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Graham Y, Spencer AE, Velez GE, Herbell K. Engaging Youth Voice and Family Partnerships to Improve Children's Mental Health Outcomes. Child Adolesc Psychiatr Clin N Am 2024; 33:343-354. [PMID: 38823808 DOI: 10.1016/j.chc.2024.02.004] [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] [Indexed: 06/03/2024]
Abstract
Promoting active participation of families and youth in mental health systems of care is the cornerstone of creating a more inclusive, effective, and responsive care network. This article focuses on the inclusion of parent and youth voice in transforming our mental health care system to promote increased engagement at all levels of service delivery. Youth and parent peer support delivery models, digital innovation, and technology not only empower the individuals involved, but also have the potential to enhance the overall efficacy of the mental health care system.
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Affiliation(s)
- Yolanda Graham
- Morehouse School of Medicine, Devereux Advanced Behavioral Health, 444 Devereux Drive, Villanova, PA 19085, USA.
| | - Andrea E Spencer
- Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Chicago, IL 60611, USA
| | - German E Velez
- New York-Presbyterian Hospital, Weill Cornell Medical College/ Columbia University College of Physicians and Surgeons, 525 E. 68th Street, Box 140, New York, NY 10065, USA
| | - Kayla Herbell
- Martha S. Pitzer Center for Women, Children, and Youth, The Ohio State University, 1577 Neil Avenue, Columbus, OH 43210, USA
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Hooshmand Zaferanieh M, Shi L, Jindal M, Chen L, Zhang L, Lopes S, Jones K, Wang Y, Meggett K, Walker CB, Falgoust G, Zinzow H. Web-Based Mindfulness-Based Cognitive Therapy for Adults With a History of Depression: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e53966. [PMID: 38888958 PMCID: PMC11220437 DOI: 10.2196/53966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/03/2024] [Accepted: 03/21/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Depression poses a major threat to public health with an increasing prevalence in the United States. Mindfulness-based interventions, such as mindfulness-based cognitive therapy (MBCT), are effective methods for managing depression symptoms and may help fortify existing efforts to address the current disease burden. The in-person group format of MBCT, however, incurs barriers to care such as expenses, childcare needs, and transportation issues. Alternate delivery modalities such as MBCT delivered via the web can be investigated for their capacity to overcome these barriers and still reduce symptoms of depression with adequate feasibility and efficacy. OBJECTIVE This study protocol aims to examine the feasibility and efficacy of MBCT delivered via the web for the treatment of depression. METHODS To attain study aims, 2 phases will be implemented using a waitlist control design. A total of 128 eligible participants will be randomized into either an 8-week MBCT intervention group plus treatment as usual (MBCT + TAU; group 1) or an 8-week waitlist control group (group 2). In phase I (8 weeks), group 1 will complete the intervention and group 2 will proceed with TAU. In phase II (8 weeks), group 2 will complete the intervention and group 1 will continue with TAU until reaching an 8-week follow-up. TAU may consist of receiving psychotherapy, pharmacotherapy, or combined treatment. Data collection will be completed at baseline, 8 weeks (postintervention for group 1 and preintervention for group 2), and 16 weeks (follow-up for group 1, postintervention for group 2). The primary outcomes will include (1) current, residual, or chronic depression symptoms and (2) psychiatric distress. Secondary outcomes will include perceived stress and facets of mindfulness. The feasibility will be measured by assessing protocol adherence, retention, attendance, and engagement. Finally, the extent of mindfulness self-practice and executive functioning skills will be assessed as mediators of intervention outcomes. RESULTS This study began screening and recruitment in December 2022. Data collection from the first cohort occurred in January 2023. By November 2023, a total of 30 participants were enrolled out of 224 who received screening. Data analysis began in February 2024, with an approximate publication of results by August 2024. Institutional review board approval took place on September 11, 2019. CONCLUSIONS This trial will contribute to examining mindfulness-based interventions, delivered via the web, for improving current, residual, or chronic depression symptoms. It will (1) address the feasibility of MBCT delivered via the web; (2) contribute evidence regarding MBCT's efficacy in reducing depression symptoms and psychiatric distress; and (3) assess the impact of MBCT on several important secondary outcomes. Findings from this study will develop the understanding of the causal pathways between MBCT delivered via the web and depression symptoms further, elucidating the potential for future larger-scale designs. TRIAL REGISTRATION ClinicalTrials.gov NCT05347719; https://www.clinicaltrials.gov/ct2/show/NCT05347719. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53966.
