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Pontoppidan M, Nygaard L, Hirani JC, Thorsager M, Friis-Hansen M, Davis D, Nohr EA. Effects on Child Development and Parent-Child Interaction of the FACAM Intervention: A Randomized Controlled Study of an Interdisciplinary Intervention to Support Women in Vulnerable Positions through Pregnancy and Early Motherhood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:587. [PMID: 38791801 PMCID: PMC11121224 DOI: 10.3390/ijerph21050587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/26/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024]
Abstract
Health inequality can have a profound impact on a child's life. Maternal mental health challenges can hinder bonding, leading to impaired functioning and poorer child outcomes. To provide extra support for vulnerable pregnant women, the FACAM intervention offers the services of a health nurse or family therapist from pregnancy until the child starts school. This study examined the effects of FACAM intervention on pregnant women in vulnerable positions and their children until the child turned two years old. We randomly assigned 331 pregnant women to either FACAM intervention or care as usual and assessed them at baseline and when the infant was 3-6, 12-13.5, and 24 months old. The primary outcome was maternal sensitivity measured by Coding Interactive Behavior (CIB). Secondary outcomes included the parent-child relationship, child social-emotional development, child developmental progress, parent-child interaction, and child development. Our findings indicate that care-as-usual children were significantly more involved than FACAM children when the child was 4-6 months old (b = -0.25, [-0.42; -0.08] d = -0.42). However, we suspect this result is due to a biased dropout. We did not find any significant differences in any other outcomes. Therefore, the study suggests that the FACAM intervention is not superior to care as usual regarding child development and parent-child interaction outcomes.
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Affiliation(s)
- Maiken Pontoppidan
- VIVE—The Danish Centre for Social Science Research, Herluf Trolles Gade 11, 1052 Copenhagen, Denmark; (J.C.H.); (M.T.); (M.F.-H.)
| | - Lene Nygaard
- Research Unit for Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark; (L.N.); (E.A.N.)
- Department of Gynaecology and Obstetrics, Odense University Hospital, 5230 Odense, Denmark
| | - Jonas Cuzulan Hirani
- VIVE—The Danish Centre for Social Science Research, Herluf Trolles Gade 11, 1052 Copenhagen, Denmark; (J.C.H.); (M.T.); (M.F.-H.)
| | - Mette Thorsager
- VIVE—The Danish Centre for Social Science Research, Herluf Trolles Gade 11, 1052 Copenhagen, Denmark; (J.C.H.); (M.T.); (M.F.-H.)
| | - Mette Friis-Hansen
- VIVE—The Danish Centre for Social Science Research, Herluf Trolles Gade 11, 1052 Copenhagen, Denmark; (J.C.H.); (M.T.); (M.F.-H.)
| | - Deborah Davis
- Faculty of Health, University of Canberra and ACT Health, Bruce, ACT 2617, Australia;
| | - Ellen Aagaard Nohr
- Research Unit for Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark; (L.N.); (E.A.N.)
- Department of Gynaecology and Obstetrics, Odense University Hospital, 5230 Odense, Denmark
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Sampaio F, Nystrand C, Feldman I, Mihalopoulos C. Evidence for investing in parenting interventions aiming to improve child health: a systematic review of economic evaluations. Eur Child Adolesc Psychiatry 2024; 33:323-355. [PMID: 35304645 PMCID: PMC10869412 DOI: 10.1007/s00787-022-01969-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 03/03/2022] [Indexed: 12/01/2022]
Abstract
A comprehensive review of the economic evidence on parenting interventions targeting different aspects of child health is lacking to support decision-making. The aim of this review is to provide an up to date synthesis of the available health economic evidence for parenting interventions aiming to improve child health. A systematic review was conducted with articles identified through Econlit, Medline, PsychINFO, and ERIC databases. Only full economic evaluations comparing two or more options, considering both costs and outcomes were included. We assessed the quality of the studies using the Drummond checklist. We identified 44 studies of varying quality that met inclusion criteria; 22 targeting externalizing behaviors, five targeting internalizing problems, and five targeting other mental health problems including autism and alcohol abuse. The remaining studies targeted child abuse (n = 5), obesity (n = 3), and general health (n = 4). Studies varied considerably and many suffered from methodological limitations, such as limited costing perspectives, challenges with outcome measurement and short-time horizons. Parenting interventions showed good value for money in particular for preventing child externalizing and internalizing behaviors. For the prevention of child abuse, some programs had the potential of being cost-saving over the longer-term. Interventions were not cost-effective for the treatment of autism and obesity. Future research should include a broader spectrum of societal costs and quality-of-life impacts on both children and their caregivers.
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Affiliation(s)
- Filipa Sampaio
- Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3 (Entry A11), 751 22, Uppsala, Sweden.
| | - Camilla Nystrand
- Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3 (Entry A11), 751 22, Uppsala, Sweden
| | - Inna Feldman
- Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3 (Entry A11), 751 22, Uppsala, Sweden
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Cathrine Mihalopoulos
- School of Health and Social Development, Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
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van Leuven L, Engelbrektsson J, Forster M. Reach and predictors of effects during nation-wide dissemination of the universal parenting program All Children in Focus. BMC Public Health 2023; 23:2027. [PMID: 37853429 PMCID: PMC10583325 DOI: 10.1186/s12889-023-16823-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/23/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Parenting programs have the potential to improve population health, if widely disseminated. However, wide-scale dissemination is challenging. Also, more knowledge is needed of whether parenting programs are effective for the variability of families in the general population. METHODS This study aimed to investigate who the universal parenting program All Children in Focus (ABC) reaches when offered in routine care in Sweden. A second aim was to investigate if the outcomes were predicted by factors related to family background, group leader experience, and homework completion. Questionnaires were collected before and after ABC from 1420 parents. Hierarchical regression analyses were performed to examine predictors of disruptive child behavior, parenting practices, and satisfaction. RESULTS ABC was available in about 40% of Swedish municipalities and reached a fairly representative population sample, with the exception that fewer fathers than mothers participated. The examined predictors explained a small proportion of the variance in the outcomes (2.5, 3.5 and 14.7%, respectively). Still, the effect on disruptive child behavior was statistically significantly larger for parents born in Sweden, with higher education, and older children. The effect on parenting practices was also larger for parents born in Sweden, for mothers, and for those practicing homework more frequently. Most examined predictors showed no statistically significant association with child and parenting outcomes. Parents were generally satisfied with ABC and the significant predictors of satisfaction had little practical meaning. CONCLUSIONS A fairly representative group of parents across Sweden were reached by ABC. Background variables, homework completion, and group leaders' experience explained a small proportion of variance in the outcomes. Meanwhile, the slightly lower intervention effects found for preschool children and parents born abroad calls for further investigation, since even small differences in effects can have an impact at a population level. The study also points to the importance of stressing homework completion and to increase the reach of universal parenting interventions to some underrepresented groups.
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Affiliation(s)
- Livia van Leuven
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels Väg 9, 171 65, Solna, Sweden.
| | - Johanna Engelbrektsson
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels Väg 9, 171 65, Solna, Sweden
| | - Martin Forster
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels Väg 9, 171 65, Solna, Sweden
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Martin M, Steele B, Spreckelsen TF, Lachman JM, Gardner F, Shenderovich Y. The Association Between Facilitator Competent Adherence and Outcomes in Parenting Programs: a Systematic Review and SWiM Analysis. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:1314-1326. [PMID: 36884129 PMCID: PMC10575799 DOI: 10.1007/s11121-023-01515-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 03/09/2023]
Abstract
There is increasing interest about the fidelity with which interventions are implemented because it is theorized that better implementation fidelity by facilitators is associated with better participant outcomes. However, in the parenting program literature, there is mixed evidence on the relationship between implementation fidelity and outcomes. This paper provides a synthesis of the evidence on the relationship between facilitator delivery and outcomes in the parenting program literature. Following PRISMA guidelines, this paper synthesizes the results of a systematic review of studies on parenting programs aiming to reduce violence against children and child behavior problems. Specifically, it examines associations between observational measures of facilitator competent adherence and parent and child outcomes. A meta-analysis was not feasible due to study heterogeneity. As a result, Synthesis Without Meta-Analysis guidelines were followed. Searches in electronic databases, reference searching, forward citation tracking, and expert input identified 9653 articles. After screening using pre-specified criteria, 18 articles were included. The review found that most studies (n = 13) reported a statistically significant positive relationship with at least one parent or child outcome. However, eight studies reported inconsistent findings across outcomes, and four studies found no association with outcomes. The results suggest that better facilitator competent adherence is generally associated with positive parent and child outcomes. However, this finding is weakened by the methodological heterogeneity of included studies and due to the wide variety of ways in which studies conceptualized competent adherence-outcome relationships.
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Affiliation(s)
- M Martin
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
| | - B Steele
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - T F Spreckelsen
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - J M Lachman
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - F Gardner
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Y Shenderovich
- Wolfson Centre for Young People's Mental Health, Cardiff, UK
- Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Centre for the Development, Cardiff University, Cardiff, UK
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Mason SM, Lind A, Sherwood NE, Sugrue EP. Building School-Based Capacity to Support Parenting: Challenges and Lessons Learned. SCHOOL MENTAL HEALTH 2023; 15:886-899. [PMID: 38912427 PMCID: PMC11192462 DOI: 10.1007/s12310-023-09593-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/25/2024]
Abstract
Both schools and caregivers play an important role in supporting children's mental health, but there are few mechanisms for caregivers and school-based mental health providers to work collaboratively to address children's needs. Closures of schools during the first wave of the COVID-19 pandemic left gaps in mental health support services to children and increased the burden on caregivers to ensure their children's well-being. In this study, investigators explored the feasibility and acceptability of a motivational interviewing-based program in which school-based mental health providers were trained to connect directly to caregivers to assist them in supporting key aspects of their children's well-being, including sleep, coping, and academic behavior. Results indicated a high degree of satisfaction with the program and a perception that it was helpful to caregivers and children. However, major challenges in recruitment of providers, as well as qualitative interviews with those providers who participated, indicated that the feasibility of implementing such a program is limited without significant additional implementation infrastructure. Findings suggest that structured support of caregivers, accessed through their children's schools, has high potential for improving child outcomes and family well-being. Future research should explore what implementation infrastructure is needed for schools to effectively offer these types of supports.
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Affiliation(s)
- Susan M. Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN 55415, USA
| | - Allison Lind
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN 55415, USA
| | - Nancy E. Sherwood
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN 55415, USA
| | - Erin P. Sugrue
- Department of Social Work, Augsburg University, Minneapolis, MN, USA
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Rimvall MK, Vassard D, Nielsen SM, Wolf RT, Plessen KJ, Bilenberg N, Thomsen PH, Thastum M, Neumer SP, Puggaard LB, Pedersen MMA, Pagsberg AK, Silverman WK, Correll CU, Christensen R, Jeppesen P. Effect modification of an effective transdiagnostic cognitive behavioral psychotherapy in youths with common mental health problems: Secondary analyses of the randomized mind-my-mind trial. Eur Neuropsychopharmacol 2023; 74:64-75. [PMID: 37279641 DOI: 10.1016/j.euroneuro.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 06/08/2023]
Abstract
Mind My Mind (MMM) cognitive behavioral therapy (CBT) manualized treatment is effective in the management of common emotional and behavioral mental health problems in youth, yet not all individuals respond satisfactorily to treatment. This study explored potential effect modifiers, i.e., baseline factors associated with a differential treatment effect. We conducted secondary effect modifier analyses with MMM trial data, which involved randomization of 396 youths aged 6-16 years to either MMM CBT treatment (9-13 sessions) or management as usual in local community settings. We examined sociodemographic- (sex, age, family composition, ethnicity, parental education, and income) and clinical variables (mental disorders and duration of mental health problems) as potential effect modifiers of the a) change in parent-rated impact of mental health problems measured by the Strengths and Difficulties Questionnaire (SDQ) or b) response (reduction of ≥1 on SDQ-impact). In intention-to-treat analyses, superior treatment (net) benefits from the MMM intervention were found among youths who met criteria for any mental disorder at baseline (-1.25 [95%CI: -1.67;-0.82]) compared to youths that did not meet diagnostic criteria (-0.22 [95%CI:-1.09;0.65]). Comorbidity vs no comorbidity (-1.84 [95%CI:-2.58;-1.10] vs -0.72 [95%CI:-1.15;-0.29]) and longer duration of untreated mental health problems, i.e., more vs less than 6 months (-1.16 [95%CI:-1.55;-0.78] vs 0.43 [95%CI:-1.01;1.86]) were also associated with superior treatment benefits. The sociodemographic factors were not associated with differential treatment effects in the intention-to-treat analyses. These findings suggest that community-based programs like the MMM are well-suited for youths with substantial mental health problems. Clinical Trials Identifier: NCT03535805.
