled). Both groups experienced changes in efficacy and satisfaction on the Parenting Sense of Competence Scale (p < 0.001), favoring the intervention group. Clinically significant stress was lower in the intervention group (16.4%) than in the control group (28.9%, p = 0.03). Participants reported numerous benefits and high satisfaction with the intervention. INTERPRETATION: BRIGHT Coaching empowered caregivers with knowledge and skills while awaiting services, addressing service gaps and complementing existing services. It is a promising approach for families of children with emerging developmental delays.