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Affiliation(s)
| | - Lu Shi
- Department of Health Sciences, College of Health Professions, Pace University, New York, NY, United States
| | - Meenu Jindal
- Department of Internal Medicine, Prisma Health, Greenville, SC, United States
| | - Liwei Chen
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States
| | - Lingling Zhang
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, United States
| | - Snehal Lopes
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Karyn Jones
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Yucheng Wang
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Kinsey Meggett
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Cari Beth Walker
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Grace Falgoust
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Heidi Zinzow
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
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Sit SMM, Lai AYK, Wong HW, Hung KS, Wang MP, Ho SY, Lam TH. Gamified Strength Recognition and Quiz to Enhance COVID-19 Prevention, Knowledge, Behaviors, and Family Well-Being. Games Health J 2024; 13:172-183. [PMID: 38512294 DOI: 10.1089/g4h.2023.0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
Background: Promoting COVID-19 prevention is key to pandemic control and innovative interventions can help communicate reliable science to the public. Under the Hong Kong Jockey Club SMART Family-Link Project, we developed and evaluated a pilot intervention for promoting COVID-19 prevention through a web-based family game, guided by the Theory of Planned Behavior and a strength-based approach. Methods: The "SMART Epidemic prevention" pilot theme was launched to the public on September 21, 2020 for 4 weeks. The game had two parts: (i) strength recognition and (ii) quiz questions on knowledge and behaviors about COVID-19 prevention. Simple baseline, in-game, and postgame evaluation assessed players' perceived knowledge, behaviors, family well-being, game satisfaction, and perceived benefits. Results: Of 86 registered families, 55 played actively, including 212 players (51% female, 35% aged below 18) who self-identified as children (44%), parents (39%), and grandparents (11%). In weeks 1 and 4, an average of 7 and 18 game rounds were played per family, and 86.6% and 75.9% of rounds had perfect (2) behavior matches. Postgame evaluation with 51 families showed improvements in epidemic prevention knowledge and behaviors, family communication, family happiness (all P < 0.001), and family relationship (P = 0.002) with small effect sizes (0.15-0.29). Overall game satisfaction was rated 4.49 (scale of 1-5). Ninety-four percent of families shared knowledge from the game with others. Conclusions: Our pilot web-based family game first showed preliminary evidence on enhancing COVID-19 prevention knowledge and behaviors, and family well-being, with participants recognizing family strengths, reporting high satisfaction and various perceived benefits, and showing sustained gameplay. Trial Registration: The research protocol was registered at the National Institutes of Health (Identifier No. NCT04550065) on September 16, 2020.
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Affiliation(s)
| | - Agnes Yuen-Kwan Lai
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Hoi-Wa Wong
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Ka-Shun Hung
- Technology-Enriched Learning Initiative, The University of Hong Kong, Hong Kong, China
| | - Man-Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Sai-Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
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Csirmaz L, Nagy T, Vikor F, Kasos K. Cognitive Behavioral Digital Interventions are Effective in Reducing Anxiety in Children and Adolescents: A Systematic Review and Meta-analysis. JOURNAL OF PREVENTION (2022) 2024; 45:237-267. [PMID: 38093033 PMCID: PMC10981643 DOI: 10.1007/s10935-023-00760-0] [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] [Accepted: 11/19/2023] [Indexed: 04/02/2024]
Abstract
Anxiety disorders are the most prevalent mental health issues in childhood, yet most children do not receive treatment. With recent advances in technology, a growing number of digital anxiety interventions are becoming accessible. This study is the first meta-analysis to evaluate the effectiveness and usefulness of digital cognitive-behavioral anxiety interventions for individuals under the age of 18. Five electronic databases (PsycNET, Web of Science, Science Direct, Pub Med, SAGE Journals.) were systematically searched in 2021. Inclusion criteria were: randomized control trials with a wait list no treatment control, standalone to blended care with minimal therapist involvement, diagnosed anxiety disorder or elevated levels of anxiety, outcome anxiety levels had to be assessed by a clinician, or the patients themselves by a validated anxiety measure. We assessed and controlled for publication bias, and considered the risk of bias using the Cochrane risk-of-bias tool. Eighteen studies were found eligible, which examined 1290 participants in total. Pooled effect sizes using a random-effects model yielded low overall effect for self-ratings (g = 0.28, k = 18, p < 0.001, 95% CI [0.14; 0.41]), and medium effect for ratings of clinicians (g = 0.66, k = 13, p < 0.001, 95% CI [0.50; 0.80]) as well as for parental report (g = 0.49, k = 16, p < 0.001, 95% CI [0.29; 0.69]). We found that the effects were homogenous across studies. Further examining potential moderating factors of treatment efficacy is needed in future research, as well as conducting studies that compare traditional methods of care to their digital counterparts. Digital interventions could contribute to the well-being of children regardless of age, minimizing therapist involvement. We conclude that digital cognitive-behavioral interventions may provide an accessible, cost-effective, and scalable anxiety treatment option for children and adolescents.
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Affiliation(s)
- Luca Csirmaz
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- MTA-ELTE Lendület Adaptation Research Group, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Tamás Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella u. 6, Budapest, 1064, Hungary
| | - Fanni Vikor
- MTA-ELTE Lendület Adaptation Research Group, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Krisztian Kasos
- MTA-ELTE Lendület Adaptation Research Group, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella u. 6, Budapest, 1064, Hungary.
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Bischops AC, Sieper L, Dukart J, Schaal NK, Reinauer C, Oommen PT, Tomoiaga C, David O, Mayatepek E, Meissner T. Resilience strengthening in youth with a chronic medical condition: a randomized controlled feasibility trial of a combined app and coaching program. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02395-w. [PMID: 38431540 DOI: 10.1007/s00787-024-02395-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/11/2024] [Indexed: 03/05/2024]
Abstract
Youth with a chronic medical condition (CMC) are often affected by comorbid mental disorders. Resilience-strengthening interventions can protect youth's mental health, yet evidence-based programs remain scarce. To address this lack, this study aimed to evaluate the feasibility of a dual approach combining app-based resilience training and cognitive behavioral group coaching. Fifty-one youths with CMC treated at a German university children's hospital aged 12-16 years were recruited. They were randomly assigned to a combined app game and coaching intervention or sole app gameplay. At pre-, post-intervention, and at a 2-month follow-up resilience, automatic negative thoughts and an app and coaching evaluation were assessed. Feasibility was defined as a recruitment rate of 70%, an 85% adherence rate for the REThink game, and 70% participation in both coaching sessions. Feasibility criteria were reached for coaching participation but not for recruitment or app adherence. While both the REThink game app and coaching intervention had high acceptance rates among youth with CMC, participants receiving additional coaching sessions showed higher satisfaction and adherence rates. Participants preferred remote to in-person meetings. The findings support a combination of a gamification app approach with online group coaching. Group coaching can improve adherence while online options increase accessibility. Future research should focus on testing in diverse participant samples, language, and age-adapted updates of the REThink game app. These findings provide guidance for increasing adherence in future intervention studies in youth with CMC cohorts.