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Affiliation(s)
- Martin Køster Rimvall
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark; Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Ditte Vassard
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Sabrina Mai Nielsen
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Rasmus Trap Wolf
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Kerstin Jessica Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - Niels Bilenberg
- Department for Child and Adolescent Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark; University of Southern Denmark, Odense, Denmark
| | - Per Hove Thomsen
- Research Center at Department for Child and Adolescent Psychiatry, Aarhus University Hospital, Skejby, Denmark; Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Mikael Thastum
- Centre for the Psychological Treatment of Children and Adolescents, Department of Psychology and Behavioural Sciences, Aarhus BSS, Aarhus University, Denmark
| | - Simon-Peter Neumer
- Centre for Child and Adolescent Mental Health, Oslo, Norway; The Arctic University of Norway, Centre for Child and Youth Mental Health and Child Welfare, North Norway (RKBU North), Tromsø, Norway
| | - Louise Berg Puggaard
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Mette Maria Agner Pedersen
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Anne Katrine Pagsberg
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Wendy K Silverman
- Anxiety and Mood Disorders Program, Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, United States
| | - Christoph U Correll
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, New York, United States; The Zucker Hillside Hospital, Department of Psychiatry, Glen Oaks, New York, United States; Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, New York, United States; Charité Universitätsmedizin, Department of Child and Adolescent Psychiatry, Berlin, Germany
| | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Pia Jeppesen
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark; Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Arai T, Goto A. Parents' Needs and Satisfaction Levels for Parenting Support Schemes Provided by Local Government: Secondary Analysis of Cross-Sectional Survey Data. J Prim Care Community Health 2023; 14:21501319231199978. [PMID: 37772511 PMCID: PMC10542223 DOI: 10.1177/21501319231199978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/30/2023] Open
Abstract
We conducted a secondary analysis of the data derived from a cross-sectional survey among parents of school-age children in Japan. The present study explored variables associated with parents' satisfaction with the local parenting environment. Multivariable logistic regression was used by entering parental satisfaction as a dependent variable and basic and parenting-related items as independent variables. A total of 2218 respondents were stratified by self-determined financial circumstances. A higher proportion of respondents stated low satisfaction with the local parenting environment and support schemes among the financially struggling group (50.4%) than among the non-struggling group (33.8%). Among the financially struggling group, the variables significantly associated with low satisfaction were a lack of parenting support (adjusted odds ratio [aOR] = 1.612) and being unable to use after-school children's clubs (aOR = 1.747). Our exploratory analysis suggests that after-school children's clubs can be expected to play a role in widening social networks and community connectedness among parents struggling financially. This role should be reflected in municipal welfare policy.
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Affiliation(s)
- Takehiro Arai
- Yamagata University, Yamagata, Japan
- Fukushima Medical University, Fukushima, Japan
| | - Aya Goto
- Fukushima Medical University, Fukushima, Japan
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Studts CR, Jacobs JA, Bush ML, Lowman J, Westgate PM, Creel LM. Behavioral Parent Training for Families With Young Deaf or Hard of Hearing Children Followed in Hearing Health Care. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3646-3660. [PMID: 35985319 PMCID: PMC9802658 DOI: 10.1044/2022_jslhr-22-00055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/13/2022] [Accepted: 05/19/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE It is well established that individuals with a communication disability, including being deaf or hard of hearing (DHH), experience inequities in health services and outcomes. These inequities extend to DHH children's access to psychosocial evidence-based interventions (EBIs). Behavioral parent training is an EBI that can be used to improve caregiver and child outcomes. Despite being supported by decades of effectiveness research, this EBI is rarely accessed by, or studied with, caregivers of DHH children. The purpose of this article is to describe a program of stakeholder-engaged research adapting and assessing behavioral parent training with caregivers of young DHH children followed in hearing health care, aimed at reducing inequities in access to this EBI. METHOD The first section briefly summarizes the literature on disruptive behavior problems in young children, with a focus on preschool-age DHH children. The evidence base for behavioral parent training is described. Next, the gaps in knowledge and practice regarding disruptive behaviors among DHH children are highlighted, and the potential integration of behavioral parent training into the standard of care for this population is proposed. CONCLUSIONS Young DHH children who use hearing aids and/or cochlear implants experience disruptive behavior problems at rates at least as high as typically hearing children, but their access to EBIs is limited, and behavioral parent training programs tailored to this population have not been rigorously tested. Caregivers and hearing health care service providers affirm the potential benefits of behavioral parent training and were partners in adapting this EBI. This research highlights several principles and approaches essential for reducing inequities and improving the quality of life not only for DHH children and their families but also for individuals with communication disabilities more broadly: engagement of key stakeholders in research, collaboration across disciplines, and using implementation science methods and models to design for implementation, dissemination, and sustainment. Presentation Video: https://doi.org/10.23641/asha.21215900.
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Affiliation(s)
- Christina R. Studts
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora
| | - Julie A. Jacobs
- Department of Otolaryngology - Head and Neck Surgery, University of Kentucky, Lexington
| | - Matthew L. Bush
- Department of Otolaryngology - Head and Neck Surgery, University of Kentucky, Lexington
| | - Joneen Lowman
- Department of Communication Sciences and Disorders, University of Kentucky, Lexington
| | | | - Liza M. Creel
- Department of Health Management and Systems Sciences, University of Louisville, KY
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Schilling S, Romero-Cely D, Mebane A, Perreira KM. Criando Niños Con Cariño : Primary Care-Based Group Parenting Program Adaptation and Pilot. J Dev Behav Pediatr 2022; 43:e370-e380. [PMID: 35316254 PMCID: PMC9329156 DOI: 10.1097/dbp.0000000000001066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/14/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study culturally adapted and piloted a primary care-based group parenting program (Child-Adult Relationship Enhancement in Primary Care, PriCARE) for Spanish-speaking, Hispanic parents of 2- to 6-year-old children. METHODS The process was informed by the cultural adaptation literature, expert consultation, and focus group data from 18 previous PriCARE, eligible Cariño , and initial Cariño test participants. As adaptations were made, an implementation framework was applied to systematically record all changes. Finally, parents of children aged 2 to 6 years participated in the Cariño pilot study (n = 32). Enrollment and attendance data were used to examine feasibility, and the Therapy Attitude Inventory (TAI) was administered postintervention to measure acceptability. RESULTS Most adaptations were minor changes to make the adapted program, Criando Niños con Cariño , more appropriate, applicable, or acceptable. Some changes required reframing Cariño concepts (e.g., child-led play) or incorporating new concepts (e.g., respeto , armonía , and educación ) to better align Cariño goals with parents' values. Among the 121 dyads invited to participate in the Cariño pilot study, 52 (43%) enrolled. Among the 52 enrolled, 32 (62%) attended at least 4 of the 6 sessions and reported high satisfaction on the TAI (mean 47/50, range 33-50). CONCLUSION Cariño is the result of a rigorous adaption process and incorporates multiple changes to ensure the translation reflects the intended meaning and to reframe the program goals and concepts in a culturally congruent manner. Pilot data suggest Cariño is feasible and acceptable to parents.
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Affiliation(s)
- Samantha Schilling
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC; USA
| | - Daniela Romero-Cely
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC; USA
| | - Alexander Mebane
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC; USA
| | - Krista M. Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC; USA
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Wolf RT, Jeppesen P, Pedersen MMA, Puggaard LB, Thastum M, Bilenberg N, Thomsen PH, Silverman WK, Plessen KJ, Neumer SP, Correll CU, Pagsberg AK, Gyrd-Hansen D. Cost-effectiveness of a transdiagnostic psychotherapy program for youth with common mental health problems. BMC Health Serv Res 2022; 22:819. [PMID: 35739556 PMCID: PMC9229821 DOI: 10.1186/s12913-022-08187-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 06/08/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Our objective was to evaluate the cost-effectiveness of the transdiagnostic psychotherapy program Mind My Mind (MMM) for youth with common mental health problems using a cost-utility analysis (CUA) framework and data from a randomized controlled trial. Furthermore, we analyzed the impact of the choice of informant for both quality-of-life reporting and preference weights on the Incremental Cost-Effectiveness Ratio (ICER). METHODS A total of 396 school-aged (6-16 years) youth took part in the 6-month trial carried out in Denmark. CUAs were carried out for the trial period and four one-year extrapolation scenarios. Costs were based on a combination of budget and self-reported costs. Youths and parents were asked to report on the youth's quality-of-life three times during the trial using the Child Health Utility 9D (CHU9D). Parental-reported CHU9D was used in the base case together with preference weights of a youth population. Analyses using self-reported CHU9D and preference weights of an adult population were also carried out. RESULTS The analysis of the trial period resulted in an ICER of €170,465. The analyses of the one-year scenarios resulted in ICERs between €23,653 and €50,480. The ICER increased by 24% and 71% compared to the base case when using self-reported CHU9D and adult preference weights, respectively. CONCLUSION The MMM intervention has the potential to be cost-effective, but the ICER is dependent on the duration of the treatment effects. Results varied significantly with the choice of informant and the choice of preference weights indicating that both factors should be considered when assessing CUA involving youth.
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Affiliation(s)
- Rasmus Trap Wolf
- Child and Adolescent Mental Health Center, Mental Health Services - Capital Region of Denmark, Copenhagen, Denmark.
- Danish Centre for Health Economics, Department of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Pia Jeppesen
- Child and Adolescent Mental Health Center, Mental Health Services - Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Smedegade 16, 4000, Roskilde, Denmark
| | - Mette Maria Agner Pedersen
- Child and Adolescent Mental Health Center, Mental Health Services - Capital Region of Denmark, Copenhagen, Denmark
| | - Louise Berg Puggaard
- Child and Adolescent Mental Health Center, Mental Health Services - Capital Region of Denmark, Copenhagen, Denmark
| | - Mikael Thastum
- Centre for the Psychological Treatment of Children and Adolescents, Department of Psychology and Behavioural Sciences, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Niels Bilenberg
- Department for Child and Adolescent Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
- Institute of Clinical Medicine, University of Southern Denmark, Odense, Denmark
| | - Per Hove Thomsen
- Research Center at the Department for Child- and Adolescent Psychiatry, Aarhus University Hospital, Skejby, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Wendy K Silverman
- Anxiety and Mood Disorders Program, Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Kerstin Jessica Plessen
- Child and Adolescent Mental Health Center, Mental Health Services - Capital Region of Denmark, Copenhagen, Denmark
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - Simon-Peter Neumer
- Centre for Child and Adolescent Mental Health, Oslo, Norway
- The Arctic University of Norway, Centre for Child and Youth Mental Health and Child Welfare, North Norway (RKBU North), Tromsø, Norway
| | - Christoph U Correll
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Anne Katrine Pagsberg
- Child and Adolescent Mental Health Center, Mental Health Services - Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dorte Gyrd-Hansen
- Danish Centre for Health Economics, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Schilling S, Bigal L, Powell BJ. Developing and applying synergistic multilevel implementation strategies to promote reach of an evidence-based parenting intervention in primary care. IMPLEMENTATION RESEARCH AND PRACTICE 2022; 3:26334895221091219. [PMID: 37091079 PMCID: PMC9924241 DOI: 10.1177/26334895221091219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: This practical implementation report describes a primary care-based group parenting intervention—Child–Adult Relationship Enhancement in Primary Care (PriCARE)—and the approach taken to understand and strengthen the referral process for PriCARE within a pediatric primary care clinic through the deployment of synergistic implementation strategies to promote physician referrals. PriCARE has evidence of effectiveness for reducing child behavior problems, harsh and permissive parenting, and parent stress from three randomized controlled trials (RCTs). The integration of evidence-based parenting interventions into pediatric primary care is a promising means for widespread dissemination. Yet, even when integrated into this setting, the true reach will depend on parents knowing about and attending the intervention. A key factor in this process is the endorsement of and referral to the intervention by the child's pediatrician. Therefore, identifying strategies to improve physician referrals to parenting interventions embedded in primary care is worthy of investigation. Method: Through lessons learned from the RCTs and key informant interviews with stakeholders, we identified barriers and facilitators to physician referrals of eligible parent–child dyads to PriCARE. Based on this data, we selected and implemented five strategies to increase the PriCARE referral rate. We outline the selection process, the postulated synergistic interactions, and the results of these efforts. Conclusions: The following five discrete strategies were implemented: physician reminders, direct advertising to patients, incentives/public recognition, interpersonal patient narratives, and audit and feedback. These discrete strategies were synergistically combined to create a multifaceted approach to improve physician referrals. Following implementation, referrals increased from 13% to 55%. Continued development, application, and evaluation of implementation strategies to promote the uptake of evidence-based parenting interventions into general use in the primary care setting are discussed. Plain Language Summary There is strong evidence that parenting interventions are effective at improving child behavioral health outcomes when delivered in coordination with pediatric primary care. However, there is a lack of focus on the implementation, including the screening and referral process, of parenting interventions in the primary care setting. This is contributing to the delay in the scale-up of parenting interventions and to achieving public health impact. To address this gap, we identified barriers and facilitators to physician screening and referrals to a primary care-based parenting intervention, and selected and piloted five synergistic strategies to improve this critical process. This effort successfully increased physician referrals of eligible patients to the intervention from 13% to 55%. This demonstration project may help advance the implementation of evidence-based interventions by providing an example of how to develop and execute multilevel strategies to improve intervention referrals in a local context.
