Theory of Planned Behavior Variables As Predictors of Community Providers’ Intent to Implement a Parent-Mediated Intervention for Children with ASD.

Background: Parent-mediated interventions are an effective method for improving outcomes for children with ASD (e.g. Ingersoll, Wainer, Berger, Pickard, & Bonter, 2016; Kasari, Gulsrud, Wong, Kwon, & Locke, 2010), yet they are underutilized in community settings where the majority of children receive their services (Lord et al., 2005; Stahmer & Aarons, 2009). The theory of planned behavior (TPB) posits that an individual’s beliefs/attitudes, perceptions of norms, and perceived behavioral control predict their intent to perform a behavior (Ajzen, 1985). A strong research base has demonstrated that TPB is an effective model for understanding and changing health-related behaviors (e.g. Albarracin, Johnson, Fisbein, & Muellerleile, 2001; Godin & Kok, 1996) but TPB has thus far not been examined in reference to community providers’ intentions to implement parent-mediated intervention for families of children with ASD.

Objectives: This study examined the extent to which TPB could predict community providers’ intent to implement an evidence-based, parent-mediated social communication intervention for children with ASD.

Methods: Providers (n = 72) participated in a workshop for Project ImPACT and provided demographic variables (gender, age, racial/ethnic minority status, graduate degree, years of ASD experience, degree to which their caseload matched Project ImPACT’s target population) as well as variables derived from TPB (attitudes towards parent-mediated interventions, agency norms regarding parent-mediated interventions, self-efficacy regarding parent coaching skills).

Results: Demographic variables associated with intent to use the intervention included the degree to which providers’ caseloads matched Project ImPACT’s targeted population and whether the provider had a graduate degree (r = .268, p =.031 and r = .360, p = .003, respectively). Providers’ attitudes toward parent-mediated interventions and ratings of perceived behavioral control (i.e. perceived coaching skill level) were associated with intent to implement (r = .330, p = .004 and r = .247, p = .035, respectively), consistent with research on TPB regarding intentions to change health-related behaviors (Ajzen, 2007). Contrary to hypothesis, perceived agency norms were not associated with intentions, r = .002, p = .987. Multiple regression of demographic and TPB variables demonstrated that holding a graduate degree (β = .317, p = .006), having positive attitudes towards parent-mediated interventions (β = .251, p = .026), and having high ratings of self-efficacy regarding parent coaching skills (β = .242, p = .031) were each unique predictors of intention to implement Project ImPACT and together explained ~27% of variance.

Conclusions: Results demonstrate support for the application of TPB to providers’ intentions to implement parent-mediated ASD interventions in community settings. TPB provides a theoretical foundation for understanding providers’ intentions to implement parent-mediated interventions, which in turn can be used to develop intention interventions to increase implementation of these evidence-based practices. Future research will examine the efficacy of an intervention to influence providers’ perceived behavioral control and attitudes towards parent-mediated intervention in an effort to increase provider implementation of parent-mediated interventions for families of traditionally underserved children with ASD served in community mental health settings.