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Affiliation(s)
- Anne Christine Bischops
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany.
| | - L Sieper
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - J Dukart
- Institute for Neurosciences and Medicine: Brain and Behavior (INM-7), Research Center Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - N K Schaal
- Department of Experimental Psychology, Heinrich Heine University, Düsseldorf, Germany
| | - C Reinauer
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - P T Oommen
- Division of Pediatric Rheumatology, Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - C Tomoiaga
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babes-Bolyai University, Cluj-Napoca, Romania
| | - O David
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babes-Bolyai University, Cluj-Napoca, Romania
| | - E Mayatepek
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - T Meissner
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany
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Ertl MM, Jones A, Hickson R, Achebe I, Gyamfi Ertl SL, Sichel CE, Campos S, O'Grady MA, Tross S, Wilson P, Cohall RM, Cohall AT, Elkington KS. Technology Access and Perceptions of Telehealth Services Among Young Adults Involved in the Court System. J Adolesc Health 2024; 74:582-590. [PMID: 38069927 PMCID: PMC10872968 DOI: 10.1016/j.jadohealth.2023.09.019] [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: 04/30/2023] [Revised: 08/22/2023] [Accepted: 09/22/2023] [Indexed: 02/05/2024]
Abstract
PURPOSE This study examined access to technology and telehealth among young adults (ages 18-24) who were court-involved and were recruited from an alternative sentencing program in New York City. METHODS Using sequential mixed methods design, we examined demographic factors linked with access to technology and perceived usefulness of the Internet among n = 321 young adults who were court-involved (75% male, 65% African American, 35% Latinx). We then conducted in-depth interviews with 27 young adults to elicit first-person account of their access to, interest in, and experience with technology and telehealth. RESULTS Although most participants had access to a phone with a data plan, a substantial proportion reported inconsistent access to the technology critical to telehealth. Certain young adults were more likely to lack consistent access to the technology needed for telehealth, including Black young adults, males, those with less than a high school diploma, those with a history of homelessness, and those who had difficulties paying for basic necessities. Qualitative interviews revealed that most had a strong self-efficacy using technology, while distrust of technology, inexperience with and skepticism of telehealth, low perceived need for care, and medical mistrust were common significant barriers in this underserved population. DISCUSSION Findings underscored the critical need to address medical mistrust and increase access to and utilization of care among young adults who are court-involved. Results can inform the development and implementation of interventions designed to improve accessibility and acceptability of telehealth.
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Affiliation(s)
- Melissa M Ertl
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Alexis Jones
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Haley Center, Auburn, Alabama
| | - Robert Hickson
- Department of Clinical Psychology, Palo Alto University, Palo Alto, California
| | - Ikenna Achebe
- Division of Child and Adolescent Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, New York
| | - Serwa L Gyamfi Ertl
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Corianna E Sichel
- Division of Child and Adolescent Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, New York
| | - Stephanie Campos
- Division of Child and Adolescent Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, New York
| | - Megan A O'Grady
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Susan Tross
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, New York; Division on Substance Use Disorders, New York State Psychiatric Institute, New York, New York
| | - Patrick Wilson
- Department of Psychology, University of California-Los Angeles, Los Angeles, California
| | - Renee M Cohall
- Mailman School of Public Health, Columbia University, New York, New York
| | - Alwyn T Cohall
- Mailman School of Public Health, Columbia University, New York, New York
| | - Katherine S Elkington
- Division of Child and Adolescent Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, New York; HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, New York.
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Peake E, Miller I, Flannery J, Chen L, Lake J, Padmanabhan A. Preliminary Efficacy of a Digital Intervention for Adolescent Depression: Randomized Controlled Trial. J Med Internet Res 2024; 26:e48467. [PMID: 38324367 PMCID: PMC10882470 DOI: 10.2196/48467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/28/2023] [Accepted: 10/25/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Adolescent depression is a significant public health concern; however, access to effective mental health care is limited. Digital therapeutics (DTx) can improve access to evidence-based interventions; however, their efficacy in adolescents is sparsely documented. OBJECTIVE This study aims to examine the efficacy of a mobile app DTx versus an active control as an adjunct treatment for adolescent depression symptoms. METHODS An internet-based open-label randomized control trial was conducted nationwide with a partial crossover design, and 168 adolescents aged 13 to 21 years with symptoms of depression were recruited between November 2020 and September 2021. Participants were randomized (1:1) to the cognitive behavioral therapy-based treatment app (Spark) or to a psychoeducational control app (control), which they would use for a duration of 5 weeks. The primary outcome was a between-group (Spark vs control) difference in the change in depression symptoms from baseline to postintervention, as measured by the Patient Health Questionnaire-8 (PHQ-8) using a linear mixed-effects analysis. The PHQ-8 ranges from 0 to 24, with scores of 5 to 9 indicating mild depression symptoms, scores of 10 to 14 indicating moderate symptoms, scores of 15 to 19 indicating moderately severe symptoms, and scores of 20 to 24 indicating severe symptoms. A minimal clinically important difference (5-point reduction between baseline and postintervention) in the Spark arm and group differences in remission and treatment response rates based on the PHQ-8 at postintervention were also investigated. RESULTS A total of 160 participants were randomized, 80 in the Spark arm (mean age 16.89, SD 2.5 y) and 80 in the control arm (mean age 16.79, SD 2.59 y). Data from 121 participants (Spark: n=63; control: n=58) with moderate to severe (PHQ-8≥10) symptoms at baseline were included in the primary analyses following a modified intention-to-treat principle. A linear mixed-effect analysis revealed a nonsignificant difference between the study arms in depression symptom change over the intervention period. The Spark arm met a minimal clinically important difference threshold (mean -5.08, 95% CI -6.72 to -3.42). The remission rate in the Spark arm was significantly higher than that in the control arm (11/63, 17% vs 2/58, 3%; χ21=6.2; P=.01; false discovery rate-adjusted P=.03). The treatment response rates were not significantly different between the study arms (P=.07; false discovery rate-adjusted P=.16). Post hoc analyses including participants with mild to severe (PHQ-8 score ≥5) symptoms at baseline revealed promising evidence that Spark is effective in those with mild to severe symptoms. CONCLUSIONS There is initial evidence that a self-guided, cognitive behavioral therapy-based DTx intervention may effectively treat mild to severe depression symptoms in adolescents. DTx may improve access to mental health care for adolescents or serve as an important adjunct to the standard of care. TRIAL REGISTRATION ClinicalTrials.gov NCT04524598; https://clinicaltrials.gov/study/NCT04524598.