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Affiliation(s)
- Samantha Schilling
- Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Luisa Bigal
- Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Byron J. Powell
- Center for Mental Health Services Research, Brown School and School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
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12
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Woodfield MJ, Merry S, Hetrick SE. Clinician adoption of Parent–Child Interaction Therapy: A systematic review of implementation interventions. IMPLEMENTATION RESEARCH AND PRACTICE 2022; 3:26334895221082330. [PMID: 37091096 PMCID: PMC9924277 DOI: 10.1177/26334895221082330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Parent–Child Interaction Therapy (PCIT) is a parent training intervention for childhood conduct problems, distinctive in its use of live clinician coaching of the parent–child dyad via a one-way mirror and discrete earpiece. However, despite a compelling evidence base, uptake of evidence-based parent training programmes such as PCIT by clinicians in routine care settings remains poor. This systematic review aimed to identify and synthesise implementation interventions that have sought to increase clinician adoption of PCIT in usual care settings. Methods We searched MEDLINE (Ovid), Embase (Ovid), PsycInfo (Ovid), CINAHL (EBSCO), Science Citation Index and Social Sciences Citation Index, and Web of Science Core Collection from inception to October 2020. Articles were included if they tested (by way of randomised controlled trials, controlled clinical trials, interrupted time series and controlled before and after trials) implementation interventions across any and all of the patient, clinician, clinic, system or policy domains. Two independent reviewers screened and selected studies, assessed risk of bias and extracted data – summarising implementation intervention components according to items from the Template for Intervention Description and Replication (TIDieR) checklist ( Hoffmann et al., 2014 ). Results Of the 769 articles identified once duplicates were removed, 13 papers relating to three studies met the inclusion criteria – all were quantitative or mixed-methods examinations of the effectiveness of different PCIT clinician training or training-related consultation methods. A narrative description of interventions was provided, as quantitative synthesis was not possible. Conclusions Research attention has to date been focussed on the establishment of an evidence-base for PCIT's effectiveness, with relatively little attention to the dissemination, implementation and sustainment of this treatment. Those studies that do exist have focused on training methods and training-related expert consultation. Research attention could usefully turn to both adoption and sustainment of this effective treatment in usual care settings. Plain language summary In this review, we aimed to summarise what is already known about how to implement PCIT in community settings after clinicians have received training in the approach. While research relating to the implementation of other parent training programmes is interesting and informative, implementation efforts are most effective when tailored to a specific programme in a specific context. As such, it was important to review published studies relating to PCIT specifically. We identified three relevant studies, one of which is yet to publish its main implementation findings. The three studies have focused on how best to train clinicians in PCIT, including how best to provide post-training support from expert trainers. We concluded that a fruitful line for future research would be to focus on the post-training period, particularly how best to support clinicians to adopt and sustain PCIT in their practice. Systematic review registration The study was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 01/10/2020 (CRD42020207118).
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Affiliation(s)
- Melanie J Woodfield
- The Werry Centre, Department of Psychological Medicine, University of Auckland, New Zealand
| | - Sally Merry
- The Werry Centre, Department of Psychological Medicine, University of Auckland, New Zealand
| | - Sarah E Hetrick
- The Werry Centre, Department of Psychological Medicine, University of Auckland, New Zealand
- Centre for Youth Mental Health, University of Melbourne, Australia
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13
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Scattolin MADA, Resegue RM, Rosário MCD. The impact of the environment on neurodevelopmental disorders in early childhood. J Pediatr (Rio J) 2022; 98 Suppl 1:S66-S72. [PMID: 34914896 PMCID: PMC9510913 DOI: 10.1016/j.jped.2021.11.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/04/2021] [Accepted: 11/04/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To review the literature about the environmental impact on children's mental, behavior, and neurodevelopmental disorders. SOURCES OF DATA A nonsystematic review of papers published on MEDLINE-PubMed was carried out using the terms environment and mental health or psychiatric disorders or neurodevelopmental disorders. SUMMARY OF FINDINGS Psychopathology emerges at different developmental times as the outcome of complex interactions between nature and nurture and may impact each person in different ways throughout childhood and determine adult outcomes. Mental health is intertwined with physical health and is strongly influenced by cultural, social and economic factors. The worldwide prevalence of psychiatric disorders in children and adolescents is 13.4%, and the most frequent are anxiety, disruptive behavior disorders, attention deficit hyperactivity disorder and depression. Neurodevelopment begins at the embryonic stage and continues through adulthood with genetic differences, environmental exposure, and developmental timing acting synergistically and contingently. Early life experiences have been linked to a dysregulation of the neuroendocrine-immune circuitry which results in alterations of the brain during sensitive periods. Also, the environment may trigger modifications on the epigenome of the differentiating cell, leading to changes in the structure and function of the organs. Over 200 million children under 5 years are not fulfilling their developmental potential due to the exposure to multiple risk factors, including poverty, malnutrition and unsafe home environments. CONCLUSIONS Continued support for the promotion of a protective environment that comprises effective parent-child interactions is key in minimizing the effects of neurodevelopmental disorders throughout the lifetime.
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Affiliation(s)
- Mônica Ayres de Araújo Scattolin
- Pontifícia Universidade Católica de São Paulo (PUC-SP), Faculdade de Ciências Médicas e da Saúde, Departamento de Reprodução Humana e Infância, São Paulo, SP, Brazil.
| | - Rosa Miranda Resegue
- Universidade Federal de São Paulo (UNIFESP), Disciplina de Pediatria Geral e Comunitária, São Paulo, SP, Brazil
| | - Maria Conceição do Rosário
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Psiquiatria, São Paulo, SP, Brazil
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14
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Group Triple P Intervention Effects on Children and Parents: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042113. [PMID: 35206299 PMCID: PMC8872306 DOI: 10.3390/ijerph19042113] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 11/23/2022]
Abstract
Supporting parents through the delivery of evidence-based parenting interventions (EBPI) is a way of promoting children’s rights, given the known benefits to child development and family wellbeing. Group Triple P (GTP) is an EBPI suitable for parents of children aged 2–12 years, who experience parenting difficulties, and/or child behavior problems. Even though GTP has been intensively studied, information lacks on the magnitude of its effects, considering the risk of bias within and across prior research. To address this, a systematic review and meta-analysis (PROSPERO registration CRD42019085360) to evaluate the effects of GTP on child and parent outcomes at short- and longer-term was performed. Through a systematic search of a set of databases, 737 research papers were identified, and 11 trials were selected. The risk of bias within and across studies was evaluated. Significant positive effects of GTP were found immediately after the intervention for child behavior problems, dysfunctional parenting practices, parenting sense of competence, psychological adjustment, parental stress levels, conflict, and relationship quality. Six months after the intervention, positive effects were found only for child behavior problems. Data suggest that GTP might be an effective EBPI leading to positive family outcomes. Substantial risk of bias was found, highlighting the importance of improving the quality of research.
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15
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Vacher C, Romo L, Dereure M, Soler M, Picot MC, Purper-Ouakil D. Efficacy of cognitive behavioral therapy on aggressive behavior in children with attention deficit hyperactivity disorder and emotion dysregulation: study protocol of a randomized controlled trial. Trials 2022; 23:124. [PMID: 35130934 PMCID: PMC8819925 DOI: 10.1186/s13063-022-05996-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is frequently associated with emotional dysregulation (ED). ED is characterized by excessive and inappropriate emotional reactions compared to social norms, uncontrolled and rapid shifts in emotion, and attention focused on emotional stimuli. Few studies have evaluated non-pharmacological interventions to improve ED in children with ADHD. The current randomized controlled trial assesses the efficacy of a cognitive behavioral therapy (CBT) intervention compared with a theater-based intervention (TBI) in children with ADHD and ED. METHODS Sixty-eight 7- to 13-year-old children with ADHD and ED will be recruited and randomly assigned to the CBT or TBI group. CBT aims to reduce ED by teaching anger management strategies. TBI seeks to reduce ED by improving emotion understanding and expression through mimics and movement. In both groups, children participate in 15 1-h sessions, and parents participate in 8 sessions of a parent management program. The primary outcome measure is the change in the "Aggression" sub-score of the Child Behavior Checklist (CBCL). Secondary outcome measures include overall impairment (Children's Global Assessment Scale, Strengths and Difficulties Questionnaire), personality profile (Hierarchical Personality Inventory for Children), executive function (Behavioral Rating Inventory of Executive Function), quality of life (Kidscreen-27), parental stress (Parenting Stress Index, 4th edition), parental depression (Beck Depression Inventory-II), and impact of child disorders on the quality of the family life (Parental Quality of Life and Developmental Disorder). DISCUSSION Children with ADHD and ED are at risk of functional impairment and poor outcomes and have specific therapeutic needs. This randomized controlled trial wants to assess non-pharmacological treatment options for this population. TRIAL REGISTRATION Clinicaltrials.gov. NCT03176108 . Registered on June 5, 2017.
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Affiliation(s)
- C Vacher
- Centre Hospitalo-Universitaire de Montpellier, Service Médecine Psychologique de l'Enfant et de l'Adolescent, Montpellier, Hérault, France. .,CLIPSYD EA-4430, UFR Sciences Psychologiques et Sciences de l'Education, Université de Nanterre, Nanterre, Hauts de Seine, France. .,INSERM U 1018, CESP, Psychiatrie du développement - Evaluer et traiter les troubles émotionnels et du neurodéveloppement (ETE-ND), Montpellier, France.
| | - L Romo
- CLIPSYD EA-4430, UFR Sciences Psychologiques et Sciences de l'Education, Université de Nanterre, Nanterre, Hauts de Seine, France.,Service de Pathologies professionnelles et de l'environnement, Assistance Publique des Hôpitaux de Paris, Hôpital Universitaire Raymond Poincaré, Garches, France
| | - M Dereure
- Unité de Recherche Clinique et Epidémiologie, Département de l'Information Médicale, Centre Hospitalo-Universitaire de Montpellier, Montpellier, Hérault, France
| | - M Soler
- Unité de Recherche Clinique et Epidémiologie, Département de l'Information Médicale, Centre Hospitalo-Universitaire de Montpellier, Montpellier, Hérault, France
| | - M C Picot
- Unité de Recherche Clinique et Epidémiologie, Département de l'Information Médicale, Centre Hospitalo-Universitaire de Montpellier, Montpellier, Hérault, France.,Centre d'Investigation Clinique, Hôpital Saint Eloi, Centre Hospitalo-Universitaire de Montpellier, Montpellier, Hérault, France
| | - D Purper-Ouakil
- Centre Hospitalo-Universitaire de Montpellier, Service Médecine Psychologique de l'Enfant et de l'Adolescent, Montpellier, Hérault, France.,INSERM U 1018, CESP, Psychiatrie du développement - Evaluer et traiter les troubles émotionnels et du neurodéveloppement (ETE-ND), Montpellier, France
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16
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Mindful Parent Training for Parents of Children Aged 3-12 Years with Behavioral Problems: a Scoping Review. Mindfulness (N Y) 2022; 13:801-820. [PMID: 35035596 PMCID: PMC8741537 DOI: 10.1007/s12671-021-01799-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 01/05/2023]
Abstract
Objectives While mindfulness-based parenting programs (MPPs) are increasingly popular for reducing child behavior problems, the evidence for the advantages of MPP over existing behavioral parent training is unclear. Existing systematic reviews have largely excluded the breadth of MPP protocols, including those that integrate behavioral skills components. Therefore, a scoping review was conducted to map the nature and extent of research on MPPs for parents of children aged 3 to 12 years with behavioral problems. Methods PRISMA-ScR guidelines were used to conduct an encompassing peer literature review of cross-disciplinary databases. Studies were included if they reported mindfulness interventions for parents of children aged between 3 and 12 years with externalizing behavior problems and had an outcome measure of child behavioral problems that could be represented as an effect size. Randomized controlled trials as well as quasi-experimental, pre-post studies and unpublished dissertations were included. Results Sixteen studies met the inclusion criteria (N = 1362). The majority of MPPs delivered mindfulness adapted to parenting based on the Bögels' protocol within clinical settings. There was a dearth of fully integrated mindfulness and behavioral programs. MPPs generally produced pre-to-post-intervention improvements with small effect sizes across child behavior and parent style, stress, and mindfulness measures. Examining longer follow-up periods compared to pre-intervention, effects reached a moderate size across most outcome measures. Conclusions MPPs continue to show promise in improving child behavior and parental mindfulness, well-being, and style. Further research is needed to determine how to best leverage the advantages of mindfulness in augmenting the well-established effectiveness of behavioral programs.