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Affiliation(s)
- Emily Peake
- Limbix Health Inc, San Francisco, CA, United States
- Big Health Inc, San Francisco, CA, United States
| | - Ian Miller
- Limbix Health Inc, San Francisco, CA, United States
- Digital Medicine Society, Boston, MA, United States
| | - Jessica Flannery
- Limbix Health Inc, San Francisco, CA, United States
- Akili, Boston, MA, United States
| | - Lang Chen
- Neuroscience Unit, Santa Clara University, Santa Clara, CA, United States
| | - Jessica Lake
- Limbix Health Inc, San Francisco, CA, United States
- Big Health Inc, San Francisco, CA, United States
| | - Aarthi Padmanabhan
- Limbix Health Inc, San Francisco, CA, United States
- Big Health Inc, San Francisco, CA, United States
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Moreira H, Skvarc D, Gomes-Pereira B, Albuquerque A, Góis AC, Fonseca A, Pereira AM, Caiado B, Paulino B, Santos C, Ehrenreich-May J, Canavarro MC, Saraiva M, Vicente VN, Pereira AI. Study protocol for a randomized controlled trial testing the efficacy of Emotion Detectives In-Out: a blended version of the unified protocol for transdiagnostic treatment of emotional disorders in Portuguese children. BMC Psychol 2024; 12:63. [PMID: 38326847 PMCID: PMC10851582 DOI: 10.1186/s40359-024-01532-z] [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: 01/02/2024] [Accepted: 01/10/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Childhood emotional disorders (EDs; i.e., anxiety and depressive disorders) are currently a public health concern. Their high prevalence, long-term effects, and profound influence on the lives of children and families highlight the need to identify and treat these disorders as early and effectively as possible. This clinical trial will examine the efficacy of a blended version (i.e., combining face-to-face and online sessions into one treatment protocol) of the Unified Protocol for Children (the "Emotion Detectives In-Out" program). This program is a manualized cognitive-behavioral therapy for the transdiagnostic treatment of EDs in children aged 7 to 12 years that aims to reduce the intensity and frequency of strong and aversive emotional experiences by helping children learn how to confront those emotions and respond to them in more adaptive ways. METHODS This study is designed as a multicenter equivalence randomized controlled parallel-group two-arm trial comparing the Emotion Detectives In-Out program with an evidenced-based group intervention for children with anxiety disorders (the Coping Cat program). Participants will be children aged between 7 and 12 years with an anxiety disorder or with clinically significant anxiety symptoms as well as one of their parents or a legal representative. A minimum sample size of 138 children (69 per group) is needed to test whether the efficacy of the proposed intervention is equivalent to that of the well-established Coping Cat intervention. DISCUSSION We expect Emotion Detectives In-Out to be a feasible and efficacious alternative intervention for treating children's EDs by allowing for a greater increase in children's access to care. A blended format is expected to overcome common barriers to treatment (e.g., parents´ lack of time to attend regular sessions) and make the intervention more accessible to families. TRIAL REGISTRATION The clinical trial is registered at ClinicalTrials.gov (Identifier: NCT05747131, date assigned February 28, 2023).
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Affiliation(s)
- Helena Moreira
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3030-115, Coimbra, Portugal.