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17
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Forte A, Orri M, Turecki G, Galera C, Pompili M, Boivin M, Tremblay RE, Côté SM, Geoffroy MC. Identifying environmental pathways between irritability during childhood and suicidal ideation and attempt in adolescence: findings from a 20-year population-based study. J Child Psychol Psychiatry 2021; 62:1402-1411. [PMID: 33721915 DOI: 10.1111/jcpp.13411] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Irritable children are at increased risk of suicidal ideation and suicide attempt, but the underlying environmental mechanisms accounting for these associations are largely unknown. We aimed to investigate the mediating role of peer victimization and harsh parenting in the association between childhood irritability and adolescent suicidal ideation and attempt. METHOD N = 1,483 participants from the Québec Longitudinal Study of Child Development followed up from 5 months until 20 years of age (2018) with annual or biannual assessments. Irritability was operationalized using assessments of teacher-reported temper tantrums and reactive aggression. Suicidal ideation and suicide attempt at ages 13, 15, 17, and 20 years were self-reported. Peer victimization (self-reported at age 13) and harsh parenting (mothers reported at age 13) were considered as potential mediators. RESULTS We identified four trajectories of teacher-reported irritability symptoms from 6 to 12 years: low (74.8%), rising (12.9%), declining (7.3%), and persistent (4.9%). In adjusted models, children in the persistent and rising trajectories had, respectively, 2.81-fold (CI, 1.27-6.22) and 2.14-fold (CI, 1.20-3.81) increased odds of suicide attempt in adolescence, but not suicidal ideation. We found that a significant proportion of the association between irritability trajectories and suicide attempt was mediated by peer victimization (33% and 35% for rising and persistent, respectively), but there was no mediation via harsh parenting. CONCLUSIONS Our findings suggest that peer victimization may be a key mechanism explaining the increased suicide attempt risk of children presenting with persistently high or increasing irritability. Interventions to reduce peer victimization may be helpful to reduce suicide risk among irritable children.
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Affiliation(s)
- Alberto Forte
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy.,Department of Psychiatry and Substance Abuse, ASL Roma 5, Rome, Italy
| | - Massimiliano Orri
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.,Bordeaux Population Health Research Centre, Inserm U1219, Université de Bordeaux, Bordeaux, France
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Cedric Galera
- Bordeaux Population Health Research Centre, Inserm U1219, Université de Bordeaux, Bordeaux, France
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Michel Boivin
- School of Psychology, Laval University, Quebec, QC, Canada
| | - Richard E Tremblay
- Departments of Pediatrics and Psychology, University of Montreal, Montreal, QC, Canada.,School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Sylvana M Côté
- Bordeaux Population Health Research Centre, Inserm U1219, Université de Bordeaux, Bordeaux, France.,Department of Social and Preventive Medicine, University of Montreal, Montreal, QC, Canada
| | - Marie-Claude Geoffroy
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.,Department of Education and Counselling Psychology, McGill University, Montreal, QC, Canada
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18
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Schilling S, Mebane A, Perreira KM. Cultural Adaptation of Group Parenting Programs: Review of the Literature and Recommendations for Best Practices. FAMILY PROCESS 2021; 60:1134-1151. [PMID: 33908027 PMCID: PMC8551301 DOI: 10.1111/famp.12658] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Group parenting programs based on cognitive-behavioral and social learning principles are effective in improving child behavior problems and positive parenting. However, most programs target non-Hispanic, White, English-speaking families and are largely inaccessible to a growing Hispanic and non-White population in the United States. We sought to examine the extent to which researchers have culturally adapted group parenting programs by conducting a systematic review of the literature. We identified 41 articles on 23 distinct culturally adapted programs. Most cultural adaptations focused on language translation and staffing, with less focus on modification of concepts and methods, and on optimizing the fit between the target cultural group and the program goals. Only one of the adapted programs engaged a framework to systematically record and publish the adaptation process. Fewer than half of the culturally adapted programs were rigorously evaluated. Additional investment in cultural adaptation and subsequent evaluation of parenting programs is critical to meet the needs of all US families.
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Affiliation(s)
- Samantha Schilling
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC; USA
| | - Alexander Mebane
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC; USA
| | - Krista M. Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC; USA
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19
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Highlander A, Zachary C, Jenkins K, Loiselle R, McCall M, Youngstrom J, McKee LG, Forehand R, Jones DJ. Clinical Presentation and Treatment of Early-Onset Behavior Disorders: The Role of Parent Emotion Regulation, Emotion Socialization, and Family Income. Behav Modif 2021; 46:1047-1074. [PMID: 34378434 PMCID: PMC9364231 DOI: 10.1177/01454455211036001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Parent emotion regulation and socialization have been linked to various aspects
of child functioning. In the case of early-onset behavior disorders in
particular, parent emotion regulation may be an important correlate of the
coercive cycle implicated in early-onset behavior disorders thus, symptom
presentation at baseline. Further, emotion socialization may be complicated by a
pattern of parent-child interactions in which both supportive or unsupportive
parenting behaviors in response to behavioral dysregulation may increase
vulnerability for problem behavior in the future. Some work suggests standard
Behavioral Parent Training may impact parent emotion regulation and
socialization. Still little is known, however, about how such processes may vary
by family income, which is critical given the overrepresentation of low-income
children in statistics on early-onset behavior disorders. This study explored
parent emotion regulation, socialization, and family income in a sample of
socioeconomically diverse treatment-seeking families of young (3–8 years old)
children. Findings suggest relations between parental emotion regulation,
socialization, and child behavior although the pattern of associations differed
at baseline and post-treatment and varied by family income. Clinical
implications and future directions are discussed.
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Affiliation(s)
- April Highlander
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Kaeley Jenkins
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Raelyn Loiselle
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Madison McCall
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | | | - Deborah J Jones
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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20
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McCoy A, Lachman JM, Ward CL, Tapanya S, Poomchaichote T, Kelly J, Mukaka M, Cheah PY, Gardner F. Feasibility pilot of an adapted parenting program embedded within the Thai public health system. BMC Public Health 2021; 21:1009. [PMID: 34051772 PMCID: PMC8164235 DOI: 10.1186/s12889-021-11081-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/17/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND This feasibility pilot of the Parenting for Lifelong Health for Young Children program in Thailand aimed to: 1) explore the feasibility of study evaluation approaches; 2) assess the feasibility of delivering an adapted program; 3) report indicative effects on child maltreatment and related outcomes; and 4) examine intervention content associated with key mechanisms of change perceived by caregivers and facilitators. METHOD Sixty primary caregivers of children aged 2-9 years were recruited for an 8-week parenting program embedded within the local health system. Mixed-methods approaches included quantitative caregiver-report and observational data from standardized instruments, and qualitative data from individual and group interviews with caregivers and program facilitators. Analyses involved Wilcoxon signed-rank tests, paired t-tests, Friedman's ANOVA, and thematic analysis. RESULTS Participants reported that most (65%) were grandparents or great-grandparents. Study retention and response rates were high, and enrolled caregivers attended an average of 93% of sessions. Primary outcomes showed caregiver-reported pre-post reductions in overall child maltreatment (d = - 0.58, p < 0.001), as well as reductions in physical (d = - 0.58, p < 0.001) and emotional abuse (d = - 0.40, p < 0.001). Combined caregiver report and observational assessments using the HOME Inventory showed reductions in abusive and harsh parenting (d = - 0.52, p < 0.001). Secondary outcomes demonstrated decreases in child neglect; dysfunctional parenting; poor child monitoring and supervision; parental sense of inefficacy; child behavior problems; daily report on child problem behavior; parent overall depression, anxiety, and stress; and attitudes supporting physical punishment and harsh discipline. There were increases in overall positive parenting, daily positive parenting behavior, as well as HOME Inventory assessments on parent-child relationships. Thematic analyses from interviews and focus group data identified six key program themes associated with strengthened parent-child relationships, reduced child behavior problems, improved attitudes and strategies toward discipline, and improved management of parental stress. CONCLUSIONS This study represents one of few evaluations to test the feasibility of an evidence-based parenting program embedded within routine public health service delivery in a low- or middle-income country. Findings show preliminary effectiveness in reducing child maltreatment, improvements on 22 of 24 secondary outcomes, and perceived mechanisms of change that support quantitative findings. Prospects are promising for program scalability, pending randomized controlled trial results. TRIAL REGISTRATION 11/01/2019, ClinicalTrials.gov, ID# NCT03539341 .
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Affiliation(s)
- Amalee McCoy
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK.
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Jamie M Lachman
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Sombat Tapanya
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Tassawan Poomchaichote
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Jane Kelly
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Mavuto Mukaka
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Phaik Yeong Cheah
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK
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Fareleira F, Xavier MR, Velte J, Teixeira A, Martins C. Parenting, child development and primary care-'Crescer em Grande!' intervention (CeG!) based on the Touchpoints approach: a cluster-randomised controlled trial protocol. BMJ Open 2021; 11:e042043. [PMID: 33980514 PMCID: PMC8117987 DOI: 10.1136/bmjopen-2020-042043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Despite support for parenting being already recognised as a priority, there remains a paucity of evidence on how to facilitate its adoption in regular visits of maternal and child health primary care (PC). We describe the protocol for a study to assess the effect of an innovative universal Touchpoints-based intervention-'Crescer em Grande!' (CeG!) - when supporting the process of transition to parenthood and early infancy, at multiple PC units. METHODS AND ANALYSIS A cluster-randomised trial will be conducted in 12 PC units (clusters) from the Lisbon metropolitan area, Portugal. Participants will be a minimum of three family physicians and one nurse/unit, as well as 216 expecting parents and future babies until 18 months who are using the PC services. Sites will be randomised to either the CeG! or usual care. The CeG! will consist of: (1) the integration of the Touchpoints approach in PC maternal and well-child visits, with the support of 28 leaflets for parents to file in a folder; plus (2) training for PC providers on how to perform the CeG! into existing practice. Parents will be required to fill in questionnaires at point throughout their child's 18-month, mostly online. The primary outcome will be the self-perception of parental competence (Parenting Sense of Competence Scale). Other outcomes include: family functioning, couple dynamics, mental health, well-being/quality of life, psychological experience of pregnancy, attachment, child development. Acceptability, satisfaction and feasibility of CeG! will also be obtained from providers' and parents' perspectives. Costs associated with delivering the CeG! will be calculated. Study analyses will be under the principle of intention-to-treat. ETHICS AND DISSEMINATION Approval was obtained from the Ethics Committee of the Regional Health Administration. The results will be shared with participants and disseminated via peer-reviewed published papers, presentations at scientific and professional conferences. TRIAL REGISTRATION NUMBER ISRCTN90692907.