| | - Dave Skvarc
- School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Bárbara Gomes-Pereira
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3030-115, Coimbra, Portugal
| | | | - Ana Carolina Góis
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3030-115, Coimbra, Portugal
| | - Ana Fonseca
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3030-115, Coimbra, Portugal
| | - Ana Maria Pereira
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
| | - Brígida Caiado
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3030-115, Coimbra, Portugal
- Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Bruna Paulino
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
| | - Catarina Santos
- Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | | | - Maria Cristina Canavarro
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3030-115, Coimbra, Portugal
| | - Mariana Saraiva
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
| | - Vitória Nunes Vicente
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua Do Colégio Novo, 3030-115, Coimbra, Portugal
| | - Ana Isabel Pereira
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
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Conroy K, Kehrer SM, Georgiadis C, Hare M, Ringle VM, Shaw AM. Learning from Adolescents and Caregivers to Enhance Acceptability and Engagement Within Virtual Dialectical Behavior Therapy for Adolescents Skills Groups: A Qualitative Study. Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01641-7. [PMID: 38183575 DOI: 10.1007/s10578-023-01641-7] [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] [Accepted: 11/14/2023] [Indexed: 01/08/2024]
Abstract
Despite the significant increase in adolescent mental health challenges in recent years, structural barriers continue to limit access to and engagement in mental health services. As such, opportunities to learn directly from adolescents and their families on how to best structure and deliver services are paramount. The current study assumes a multi-informant approach and reports on adolescents' and caregivers' (N = 33) experiences in an adapted telehealth/hybrid Dialectical Behavior Therapy for Adolescents (DBT-A) program. Focus groups were conducted across two cohorts of families who participated in DBT-A skills groups, to collect family-centered data on the acceptability of program modifications, engagement in the adapted telehealth/hybrid DBT-A, and recommendations for improvement. Participants were predominately Latine White and were from a broad range of socioeconomic backgrounds. Additionally, 45.5% of the adolescents identified as LGBTQ + . Focus group findings emphasized how the telehealth platform was both convenient and disengaging, and how in-person sessions offered improved group connection and content engagement. Participants underscored the importance of balancing multi-family group sessions with adolescent- and caregiver-only group sessions in the program, and adolescents emphasized a need for the DBT-A program to better center adolescents' unique experiences and voices throughout sessions. Both adolescents and caregivers suggested modifications to synthesize the content and improve generalizability of the DBT-A skills to their real lives. Overall, these findings add to a new and evolving branch of DBT-A qualitative inquiry, as well as the growing body of work that recommends incorporating the voices of people with lived experiences into the development and modification of psychological services.
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Affiliation(s)
- Kristina Conroy
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA.
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
| | - Sabrina M Kehrer
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Christopher Georgiadis
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
- The Warren Alpert Medical School, Department of Psychiatry, Brown University, Providence, RI, USA
| | - Megan Hare
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Vanesa Mora Ringle
- Counseling Psychology Program, Department of Education and Human Services, Lehigh University, Bethlehem, PA, USA
| | - Ashley M Shaw
- School of Social and Behavioral Sciences, University of New England, Biddeford, ME, USA
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10
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Hartinger Pena SM, Mäusezahl D, Jäggi L, Aguilar L, Alvarado Llatance M, Castellanos A, Huaylinos Bustamante ML, Hinckley K, Charles McCoy D, Zhang C, Fink G. Digital Support Systems to Improve Child Health and Development in Peru: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e50371. [PMID: 38096020 PMCID: PMC10755649 DOI: 10.2196/50371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND Children living in low and middle-income countries (LMICs) are at greater risk for experiencing adversities that can undermine their health and early development. Recently launched digital early childhood development (ECD) programs attempt to support families with young children in their home environments using digital technologies. However, relatively little is known regarding the effectiveness of these new technologies. OBJECTIVE The goal of this study is to rigorously assess the reach, effectiveness, and cost-effectiveness of a newly developed digital ECD platform called Afini. The Afini platform was designed to support parents of young children in low-resource settings to improve ECD and interact with caregivers through messenger services and a chatbot. METHODS This is a 3-arm cluster randomized controlled trial. In total, 2471 caregivers and their 3- to 9-month-old children were enrolled in the study across 164 study clusters in the San Marcos, Cajabamba, and Cajamarca provinces of Peru. Clusters of participants were randomly assigned to 1 of 3 groups: a control group (72 community clusters and 980 caregiver-child dyads), a home visit intervention group (20 community clusters and 316 caregiver-child dyads), and an Afini intervention group (72 community clusters and 1175 caregiver-child dyads). Families in the control group receive no focused ECD intervention. The home visit group is receiving biweekly home visits by a trained field staff following the national ECD program (Programa Nacional Cuna Más) curriculum and training guidelines. Caregivers in the Afini group are receiving ECD activities and advice through the digital platform. The primary study outcome is children's overall development at the age of 2.5 years, using the internationally validated long form of the Global Scales for Early Development. Secondary outcomes include caregiver engagement; caregiver mental health; screen time; as well as caregiver reports of children's motor, cognitive, language, and socioemotional development measured through locally piloted and validated tools. RESULTS Enrollment started in September 2021 and ended in March 2023. Endline assessments will take place between August 2023 and September 2024. CONCLUSIONS This study is, to our knowledge, the first to rigorously assess the effectiveness and cost-effectiveness of digital ECD technologies in LMICs. Given the large number of children in LMICs currently receiving only limited external support, the evaluated platform has the potential to improve the short- and long-term well-being of millions of children and their parents globally. TRIAL REGISTRATION ClinicalTrials.gov NCT05202106; https://clinicaltrials.gov/ct2/show/NCT05202106. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50371.
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Affiliation(s)
- Stella Maria Hartinger Pena
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Daniel Mäusezahl
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Lena Jäggi
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Leonel Aguilar
- Institute for Computing Platforms, Federal Institute of Technology Zurich, Zürich, Switzerland
| | | | | | | | - Kristen Hinckley
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Ce Zhang
- Institute for Computing Platforms, Federal Institute of Technology Zurich, Zürich, Switzerland
| | - Günther Fink
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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11
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Wu Y, Fenfen E, Wang Y, Xu M, Liu S, Zhou L, Song G, Shang X, Yang C, Yang K, Li X. Efficacy of internet-based cognitive-behavioral therapy for depression in adolescents: A systematic review and meta-analysis. Internet Interv 2023; 34:100673. [PMID: 37822787 PMCID: PMC10562795 DOI: 10.1016/j.invent.2023.100673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 08/31/2023] [Accepted: 09/19/2023] [Indexed: 10/13/2023] Open
Abstract
Objective Internet-based cognitive behavior therapy (ICBT) may provide an accessible alternative to face-to-face treatment, but the evidence base in adolescents is limited. This systematic review and meta-analysis aims to comprehensively assess the efficacy of ICBT in addressing depression among adolescents. Methods Four electronic databases were searched on June 8, 2023. Randomized controlled trials (RCTs) evaluating the efficacy of ICBT for depression in adolescents were included. The quality of the studies was assessed using the risk of bias tool recommended by the Cochrane Handbook. Furthermore, the GRADE approach was employed to gauge the certainty of the obtained evidence. Meta-analysis was conducted using RevMan 5.4, and Egger's test was implemented through Stata for assessment of potential publication bias. Results A total of 18 RCTs involving 1683 patients were included. In comparison to control groups like attention control, waiting list, and treatment as usual, our meta-analysis findings elucidate a significant reduction in depression scores (SMD = -0.42, 95 % CI: [-0.74, -0.11], p < .05) as well as anxiety scores (SMD = -0.34, 95 % CI: [-0.60, -0.08], p < .05) in adolescents following ICBT interventions. Furthermore, the analysis indicated no notable distinctions in patient's quality of life (QoL) scores. (SMD = 0.12, 95 % CI: [-0.10, 0.34], p > .05). Conclusion Results provide evidence of the efficacy of ICBT to reduce depressive and anxiety symptoms in adolescents. These research findings are of vital significance for the establishment of evidence-based treatment guidelines in the digital era. Trial registration PROSPERO registration: CRD42021277562.
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Affiliation(s)
- Yanan Wu
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - E Fenfen
- Qinghai university affiliated hospital
| | - Yan Wang
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - Meng Xu
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - Simin Liu
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Liying Zhou
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - Guihang Song
- Healthcare Security Administration of Gansu Province, Lanzhou 730000, China
| | - Xue Shang
- School of Public Health and Emergency Management, Southern University of Science and Technology
| | - Chaoqun Yang
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - Kehu Yang
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - Xiuxia Li
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
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12
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Moreira H, Góis AC, Pereira AM, Pereira B, Caiado B, Nepomuceno MI, Pereira AI. Parents' acceptability of blended psychological interventions for children with emotional disorders. Internet Interv 2023; 34:100687. [PMID: 38023966 PMCID: PMC10654020 DOI: 10.1016/j.invent.2023.100687] [Citation(s) in RCA: 1] [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] [Received: 02/20/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives This study aims to (1) describe parents' knowledge and use of online resources to address children's mental health issues and the family's general internet and technology usage patterns; (2) examine parents' acceptance of blended interventions for children with emotional disorders (ED); and (3) analyse the predictors of parents' intention to use a blended intervention if their children experienced an ED. Method The sample included 164 Portuguese parents (95.7 % mothers) of children between the ages of 6 and 13 years who completed an online survey. The study was disseminated through social networks, personal contacts of the researchers, and among parents participating in a randomized controlled trial investigating the efficacy of a psychological intervention for children with ED. Results Only 4.3 % of parents knew about online psychological interventions for children, and only 1.2 % had used them before. Most parents (73.2 %) reported that they would choose face-to-face individual therapy as their first option if their child had any ED, followed by blended therapy (14.8 %). Regression analyses showed that higher levels of parents' intention to use a blended intervention were predicted by their perceptions of the utility or efficacy of this type of delivery format. Discussion/conclusion These results suggest that although most parents show unfamiliarity with blended psychological interventions for children, they consider it a treatment modality to which they would resort if their children had emotional difficulties. Their intention to use such an intervention seems to be more likely if they perceive it as useful and effective.
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Affiliation(s)
- Helena Moreira
- University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Interventions, Faculty of Psychology and Educational Sciences, Portugal
| | - Ana Carolina Góis
- University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Interventions, Faculty of Psychology and Educational Sciences, Portugal
| | - Ana Maria Pereira
- University of Coimbra, Faculty of Psychology and Educational Sciences, Portugal
| | - Bárbara Pereira
- University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Interventions, Faculty of Psychology and Educational Sciences, Portugal
| | - Brígida Caiado
- University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Interventions, Faculty of Psychology and Educational Sciences, Portugal
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Online Behavioral Parenting Interventions for Disruptive Behavioral Disorders: A PRISMA Based Systematic Review of Clinical Trials. Child Psychiatry Hum Dev 2023; 54:379-396. [PMID: 34561755 DOI: 10.1007/s10578-021-01253-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2021] [Indexed: 10/20/2022]
Abstract
Behavioral parenting interventions (BPIs) are efficacious, evidence-based interventions for disruptive behavioral disorders in children. Technological advances have seen online adaptations of BPIs further increase efficacy and expand program reach. This systematic review examined the treatment outcomes of online BPIs. Our secondary aim was to examine which components of online BPIs are associated with beneficial child outcomes. Electronic databases were searched to identify randomized controlled trials of online BPIs for children with disruptive behavioral difficulties published between 2000 and 2020. Ten studies, reporting on nine different interventions, met inclusion criteria. The review indicated online BPIs are a viable treatment for disruptive behavioral disorders with nine of ten reporting significant improvements post-treatment. Effective interventions had clearly defined program structure and included content based on operant learning principles. Future research would benefit from greater detail when reporting intervention content, and regular assessment of progress through treatment against the delivery of specific program components.