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Affiliation(s)
- Filipa Fareleira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Maria Raul Xavier
- Universidade Católica Portuguesa, Faculty of Education and Psychology, Research Centre for Human Development, Porto, Portugal
| | - Julia Velte
- Unidade de Saúde Familiar AlphaMouro, Sintra, Portugal
| | - Andreia Teixeira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal
- Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
| | - Carlos Martins
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal
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22
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Mental Health and Health Behaviour Changes for Mothers of Children with a Disability: Effectiveness of a Health and Wellbeing Workshop. J Autism Dev Disord 2021; 52:508-521. [PMID: 33728495 PMCID: PMC7962925 DOI: 10.1007/s10803-021-04956-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2021] [Indexed: 01/16/2023]
Abstract
Healthy Mothers Healthy Families (HMHF) is a program that educates and empowers mothers of children with disabilities to improve health behaviours. Outcomes were investigated in this study. A pre, post-test design was implemented using online questionnaires including the Health promoting activities scale (HPAS) and the Depressional anxiety stress scales (DASS). Mothers (N = 71) experienced improvements in HPAS scores, p < .001. Mental health symptomatology reduced: depressive symptoms (p = .005), Anxiety symptoms (p = .005) and stress (p = .002). Wellbeing improved (p < .001). Mothers also reported that their child with a disability experienced an increase in quality of life (p = .042). Mothers’ lifestyles goals improved: managing stress; dietary changes; leisure; self-perception and others. HMHF is an effective intervention with improved health status and outcomes for mothers.
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23
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Economic Return on Investment of Parent Training Programmes for the Prevention of Child Externalising Behaviour Problems. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 47:300-315. [PMID: 31630323 DOI: 10.1007/s10488-019-00984-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Economic models to inform decision-making are gaining popularity, especially for preventive interventions. However, there are few estimates of the long-term returns to parenting interventions used to prevent mental health problems in children. Using data from a randomised controlled trial evaluating five indicated parenting interventions for parents of children aged 5-12, we modeled the economic returns resulting from reduced costs in the health care and education sector, and increased long-term productivity in a Swedish setting. Analyses done on the original trial population, and on various sized local community populations indicated positive benefit-cost ratios. Even smaller local authorities would financially break-even, thus interventions were of good value-for-money. Benefit-cost analyses of such interventions may improve the basis for resource allocation within local decision-making.
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Adding the Coping Power Programme to parent management training: the cost-effectiveness of stacking interventions for children with disruptive behaviour disorders. Eur Child Adolesc Psychiatry 2021; 30:1603-1614. [PMID: 32924086 PMCID: PMC8505382 DOI: 10.1007/s00787-020-01638-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 09/01/2020] [Indexed: 02/07/2023]
Abstract
Parent management training (PMT) programmes and child cognitive behavioural therapy are recommended approaches for treatment of oppositional defiant disorder in children, and combining these may be effective. However, little is known regarding the economic efficiency of this additive effect. A within-trial cost-effectiveness analysis was carried out in Sweden including 120 children aged 8-12 who screened positive for disruptive behaviour disorders, within a psychiatric care setting, and their parents. They were randomly assigned to either the Swedish group-based PMT Comet, or to an enhanced version, where an additional child component was provided, the Coping Power Programme (CPP). Child behaviour problems as well as healthcare and educational resource use were measured at baseline, post-test and at two-year follow-up. A net benefit regression framework was used to estimate differences in costs and health outcomes between the two intervention arms during the two-year period. Comet with CPP cost on average 820 EURO more per family than Comet only. At the 2-year follow-up, there were 37% recovered cases of ODD in Comet with CPP, in comparison to 26% in the Comet only arm. At a willingness-to-pay of approximately 62,300 EURO per recovered case of ODD, Comet with CPP yielded positive net benefits, in comparison to Comet only. Offering children the CPP simultaneously as their parents receive PMT, in comparison to only providing PMT, yields clinically relevant gains. Despite the relatively small cost for CPP, investment in combining PMT and CPP should be guided by resource prioritisation. Trial registration number: ISRCTN10834473, date of registration: 23/12/2015.
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25
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Martin M, Steele B, Lachman JM, Gardner F. Measures of Facilitator Competent Adherence Used in Parenting Programs and Their Psychometric Properties: A Systematic Review. Clin Child Fam Psychol Rev 2021; 24:834-853. [PMID: 34021442 PMCID: PMC8541983 DOI: 10.1007/s10567-021-00350-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 01/15/2023]
Abstract
Implementation fidelity is a critical component of intervention science, which aims to understand how interventions unfold in practice to improve outcomes. A key element of fidelity is facilitator competent adherence-the extent to which a program is delivered as prescribed with the specified level of quality. We conducted a two-part systematic review examining these aspects in parenting programs aiming to reduce child behavior problems and maltreatment. Part One reviews measures of facilitator competent adherence and Part Two examines the psychometric properties of the observational measures found. Searches identified 9153 articles from electronic databases, citation tracking, and expert input. After screening using pre-specified criteria, 156 (Part One) and 41 (Part Two) articles remained. In Part One, measure, facilitator, and intervention characteristics were extracted and synthesized from 65 measures. Most measures were observational, used by facilitators and researchers, and employed Likert-scale ratings. In Part Two, evidence on the reliability (internal consistency, inter-rater, intra-rater, test-retest) and validity (content, construct, convergent/divergent, criterion) of 30 observational measures identified from Part One was synthesized and evaluated. An adapted COSMIN checklist was used to assess study and measure quality. We found most studies to be of reasonably high quality. This is the first review to summarize and critically appraise measures of facilitator competent adherence used in the parenting program literature and establish their psychometric properties. The findings underscore the need to advance research on measures of facilitator competent adherence; reliable, valid, and high-quality implementation measures allow for evidence-based decisions regarding the delivery and scale-up of parenting programs. PROSPERO Registration Number: CRD42020167872.
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Affiliation(s)
- Mackenzie Martin
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
| | - Bridget Steele
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Jamie M. Lachman
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
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26
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Longitudinal Predictors of Self-Regulation at School Entry: Findings from the All Our Families Cohort. CHILDREN-BASEL 2020; 7:children7100186. [PMID: 33081229 PMCID: PMC7602711 DOI: 10.3390/children7100186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/02/2020] [Accepted: 10/14/2020] [Indexed: 01/30/2023]
Abstract
Self-regulation is the ability to manage emotions, modulate behaviors, and focus attention. This critical skill begins to develop in infancy, improves substantially in early childhood and continues through adolescence, and has been linked to long-term health and well-being. The objectives of this study were to determine risk factors and moderators associated with the three elements of self-regulation (i.e., inattention, emotional control, or behavioral control) as well as overall self-regulation, among children at age 5. Participants were mother–child dyads from the All Our Families study (n = 1644). Self-regulation was assessed at age 5. Risk factors included income, maternal mental health, child sex, and screen time, and potential moderation by parenting and childcare. Adjusted odds ratios of children being at risk for poor self were estimated using multivariable logistic regression. Twenty-one percent of children had poor self-regulation skills. Risk factors for poor self-regulation included lower income, maternal mental health difficulties, and male sex. Childcare and poor parenting did not moderate these associations and hostile and ineffective parenting was independently associated with poor self-regulation. Excess screen time (>1 h per day) was associated with poor self-regulation. Self-regulation involves a complex and overlapping set of skills and risk factors that operate differently on different elements. Parenting and participation in childcare do not appear to moderate the associations between lower income, maternal mental health, male sex, and screen time with child self-regulation.
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Byrne G, Murphy S, Connon G. Mentalization-based treatments with children and families: A systematic review of the literature. Clin Child Psychol Psychiatry 2020; 25:1022-1048. [PMID: 32493055 DOI: 10.1177/1359104520920689] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Over the past decade, mentalization-based treatment (MBT) approaches have been developed specifically for children, adolescents and families. This study provides a systematic review of MBT applicable to both children and families. METHOD Five databases were searched to identify reports of MBT studies published up to February 2020. Studies were screened and reported according to PRISMA guidelines. RESULTS A total of 34 studies were included in this review. Of these, 14 focused on parent-child dyads, two on child therapy, seven applied the approach to parenting, four evaluated the application of MBT to the school environment and seven focused on adolescent populations. CONCLUSION Despite methodological shortcomings and heterogeneity in design, the existing literature does provide tentative support for the use of MBT approaches for these populations, specifically in increasing mentalizing/reflective functioning. Further controlled and methodologically rigorous studies are required.
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Affiliation(s)
- Gary Byrne
- Primary Care Psychology, Health Service Executive, Ireland
| | - Síle Murphy
- Primary Care Psychology, Health Service Executive, Ireland
| | - Graham Connon
- Primary Care Psychology, Health Service Executive, Ireland
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Masiran R, Ibrahim N, Awang H, Lim PY. Improving multicultural parenting program for children with emotional and behavioral problems: An integrated review. Asian J Psychiatr 2020; 51:101851. [PMID: 31711780 DOI: 10.1016/j.ajp.2019.101851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/16/2019] [Accepted: 10/16/2019] [Indexed: 01/13/2023]
Abstract
Children with emotional and behavioral problems are often managed using medications or behavioral therapy, but in some countries, there is no structured parenting intervention to equip parents from different cultural backgrounds with adequate parenting skills to help these children. This paper aims to synthesize key findings from previous research on multicultural parenting programs and produce a comprehensive integrated view by looking into three separate themes: effective multicultural parenting programs, ethnocultural groups and cultural adaptation process. Literature search through Scopus and Google Scholar from 1999 to 2019 was conducted using the terms "effective parenting program", "effective parenting intervention", "effective multicultural parenting program", "effective multicultural parenting intervention", "multicultural parenting program", "multicultural parenting intervention", "parenting program and ethnic groups", "parenting intervention and ethnic groups", "adapted parenting program", "adapted parenting intervention", "cultural adaptation of parenting program'' and "cultural adaptation of parenting intervention". By applying the "Literature Review Synthesis Process", authors conducted cross-analysis, integrated possibilities, and prioritized the synthesized information gearing towards highly probable solutions for improving multicultural parenting programs to manage emotional and behavioral problems in children better. Development of a culturally fit parenting intervention and its implications on existing parenting programs are also discussed. The findings highlight the need 1) to engage with ethnocultural groups of parents during development of a new multicultural parenting program, and 2) to incorporate specific measures for engaging with parents during multicultural parenting program implementation. This paper contributes in acknowledging cultural components in future parenting intervention programs. Finally, recommendations are made for future directions of research.
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Affiliation(s)
- Ruziana Masiran
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - Normala Ibrahim
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - Hamidin Awang
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
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McCoy A, Melendez-Torres GJ, Gardner F. Parenting interventions to prevent violence against children in low- and middle-income countries in East and Southeast Asia: A systematic review and multi-level meta-analysis. CHILD ABUSE & NEGLECT 2020; 103:104444. [PMID: 32171126 DOI: 10.1016/j.chiabu.2020.104444] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/23/2020] [Accepted: 03/01/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Currently, the strongest evidence for preventing violence against children lies with social learning theory-based parenting interventions. An increasing number of experimental studies on such interventions have been conducted in low- and middle-income countries (LMICs) in East and Southeast Asia. OBJECTIVE To conduct a systematic review and meta-analysis on the effectiveness of parenting interventions in preventing violence against children. PARTICIPANTS AND SETTING Parents and primary caregivers living in LMICs in East and Southeast Asia. METHODS Eleven studies were retrieved through electronic databases, expert contacts, and the reference sections of previous reviews. Studies were appraised for risk of bias and effect estimates pooled using random effects multilevel meta-analysis. RESULTS Forty-four effect estimates were meta-analyzed based on five outcome category models, finding a small effect on abusive, harsh, or negative parenting (n = 3, d = -0.42, 95 % CI [- 0.81, -0.02], p < .01, I2 = 72 %); a large, non-significant effect on parental knowledge or attitudes (n = 5, d = 1.40, 95 % CI [-0.30, 3.10], I2 = 95 %); a small effect on positive parent-child interactions (n = 5, d = 0.25, 95 % CI [0.19, 0.32], p < .001, I2 = 0); a small, non-significant effect on parental stress (n = 2, d = -0.13, 95 % CI [-0.38, 0.11], I2 = 0); and a small, non-significant effect on family environment (n = 3, d = 0.21, 95 % CI [-0.12, 0.53], I2 = 85 %). CONCLUSIONS The results suggest that parenting interventions can reduce rates of particular forms of violence against children, as well as promote positive parent-child interactions.
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Affiliation(s)
- Amalee McCoy
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, Barnett House, 32 Wellington Square, University of Oxford, Oxford, OX1 2ER, United Kingdom; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand.
| | - G J Melendez-Torres
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, 1-3 Museum Place, Cardiff University, Cardiff, CF10 3BD, United Kingdom
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, Barnett House, 32 Wellington Square, University of Oxford, Oxford, OX1 2ER, United Kingdom
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30
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Ward CL, Wessels IM, Lachman JM, Hutchings J, Cluver LD, Kassanjee R, Nhapi R, Little F, Gardner F. Parenting for Lifelong Health for Young Children: a randomized controlled trial of a parenting program in South Africa to prevent harsh parenting and child conduct problems. J Child Psychol Psychiatry 2020; 61:503-512. [PMID: 31535371 PMCID: PMC7155004 DOI: 10.1111/jcpp.13129] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Parenting programs suitable for delivery at scale in low-resource contexts are urgently needed. We conducted a randomized trial of Parenting for Lifelong Health (PLH) for Young Children, a low-cost 12-session program designed to increase positive parenting and reduce harsh parenting and conduct problems in children aged 2-9. METHODS Two hundred and ninety-six caregivers, whose children showed clinical levels of conduct problems (Eyberg Child Behavior Inventory Problem Score, >15), were randomly assigned using a 1:1 ratio to intervention or control groups. At t0 , and at 4-5 months (t1 ) and 17 months (t2 ) after randomization, research assistants blind to group assignment assessed (through caregiver self-report and structured observation) 11 primary outcomes: positive parenting, harsh parenting, and child behavior; four secondary outcomes: parenting stress, caregiver depression, poor monitoring/supervision, and social support. TRIAL REGISTRATION ClinicalTrials.gov (NCT02165371); Pan African Clinical Trial Registry (PACTR201402000755243); Violence Prevention Trials Register (http://www.preventviolence.info/Trials?ID=24). RESULTS Caregivers attended on average 8.4 sessions. After adjustment for 30 comparisons, strongest results were as follows: at t1 , frequency of self-reported positive parenting strategies (10% higher in the intervention group, p = .003), observed positive parenting (39% higher in the intervention group, p = .003), and observed positive child behavior (11% higher in the intervention group, p = .003); at t2, both observed positive parenting and observed positive child behavior were higher in the intervention group (24%, p = .003; and 17%, p = .003, respectively). Results with p-values < .05 prior to adjustment were as follows: At t1 , the intervention group self-reported 11% fewer child problem behaviors, 20% fewer problems with implementing positive parenting strategies, and less physical and psychological discipline (28% and 14% less, respectively). There were indications that caregivers reported 20% less depression but 7% more parenting stress at t1 . Group differences were nonsignificant for observed negative child behavior, and caregiver-reported child behavior, poor monitoring or supervision, and caregiver social support. CONCLUSIONS PLH for Young Children shows promise for increasing positive parenting and reducing harsh parenting.
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Affiliation(s)
- Catherine L. Ward
- Department of Psychology and Safety and Violence InitiativeUniversity of Cape TownCape TownSouth Africa
| | - Inge M. Wessels
- Department of Psychology and Safety and Violence InitiativeUniversity of Cape TownCape TownSouth Africa,Department of Social Policy and InterventionUniversity of OxfordOxfordUK
| | - Jamie M. Lachman
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK,MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Judy Hutchings
- Centre for Evidence‐Based Early InterventionBangor UniversityBangorUK
| | - Lucie D. Cluver
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK,Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
| | - Reshma Kassanjee
- Department of Statistical SciencesUniversity of Cape TownCape TownSouth Africa,Centre for Infectious Disease Epidemiology and Research (CIDER)School of Public Health and Family MedicineUniversity of Cape TownCape TownSouth Africa
| | - Raymond Nhapi
- Department of Statistical SciencesUniversity of Cape TownCape TownSouth Africa
| | - Francesca Little
- Department of Statistical SciencesUniversity of Cape TownCape TownSouth Africa
| | - Frances Gardner
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK
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Nystrand C, Feldman I, Enebrink P, Sampaio F. Cost-effectiveness analysis of parenting interventions for the prevention of behaviour problems in children. PLoS One 2019; 14:e0225503. [PMID: 31790442 PMCID: PMC6886776 DOI: 10.1371/journal.pone.0225503] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 11/05/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Behavior problems are common among children and place a high disease and financial burden on individuals and society. Parenting interventions are commonly used to prevent such problems, but little is known about their possible longer-term economic benefits. This study modelled the longer-term cost-effectiveness of five parenting interventions delivered in a Swedish context: Comet, Connect, the Incredible Years (IY), COPE, bibliotherapy, and a waitlist control, for the prevention of persistent behavior problems. METHODS A decision analytic model was developed and used to forecast the cost per averted disability-adjusted life-year (DALY) by each parenting intervention and the waitlist control, for children aged 5-12 years. Age-specific cohorts were modelled until the age of 18. Educational and health care sector costs related to behavior problems were included. Active interventions were compared to the waitlist control as well as to each other. RESULTS Intervention costs ranged between US$ 14 (bibliotherapy) to US$ 1,300 (IY) per child, with effects of up to 0.23 averted DALYs per child (IY). All parenting interventions were cost-effective at a threshold of US$ 15,000 per DALY in relation to the waitlist control. COPE and bibliotherapy strongly dominated the other options, and an additional US$ 2,629 would have to be invested in COPE to avert one extra DALY, in comparison to bibliotherapy. CONCLUSIONS Parenting interventions are cost-effective in the longer run in comparison to a waitlist control. Bibliotherapy or COPE are the most efficient options when comparing interventions to one another. Optimal decision for investment should to be based on budget considerations and priority settings.
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Affiliation(s)
- Camilla Nystrand
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- * E-mail:
| | - Inna Feldman
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Pia Enebrink
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Filipa Sampaio
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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32
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Lachman JM, Heinrichs N, Jansen E, Brühl A, Taut D, Fang X, Gardner F, Hutchings J, Ward CL, Williams ME, Raleva M, Båban A, Lesco G, Foran HM. Preventing child mental health problems through parenting interventions in Southeastern Europe (RISE): Protocol for a multi-country cluster randomized factorial study. Contemp Clin Trials 2019; 86:105855. [PMID: 31669446 DOI: 10.1016/j.cct.2019.105855] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/12/2019] [Accepted: 10/12/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Child mental health problems continue to be a major global concern, especially in low- and middle-income countries (LMICs). Parenting interventions have been shown to be effective for reducing child behavior problems in high-income countries, with emerging evidence supporting similar effects in LMICs. However, there remain substantial barriers to scaling up evidence-based interventions due to limited human and financial resources in such countries. METHODS This protocol is for a multi-center cluster randomized factorial trial of an evidence-based parenting intervention, Parenting for Lifelong Health for Young Children, for families with children ages 2-9 years with subclinical levels of behavior problems in three Southeastern European countries, Republic of Moldova, North Macedonia, and Romania (8 conditions, 48 clusters, 864 families, 108 per condition). The trial will test three intervention components: length (5 vs. 10 sessions), engagement (basic vs. enhanced package), and fidelity (on-demand vs. structured supervision). Primary outcomes are child aggressive behavior, dysfunctional parenting, and positive parenting. Analyses will examine the main effect and cost-effectiveness of each component, as well as potential interaction effects between components, in order to identify the most optimal combination of program components. DISCUSSION This study is the first factorial experiment of a parenting program in LMICs. Findings will inform the subsequent testing of the optimized program in a multisite randomized controlled trial in 2021. TRIAL REGISTRATION NCT03865485 registered in ClinicalTrials.gov on March 5, 2019.
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Affiliation(s)
- Jamie M Lachman
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
| | - Nina Heinrichs
- Department of Psychology, Clinical Psychology, and Psychotherapy, University of Bremen, Bremen, Germany
| | - Elena Jansen
- Institute for Psychology, Alpen-Adria-University Klagenfurt, Klagenfurt, Austria
| | - Antonia Brühl
- Department of Psychology, Clinical Psychology, and Psychotherapy, University of Bremen, Bremen, Germany
| | - Diana Taut
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Xiangming Fang
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Judy Hutchings
- Centre for Evidence Based Early Intervention, School of Psychology, Bangor University, Bangor, UK
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Margiad Elen Williams
- Centre for Evidence Based Early Intervention, School of Psychology, Bangor University, Bangor, UK
| | - Marija Raleva
- Institute for Marriage, Family and Systemic Practice - ALTERNATIVA, Skopje, North Macedonia
| | - Adriana Båban
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Galina Lesco
- Health for Youth Association, Chișinău, Republic of Moldova
| | - Heather M Foran
- Institute for Psychology, Alpen-Adria-University Klagenfurt, Klagenfurt, Austria
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Treatment of child externalizing behavior problems: a comprehensive review and meta-meta-analysis on effects of parent-based interventions on parental characteristics. Eur Child Adolesc Psychiatry 2019; 28:1025-1036. [PMID: 29948228 DOI: 10.1007/s00787-018-1175-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 05/23/2018] [Indexed: 11/25/2022]
Abstract
This is the first meta-meta-analysis examining the effects of parent-based interventions for children with externalizing behavior problems on parental characteristics (parenting, parental perceptions, parental mental health, parental relationship quality). Parent training interventions are recognized as evidence-based interventions for the treatment of externalizing behavior problems, although meta-analytic effects are heterogeneous. The objective of the present study was to comprehensively combine meta-analytic results on parent training interventions to arrive at valid effect predictions. Electronic databases were searched (PsycINFO, Medline, PubMed). In total, 11 meta-analyses were included that mainly comprised parents of children under the age of 13 years. Analyses were based on random effects models. Effect estimates were transformed to standardized mean differences (SMD) and corrected for primary study overlap. Results revealed a significant moderate overall effect for parenting (SMD 0.53) as well as for parents' report of parenting (SMD 0.60) and parental perceptions (SMD 0.52). Effects remained stable to follow-up. Results for observational data, parental mental health and parental relationship quality were small and only partially significant. Considerable heterogeneity within results was revealed. Overall, parent training interventions proved to be effective in improving parental characteristics for parents of children with externalizing behavior problems. Effectiveness was stronger regarding characteristics explicitly targeted by interventions. The findings should encourage health-care providers to apply evidence-based parent training interventions.
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Garcia D, Hungerford GM, Hill RM, Barroso NE, Bagner DM. Infant Language Production and Parenting Skills: A Randomized Controlled Trial. Behav Ther 2019; 50:544-557. [PMID: 31030872 PMCID: PMC6708603 DOI: 10.1016/j.beth.2018.09.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 09/06/2018] [Accepted: 09/08/2018] [Indexed: 01/03/2023]
Abstract
The current study examined the indirect effect of the use of behavioral parenting skills following the Infant Behavior Program, a brief, home-based adaptation of the child-directed interaction phase of parent-child interaction therapy, on infant language production. Participants were 60 infants (55% male, mean age 13.47 ± 1.31 months) and their caregivers, who were recruited at a large urban pediatric primary care clinic and were included if their scores exceeded the 75th percentile on a brief screener of early behavior problems. Families were randomly assigned to receive the infant behavior program or standard pediatric primary care. Results demonstrated a significant indirect effect of caregivers' use of positive parenting skills (i.e., praise, reflections, and behavior descriptions) on the relation between group and infant total utterances at the 6-month follow-up, such that infants whose caregivers increased their use of positive parenting skills following the intervention showed greater increases in language production. These findings extend previous research examining parenting skills as a mechanism of change in infant language production, and highlight the potential for an early parenting intervention to target behavior and language simultaneously during a critical period in language development.
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Affiliation(s)
| | | | - Ryan M. Hill
- Florida International University, 11200 SW 8th St., Miami, FL 33199
| | | | - Daniel M. Bagner
- Florida International University, 11200 SW 8th St., Miami, FL 33199
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Reedtz C, Klest SK, Aalo NM, Rasmussen ID, Vitterso J. Results From an RCT on Brief Parent Training: Long Term Effects on Parental Quality of Life. Front Psychol 2019; 10:260. [PMID: 30833915 PMCID: PMC6387926 DOI: 10.3389/fpsyg.2019.00260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 01/28/2019] [Indexed: 11/26/2022] Open
Abstract
Background: Previous research has shown that quality of life for adults decreases when they become parents, remains at a lower level than of non-parents and declines further with each child they have. Consistent with this, parents report that having children leads to more daily struggles and concerns than their work outside the home. In this study, we have investigated how participating in a brief parent training intervention influences parents’ quality of life. The aim of the study was to evaluate whether a brief, six-session version of an evidence-based parent training program (The Incredible Years), delivered in a non-clinical community sample, changed parent quality of life up to four years after the initial intervention. Methods: Data were collected from mothers and fathers in a randomized controlled community trial (N = 117). Children’s mean age was 3.95 years at baseline, and 7.5 years at 4-year follow-up. Results: There were no significant differences in the trajectory of change over the four time points between the intervention and control groups for mothers or fathers. However, results from analysing the linear change from pre to each of the other measurement points, revealed statistically significantly different change on life satisfaction after completing the intervention compared to the control group; immediately following the intervention, t(357) = 2.76, p = 0.006; and the difference between the groups was maintained three years after the intervention, t(360) = 3.14, p = 0.002. Conclusion: The results of this study suggest that offering a parenting program focused on building a positive parent-child relation, has the potential to improve mothers’ quality of life. Implications of this are discussed. Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT02850510. Retrospectively registered 29 July 2016.