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Jäggi L, Aguilar L, Alvarado Llatance M, Castellanos A, Fink G, Hinckley K, Huaylinos Bustamante ML, McCoy DC, Verastegui H, Mäusezahl D, Hartinger Pena SM. Digital tools to improve parenting behaviour in low-income settings: a mixed-methods feasibility study. Arch Dis Child 2023; 108:433-439. [PMID: 36977547 DOI: 10.1136/archdischild-2022-324964] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/17/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION Digital parenting interventions could be potentially cost-effective means for providing early child development services in low-income settings. This 5-month mixed-methods pilot study evaluated the feasibility of using Afinidata, a comprehensive Facebook Messenger-based digital parenting intervention in a remote rural setting in Latin America and explored necessary adaptations to local context. METHODS The study was conducted in three provinces in the Cajamarca region, Peru, from February to July 2021. 180 mothers with children aged between 2 and 24 months and regular access to a smartphone were enrolled. Mothers were interviewed three times in-person. Selected mothers also participated in focus groups or in-depth qualitative interviews. RESULTS Despite the rural and remote study site, 88% of local families with children between 0 and 24 months had access to internet and smartphones. Two months after baseline, 84% of mothers reported using the platform at least once, and of those, 87% rated it as useful to very useful. After 5 months, 42% of mothers were still active on the platform, with little variation between urban and rural settings. Modifications to the intervention focused on assisting mothers in navigating the platform independently and included adding a laminated booklet with general information on child development, sample activities and detailed instructions on how to self-enrol in case of lost phones. CONCLUSIONS We found high access to smartphones and the intervention was well received and used in very remote areas of Peru, suggesting that digital parenting interventions could be a promising path forward for supporting low-income families in remote parts of Latin America.
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Affiliation(s)
- Lena Jäggi
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Leonel Aguilar
- Department of Computer Science, ETH Zurich, Zurich, Switzerland
| | | | | | - Guenther Fink
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Kristen Hinckley
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | | | | | - Hector Verastegui
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Daniel Mäusezahl
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Stella Maria Hartinger Pena
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
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Childress S, Roberts A, LaBrenz CA, Findley E, Ekueku M, Baiden P. Exploring the lived experiences of women with children during COVID-19: Maternal stress and coping mechanisms. CHILDREN AND YOUTH SERVICES REVIEW 2023; 145:106775. [PMID: 36575706 PMCID: PMC9780639 DOI: 10.1016/j.childyouth.2022.106775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/20/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
This paper presents the results of a qualitative study of mothers' lived experiences during the COVID-19 lockdown in the United States. An analysis of open-ended interviews with 44 mothers who had children ages zero-to-five identified two main themes: (1) increased stress among mothers; and (2) resilience through the use of coping mechanisms. The findings indicate that the COVID-19 pandemic has led to higher stress among mothers due to issues of work-family life balance, family and children's needs, decision-making about getting sick, concerns for children's development, and lack of clarity from government officials. Mothers described using a variety of problem-focused and emotion-focused methods to cope with this stress. The lived experiences of mothers during the pandemic highlights the need for innovations in childcare modalities, paid leave policies to relieve stress, and strengthening whole family processes and resilience through the use of coping mechanisms.
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Affiliation(s)
- Saltanat Childress
- University of Texas-Arlington School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX 76019-0129, United States
| | - Alison Roberts
- University of Texas-Arlington School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX 76019-0129, United States
| | - Catherine A LaBrenz
- University of Texas-Arlington School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX 76019-0129, United States
| | - Erin Findley
- University of Texas-Arlington School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX 76019-0129, United States
| | - Modesty Ekueku
- University of Texas-Arlington School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX 76019-0129, United States
| | - Philip Baiden
- University of Texas-Arlington School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX 76019-0129, United States
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Bischops AC, Reinauer C, Pischke C, Mayatepek E, Meißner T. Strengthening the Resilience of Children and Adolescents during a Pandemic: A Scoping Review on Eligible Interventions. KLINISCHE PADIATRIE 2023; 235:13-22. [PMID: 35948048 DOI: 10.1055/a-1849-1355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The COVID-19 pandemic dramatically affects children's and adolescents' mental health. The accumulation of stress factors and a lack of social support complicate a healthy development. Since the beginning of the pandemic, there has been almost a doubling of mental health problems in children and adolescents. Promoting resilience is a possible approach to reduce the incidence of mental health problems despite these adverse circumstances. OBJECTIVES This literature search aims at identifying and evaluating interventions to promote resilience mechanisms, with a special focus on feasibility in a crisis situation. MATERIALS AND METHODS This scoping review is based on a systematic literature search including the databases Cochrane Library, PubMed, Psyc-Info, Psyndex and Google Scholar (2006-2020). Of 1733 identified articles 75 were included. RESULTS Out of 72 identified intervention studies 28% were feasible under pandemic conditions. The most effective resilience trainings seem to be individualized interventions using cognitive behavioral therapy elements. However, many approaches primarily show short-term success. DISCUSSION Few evidence-based