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Affiliation(s)
- Charlotte Reedtz
- Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sihu K Klest
- Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Nora Mortensen Aalo
- Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Joar Vitterso
- Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Lees D, Frampton CM, Merry SN. Efficacy of a Home Visiting Enhancement for High-Risk Families Attending Parent Management Programs: A Randomized Superiority Clinical Trial. JAMA Psychiatry 2019; 76:241-248. [PMID: 30673062 PMCID: PMC6439828 DOI: 10.1001/jamapsychiatry.2018.4183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
IMPORTANCE Antisocial behavior and adult criminality often have origins in childhood and are best addressed early in the child's life using evidence-based parenting programs. However, families with additional risk factors do not always make sufficient changes while attending such programs; these families may benefit from additional support. OBJECTIVE To evaluate the efficacy of adding a 10-session, structured home parent support (HPS) intervention to enhance outcomes for high-risk families attending the Incredible Years Parent (IYP) program. DESIGN, SETTING, AND PARTICIPANTS A randomized clinical superiority trial of 126 parents of children aged 3 to 7 years with conduct problems compared the IYP program plus HPS with treatment as usual of the IYP program alone. Child behavior measures were collected before and after treatment and at the 6-month follow-up. Recruitment from 19 IYP groups began February 13, 2013, and follow-up data collection was completed June 4, 2015. All data were analyzed using an intention-to-treat design with last observation carried forward. Statistical analysis took place from May 20, 2015, to March 31, 2016. INTERVENTION Parents were randomly assigned to receive IYP program plus HPS or IYP alone. MAIN OUTCOMES AND MEASURES The primary outcome measure was the posttreatment change in Eyberg Child Behavior Inventory Total Problem Scale (ECBI-P) score. Secondary outcomes included maintenance of change on the ECBI-P score, ECBI Intensity Scale score, and Social Competence Scale score at the 6-month follow-up; percentage of child behavior scores in the clinical range after treatment; retention; and attendance. RESULTS A total of 126 parents (112 women and 14 men; mean [SD] age, 34.7 [8.4] years) were included; 63 parents were randomly assigned to each intervention group. Analysis of variance using intention to treat showed no significant difference between groups after treatment (P = .62). At follow-up, there was a medium effect (d = 0.63) showing a significant benefit from IYP plus HPS of 3.6 (95% CI, 0.8-6.5) on the ECBI-P score (F1,124 = 6.3; P = .01). Families receiving the IYP plus HPS intervention had significantly fewer children with child behavior scores in the clinical range after treatment (9 of 51 [17.6%]) compared with families receiving the IYP program alone (18 of 45 [40.0%]), and this status was maintained at follow-up. The HPS intervention had better retention than the IYP program (dropout, 7 [5.6%] vs 16 [12.7%]) as well as better attendance. CONCLUSIONS AND RELEVANCE In this trial, the IYP plus HPS intervention significantly improved outcomes for the most vulnerable families at 6 months. This study demonstrated that the HPS intervention is an effective addition to the IYP program to improve engagement and implementation of IYP program strategies and enhance child behavior outcomes for the most vulnerable families. TRIAL REGISTRATION http://anzctr.org.au Identifier: ACTRN12612000878875.
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Affiliation(s)
- Dianne Lees
- Child Mental Health Service, Tauranga Hospital Bay of Plenty District Health Board, Tauranga, New Zealand
| | - Christopher M. Frampton
- Department of Psychological Medicine, Otago University, Christchurch, Christchurch, New Zealand
| | - Sally N. Merry
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
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Abstract
Poor mental health has profound economic consequences. Given the burden of poor mental health, the economic case for preventing mental illness and promoting better mental health may be very strong, but too often prevention attracts little attention and few resources. This article describes the potential role that can be played by economic evidence alongside experimental trials and observational studies, or through modeling, to substantiate the need for increased investment in prevention. It illustrates areas of action across the life course where there is already a good economic case. It also suggests some further areas of substantive public health concern, with promising effectiveness evidence, that may benefit from economic analysis. Financial and economic barriers to implementation are then presented, and strategies to address the barriers and increase investment in the prevention of mental illness are suggested.
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Affiliation(s)
- David McDaid
- Personal Social Services Research Unit, Department of Health Policy, London School of Economics and Political Science, London WC2A 2AE, United Kingdom; ,
| | - A-La Park
- Personal Social Services Research Unit, Department of Health Policy, London School of Economics and Political Science, London WC2A 2AE, United Kingdom; ,
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Meta-meta-analysis on the effectiveness of parent-based interventions for the treatment of child externalizing behavior problems. PLoS One 2018; 13:e0202855. [PMID: 30256794 PMCID: PMC6157840 DOI: 10.1371/journal.pone.0202855] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 08/12/2018] [Indexed: 01/20/2023] Open
Abstract
Objective The aim of this study is to perform the first meta-meta-analysis on the effectiveness of parent-based interventions for children with externalizing behavior problems. Even though parent-based interventions are considered as effective treatments the effects reported in meta-analyses are heterogeneous and the implementation in clinical practice is suboptimal. Recapitulative valid effect predictions are required to close the still existing gap between research findings and clinical practice. The meta-meta-analytic results on changes in child behavior shall result in a clear signal for clinical practice. Methods This meta-meta-analysis encompasses 26 meta-analyses identified via search in electronic databases (PsycINFO, Medline, PubMed). Meta-analyses had to report effects of parent-based interventions on child behavior and focus on children under the age of 13 years with externalizing behavior problems in a clinical setting. Analyses were based on random-effects models. To combine results, the effect estimates of the meta-analyses were transformed to SMD and weighted to correct for primary study overlap. The meta-meta-analysis is registered on PROSPERO, registration number CRD42016036486 and was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PRISMA). Results The results indicate a significant moderate overall effect for child behavior (SMD = 0.46) as well as for parent reports (SMD = 0.51) and observational data (SMD = 0.62). Further analyses focusing on child externalizing behavior yielded significant and moderate effects (SMD = 0.45). All effects remained stable to follow-up. Considerable heterogeneity was observed within results. Conclusion Parent-based interventions are shown to be effective in improving behavior in children with externalizing behavior problems, as assessed using parent reports and observational measures. The present results should encourage health care providers to apply evidence-based parent-based interventions.
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Bultas MW, McMillin SE, Broom MA, Zand DH. Brief, Rapid Response, Parenting Interventions Within Primary Care Settings. J Behav Health Serv Res 2018; 44:695-699. [PMID: 26289564 DOI: 10.1007/s11414-015-9479-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Opportunities created by the Patient Protection and Affordable Care Act along with the increased prevalence of pediatric behavioral and mental health concerns provide new challenges for pediatric health care providers. To address these matters, providers need to change the manner by which they provide health care to families. A novel approach is providing brief, rapid response, evidence-based parenting interventions within the pediatric primary care setting. Family-focused parenting programs support the American Academy of Pediatrics recommendations of improving mental health via supports in pediatric primary care to maximize the social and psychological well-being of families. A considerable body of research indicates that parenting interventions reduce the severity and frequency of disruptive behavior disorders in children and provide support to parent by bolstering parental resilience and improving overall family functioning. Providing these services within the pediatric primary care setting addresses the need for fully integrated health services that are family-centered and easily accessible.
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Affiliation(s)
- Margaret W Bultas
- School of Nursing, Saint Louis University, 3525 Caroline Street, St. Louis, MO, 63104, USA.
| | | | - Matthew A Broom
- Department of Pediatrics, School of Medicine, Saint Louis University, 1465 S Grand Blvd, St. Louis, MO, 63104, USA
| | - Debra H Zand
- Department of Pediatrics, School of Medicine, Saint Louis University, 1465 S Grand Blvd, St. Louis, MO, 63104, USA
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Risk and Protective Factors for Externalizing Behavior at 3 Years: Results from the All Our Families Pregnancy Cohort. J Dev Behav Pediatr 2018; 39:547-554. [PMID: 29794888 DOI: 10.1097/dbp.0000000000000586] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study examines risk and protective factors for externalizing behavior in children aged 3 years to inform early interventions and enhance school readiness. METHOD A total of 1314 mothers participating in a longitudinal study completed questionnaires when their children turned 2 years and again at the age of 3 years. Externalizing behavior was assessed using a short version of the Child Behavior Checklist. Risk and protective factors included the child's characteristics, maternal mental health and disposition, socioeconomic status, and community engagement and child care. Logistic regression models produced crude and adjusted odds ratios (AORs). RESULTS Poor maternal mental health and high levels of maternal neuroticism were associated with an increased risk for externalizing problems at 3 years (AOR, 1.66; 95% confidence interval [CI], 1.16-2.40 and AOR, 2.28; 95% CI, 1.58-3.30). Care by their mother, relative, or a nanny (compared with being in child care) also conferred an increased risk (AOR, 1.38; 95% CI, 1.01-1.90). Mothers' community engagement modified the risk for boys, such that boys whose mothers did not participate in community activities were 4 times more likely to have externalizing problems than did boys whose mothers engaged in community activities. CONCLUSION Families in which mothers experience mental health challenges or have dispositional traits that increase the risk of externalizing behaviors can be identified early. Identification provides the opportunity to promote engagement with parenting supports to improve the outcomes of the child and family. Providing opportunities for children to practice their self-regulation skills through participation in child care and community activities promotes development and mitigates the risk of externalizing behavior.
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Lahti M, Linno M, Pael J, Lenk-Adusoo M, Timonen-Kallio E. Mental Health Care Interventions in Child Welfare: Integrative Review of Evidence-Based Literature. Issues Ment Health Nurs 2018; 39:746-756. [PMID: 30153073 DOI: 10.1080/01612840.2018.1479902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Many of the youths living in vulnerable environments in child welfare settings are in need of psychiatric treatment as well as child protection services. There is an urgent demand for closer collaboration between these two sectors in order to ensure more effective work in child welfare regarding to mental health care interventions is provided. The aim of this integrative review was to describe the evidence-based literature related to mental health care interventions provided in child welfare. Seven databases (PubMed, EBSCOhost, Ovid MEDLINE, Eric, CINAHL, Elsevier Science Direct, Cochrane database) were searched, while search parameters included English-only manuscripts published prior to 20 May 2016. Out of 152 records, only eight studies met the inclusion criteria. Mental health care interventions described varied and were listed as follows: crisis assessment, respite child care, counselling, therapeutic interviews, cognitive and educational screening, different therapies, psychoeducational support, psychological testing, behavioural assessment, individual work and brief interval care. Despite using comprehensive searches in seven databases, we found only eight studies related to acute psychiatric services targeted at child welfare. There is not enough evidence to arrive at a definite conclusion on the effects of mental health care interventions in child welfare.
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Affiliation(s)
- Mari Lahti
- a Health and Well-being , Turku University of Applied Science , Turku , Finland.,b Department of Nursing Science , University of Turku , Turku , Finland
| | - Merle Linno
- c Department of Social Sciences , University of Tarto , Tarto , Estonia
| | - Janika Pael
- d Department of Nursing , Tartu Health Care College , Tarto , Estonia
| | | | - Eeva Timonen-Kallio
- a Health and Well-being , Turku University of Applied Science , Turku , Finland
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Freitag CM. [Conduct disorder in adolescent females]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2018; 46:191-193. [PMID: 29726755 DOI: 10.1024/1422-4917/a000583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Christine M Freitag
- 1 Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Universitätsklinikum Frankfurt am Main
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43
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Sethi A, Sarkar S, Dell'Acqua F, Viding E, Catani M, Murphy DGM, Craig MC. Anatomy of the dorsal default-mode network in conduct disorder: Association with callous-unemotional traits. Dev Cogn Neurosci 2018; 30:87-92. [PMID: 29413533 PMCID: PMC5945604 DOI: 10.1016/j.dcn.2018.01.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 01/12/2018] [Accepted: 01/12/2018] [Indexed: 01/10/2023] Open
Abstract
We recently reported that emotional detachment in adult psychopathy was associated with structural abnormalities in the dorsal 'default-mode' network (DMN). However, it is unclear whether these differences are present in young people at risk of psychopathy. The most widely recognised group at risk for psychopathy are children/adolescents with conduct disorder (CD) and callous-unemotional (CU) traits. We therefore examined the microstructure of the dorsal DMN in 27 CD youths (14-with/13-without CU traits) compared to 16 typically developing controls using DTI tractography. Both CD groups had significantly (p < 0.025) reduced dorsal DMN radial diffusivity compared to controls. In those with diagnostically significant CU traits, exploratory analyses (uncorrected for multiple comparisons) suggested that radial diffusivity was negatively correlated with CU severity (Left: rho = -0.68, p = 0.015). These results suggest that CD youths have microstructural abnormalities in the same network as adults with psychopathy. Further, the association with childhood/adolescent measures of emotional detachment (CU traits) resembles the relationship between emotional detachment and network microstructure in adult psychopaths. However, these changes appear to occur in opposite directions - with increased myelination in adolescent CD but reduced integrity in adult psychopathy. Collectively, these findings suggest that developmental abnormalities in dorsal DMN may play a role in the emergence of psychopathy.
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Affiliation(s)
- Arjun Sethi
- Natbrainlab, Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Sacker Institute for Translational Neurodevelopment, Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Developmental Risk & Resilience Unit, University College London, London, UK.
| | - Sagari Sarkar
- Natbrainlab, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Flavio Dell'Acqua
- Natbrainlab, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Essi Viding
- Developmental Risk & Resilience Unit, University College London, London, UK
| | - Marco Catani
- Natbrainlab, Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Sacker Institute for Translational Neurodevelopment, Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Declan G M Murphy
- Sacker Institute for Translational Neurodevelopment, Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Michael C Craig
- Natbrainlab, Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Sacker Institute for Translational Neurodevelopment, Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Autism Unit, Bethlem Royal Hospital, SLAM NHS Foundation Trust, Kent, UK
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Charach A, Bélanger SA, McLennan JD, Nixon MK. Screening for disruptive behaviour problems in preschool children in primary health care settings. Paediatr Child Health 2018; 22:478-493. [PMID: 29601056 DOI: 10.1093/pch/pxx128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Disruptive behaviour problems in preschool children are significant risk factors for, and potential components of, neurodevelopmental and mental health disorders. Some noncompliance, temper tantrums and aggression between 2 and 5 years of age are normal and transient. However, problematic levels of disruptive behaviour, specifically when accompanied by functional impairment and/or significant distress, should be identified because early intervention can improve outcome trajectories. This position statement provides an approach to early identification using clinical screening at periodic health examinations, followed by a systematic mental health examination that includes standardized measures. The practitioner should consider a range of environmental, developmental, family and parent-child relationship factors to evaluate the clinical significance of disruptive behaviours. Options within a management plan include regular monitoring, accompanied by health guidance and parenting advice, referral to parent behaviour training as a core evidence-based intervention, and referral to specialty care for preschool children with significant disruptive behaviours, developmental or mental health comorbidities, or who are not responding to first-line interventions.
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Affiliation(s)
- Alice Charach
- Canadian Paediatric Society, Mental Health and Developmental Disabilities Committee, Ottawa, Ontario.,Canadian Academy of Child and Adolescent Psychiatry, Ottawa, Ontario
| | | | - John D McLennan
- Canadian Academy of Child and Adolescent Psychiatry, Ottawa, Ontario
| | - Mary Kay Nixon
- Canadian Academy of Child and Adolescent Psychiatry, Ottawa, Ontario
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45
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Miller-Kuhaneck H, Watling R. Parental or Teacher Education and Coaching to Support Function and Participation of Children and Youth With Sensory Processing and Sensory Integration Challenges: A Systematic Review. Am J Occup Ther 2018; 72:7201190030p1-7201190030p11. [PMID: 29280713 DOI: 10.5014/ajot.2018.029017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This systematic review examines the literature published from January 2007 through May 2015 related to the effectiveness of occupational therapy interventions using parental or teacher education and coaching with children with challenges in sensory processing and sensory integration (SP-SI). Of more than 11,000 abstracts and 86 articles that were considered, only 4 met the criteria and were included in this review. Studies of parental training and coaching for children with challenges in SP-SI and comorbid autism spectrum disorder have suggested that educational or coaching programs could result in positive outcomes for both parents and children, often in a relatively short time period. Recommendations include a greater focus on providing educational interventions for parents and teachers and including specific assessment of SP-SI before implementing interventions meant to address those issues. Specific recommendations for future research are provided.
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Affiliation(s)
- Heather Miller-Kuhaneck
- Heather Miller-Kuhaneck, PhD, OTR/L, FAOTA, is Associate Professor, Department of Occupational Therapy, Sacred Heart University, Fairfield, CT
| | - Renee Watling
- Renee Watling, PhD, OTR/L, FAOTA, is Visiting Assistant Professor, School of Occupational Therapy, University of Puget Sound, Tacoma, WA, and Clinical Assistant Professor, Division of Occupational Therapy, University of Washington, Seattle;
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Troy V, McPherson KE, Emslie C, Gilchrist E. The Feasibility, Appropriateness, Meaningfulness, and Effectiveness of Parenting and Family Support Programs Delivered in the Criminal Justice System: A Systematic Review. JOURNAL OF CHILD AND FAMILY STUDIES 2018; 27:1732-1747. [PMID: 29755249 PMCID: PMC5932092 DOI: 10.1007/s10826-018-1034-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Children whose parents are involved in the criminal justice system (CJS) are at increased risk of developing social, emotional, and behavioural difficulties and are more likely than their peers to become involved in the CJS themselves. Parenting behaviour and parent-child relationships have the potential to affect children's outcomes with positive parenting practices having the potential to moderate some of the negative outcomes associated with parental involvement in the CJS. However, many parents in the CJS may lack appropriate role models to support the development of positive parenting beliefs and practices. Parenting programs offer an opportunity for parents to enhance their parenting knowledge and behaviours and improve relationships with children. Quantitative and qualitative evidence pertaining to the implementation and effectiveness of parenting programs delivered in the CJS was included. Five databases were searched and a total of 1145 articles were identified of which 29 met the review inclusion criteria. Overall, programs were found to significantly improve parenting attitudes; however, evidence of wider effects is limited. Additionally, the findings indicate that parenting programs can be meaningful for parents. Despite this, a number of challenges for implementation were found including the transient nature of the prison population and a lack of parent-child contact. Based on these findings, recommendations for the future development and delivery of programs are discussed.
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Affiliation(s)
- Victoria Troy
- Department of Psychology, Social Work and Allied Health Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA UK
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Ogundele MO. Behavioural and emotional disorders in childhood: A brief overview for paediatricians. World J Clin Pediatr 2018; 7:9-26. [PMID: 29456928 PMCID: PMC5803568 DOI: 10.5409/wjcp.v7.i1.9] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 11/30/2017] [Accepted: 12/05/2017] [Indexed: 02/06/2023] Open
Abstract
Mental health problems in children and adolescents include several types of emotional and behavioural disorders, including disruptive, depression, anxiety and pervasive developmental (autism) disorders, characterized as either internalizing or externalizing problems. Disruptive behavioural problems such as temper tantrums, attention deficit hyperactivity disorder, oppositional, defiant or conduct disorders are the commonest behavioural problems in preschool and school age children. The routine Paediatric clinic or Family Medicine/General Practitioner surgery presents with several desirable characteristics that make them ideal for providing effective mental health services to children and adolescents. DSM-5 and ICD-10 are the universally accepted standard criteria for the classification of mental and behaviour disorders in childhood and adults. The age and gender prevalence estimation of various childhood behavioural disorders are variable and difficult to compare worldwide. A review of relevant published literature was conducted, including published meta-analyses and national guidelines. We searched for articles indexed by Ovid, PubMed, PubMed Medical Central, CINAHL, EMBASE, Database of Abstracts and Reviews, and the Cochrane Database of Systematic reviews and other online sources. The searches were conducted using a combination of search expressions including "childhood", "behaviour", "disorders" or "problems". Childhood behaviour and emotional problems with their related disorders have significant negative impacts on the individual, the family and the society. They are commonly associated with poor academic, occupational, and psychosocial functioning. It is important for all healthcare professionals, especially the Paediatricians to be aware of the range of presentation, prevention and management of the common mental health problems in children and adolescents.
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Affiliation(s)
- Michael O Ogundele
- Department of Community Paediatrics, NHS Fife, Glenwood Health Centre, Glenrothes KY6 1HK, United Kingdom
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Helander M, Lochman J, Högström J, Ljótsson B, Hellner C, Enebrink P. The effect of adding Coping Power Program-Sweden to Parent Management Training-effects and moderators in a randomized controlled trial. Behav Res Ther 2018; 103:43-52. [PMID: 29448135 DOI: 10.1016/j.brat.2018.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 09/20/2017] [Accepted: 02/02/2018] [Indexed: 01/08/2023]
Abstract
For children with oppositional defiant disorder (ODD), Parent Management Training (PMT) is a recommended treatment in addition to child Cognitive Behavioral Therapy (child-CBT). There is however a lack of studies investigating the additive effect of group-based child-CBT to PMT for children between 8 and 12 years. The current study investigated the incremental effect of group-based child-CBT, based on the Coping Power Program, when added to the Swedish group-based PMT program KOMET. Outcomes were child behavior problems, child prosocial behavior, parenting skills and the moderating effect of child characteristics. One hundred and twenty children 8-12 years with ODD or Disruptive Behavioral Disorder NOS and their parents were randomized either to combined child-CBT and PMT (n = 63) or to PMT only (n = 57) in Swedish Child- and Adolescent Psychiatric settings. Participants were assessed pre- and post-treatment using semi-structured interviews and child- and parent ratings. After treatment, behavior problems were reduced in both groups. Prosocial behavior were significantly more improved in the combined treatment. Parenting skills were improved in both groups. In moderator analyses, behavior problems and prosocial behavior improved significantly more in the combined treatment compared to PMT only in the group of children with high levels of ODD symptoms.
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Affiliation(s)
- Maria Helander
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Sweden.
| | - John Lochman
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Jens Högström
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Sweden
| | - Brjánn Ljótsson
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Sweden
| | - Clara Hellner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Sweden
| | - Pia Enebrink
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Sweden
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Teitelbaum D. Moving towards Therapists Becoming Better Educators: A Commentary on Changes in the Content of Pediatric Physical Therapy for Infants: A Quantitative, Observational Study. Phys Occup Ther Pediatr 2018; 38:489-492. [PMID: 30321075 DOI: 10.1080/01942638.2018.1500845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Patients and their families have expressed that they want information (Hendricks, 2000) and as a result often turn to Google for health and medical information. Society as a whole is more informed than ever and no longer rely only on medical practitioners as in previous generations. Instead, and rightly so, they question medical experts and want to know the reasoning and rationale behind everything they experience. This combined with the shift towards family-centred principles over the last 20 years underscores the need to provide comprehensive and effective education to families. But what should that look like? Improving parental competence through education promotes their beliefs that they can be positive agents of change in their child's life (Guimond et al., 2008 ). Similarly, therapists are slowly starting to concede that parents have the greatest amount of time and influence over their children's development (Mahoney and Perales, 2006 ), and as a result, are the primary agents of change.
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Affiliation(s)
- Debra Teitelbaum
- a Alberta Children's Hospital , Child Development Centre , Alberta , Canada
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The NIH Science of Behavior Change Program: Transforming the science through a focus on mechanisms of change. Behav Res Ther 2017. [PMID: 29110885 DOI: 10.1016/j.brat.2017.07.002.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The goal of the NIH Science of Behavior Change (SOBC) Common Fund Program is to provide the basis for an experimental medicine approach to behavior change that focuses on identifying and measuring the mechanisms that underlie behavioral patterns we are trying to change. This paper frames the development of the program within a discussion of the substantial disease burden in the U.S. attributable to behavioral factors, and details our strategies for breaking down the disease- and condition-focused silos in the behavior change field to accelerate discovery and translation. These principles serve as the foundation for our vision for a unified science of behavior change at the NIH and in the broader research community.
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