programs are feasible online or under pandemic restrictions. Most of them show short-term effects and focus on parents and individuals. Multiple programs are ready for use, but still lack proof of efficacy. The development and improvement of (digital) resilience interventions should be an essential part of preventive health care, especially for risk groups. HINTERGRUND Die COVID-19-Pandemie beeinflusst die mentale Gesundheit von Kindern und Jugendlichen auf dramatische Weise. Durch eine Akkumulation von Belastungsfaktoren und das Wegfallen sozialer Unterstützung ist eine regelrechte Entwicklung erschwert. Seit Beginn der Pandemie kam es nahezu zu einer Verdopplung der psychischen Auffälligkeiten. Die Förderung der Resilienz kann ein Ansatz sein, das Auftreten von psychischen Auffälligkeiten trotz dieser widrigen Umstände zu vermindern. ZIEL DER ARBEIT Ziel dieser Literaturrecherche ist die Identifikation und Bewertung von Interventionen zur Förderung von Resilienzmechanismen, mit Fokus auf die Durchführbarkeit unter Krisenbedingungen. MATERIAL UND METHODEN Dieses Scoping Review basiert auf einer systematischen Literaturrecherche der Datenbanken Cochrane Library, PubMed, Psyc-Info, Psyndex sowie Google Scholar (2006-2021). Von der insgesamt 1733 Artikel umfassenden Suche wurden 75 Artikel eingeschlossen. ERGEBNISSE Von 72 identifizierten Interventionsstudien sind 28% unter Pandemiebedingungen durchführbar. Die wirksamsten Resilienztrainings scheinen individualisierte Interventionen mit Elementen der kognitiven Verhaltenstherapie zu sein. Viele Ansätze zeigen jedoch in erster Linie kurzfristige Erfolge. DISKUSSION Nur wenige evidenzbasierte Programme sind online oder unter Pandemiebedingungen verfügbar. Die meisten von ihnen zeigen kurzfristige Effekte und konzentrieren sich auf Eltern und Einzelpersonen. Zahlreiche Programme sind nutzbar, allerdings fehlt häufig ein Evidenznachweis. Die Entwicklung und Verbesserung von (digitalen) Resilienzmaßnahmen sollte ein wesentlicher Bestandteil der präventiven Gesundheitsversorgung sein, insbesondere für Risikogruppen.
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Affiliation(s)
- Anne Christine Bischops
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, Medical Faculty, Heinrich-Heine-University, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Christina Reinauer
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, Medical Faculty, Heinrich-Heine-University, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Claudia Pischke
- Institute of Medical Sociology, Universitätsklinikum Düsseldorf Centre for Health and Society, Dusseldorf, Germany
| | - Ertan Mayatepek
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, Medical Faculty, Heinrich-Heine-University, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Thomas Meißner
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, Medical Faculty, Heinrich-Heine-University, Düsseldorf University Hospital, Düsseldorf, Germany
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Horn K, Schoenberg N, Rose S, Romm K, Berg C. Tobacco use among Appalachian adolescents: An urgent need for virtual scale out of effective interventions. Tob Prev Cessat 2022; 8:39. [DOI: 10.18332/tpc/155331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 10/05/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
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Yoon S, Choi S. Stress-related to COVID-19, anxiety, and protective factors among middle-aged and older adults in the largest outbreak areas in South Korea. Aging Ment Health 2022; 26:2090-2099. [PMID: 34935533 DOI: 10.1080/13607863.2021.2017850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The present study examined the impact of psychological stress related to COVID-19 on anxiety as well as protective factors against these negative psychological consequences among middle-aged and older adults in the largest outbreak areas in South Korea. METHOD Participants included 667 middle-aged and older adults (ages 40 to 76) living in the largest outbreak areas at the time of the survey based on the number of confirmed COVID-19 cases in South Korea. Path analysis was conducted. RESULTS Stress related to COVID-19 and loneliness were positively associated with anxiety. However, family cohesion, resilience, health, and being married were negatively associated with anxiety. Also, family cohesion, resilience, income, and being married were negatively associated with loneliness among middle-aged and older adults in the largest outbreak areas in South Korea. CONCLUSION As postulated by the Stress Process Model, stress related to COVID-19 may have increased loneliness and anxiety among middle-aged and older adults in the largest outbreak areas in South Korea; however, resilience and family cohesion reduced these negative consequences both directly and indirectly. Findings are discussed and implications are addressed.
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Sit SMM, Lai AYK, Kwok TO, Wong HW, Wong YL, Chow E, Kwok YK, Wang MP, Ho SY, Lam TH. Development and evaluation of two brief digital health promotion game booths utilizing augmented reality and motion detection to promote well-being at a gerontechnology summit in Hong Kong. Front Public Health 2022; 10:923271. [PMID: 36211703 PMCID: PMC9539530 DOI: 10.3389/fpubh.2022.923271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/07/2022] [Indexed: 01/22/2023] Open
Abstract
Background The acceleration of population aging calls for simple and effective interventions catered for older people. Gerontechnology, the combination of gerontology and technology, can promote quality of life in older adults. However, public health-related events incorporating information communication technology (ICT) for older people have seldom been evaluated. Objective We reported the development and evaluation of two simple and brief digital health promotion games hosted at the annual Hong Kong Gerontech and Innovation Expo cum Summit (GIES) in 2018 and 2019 to promote well-being. Methods Two game booths (Dinosaur Augmented Reality photo-taking in 2018, Sit-and-Stand fitness challenge in 2019) were designed by our interdisciplinary team. Four gaming technologies were employed: augmented reality, chroma key (green screen), motion detection and 3D modeling. Immediately after the game, we administered a brief questionnaire survey to assess participant satisfaction, happiness and perceived benefits, and collected qualitative data through observations and informal interviews. Results Majority of 1,186 and 729 game booth participants in 2018 and 2019, respectively, were female (73.4% and 64.7%) and older adults (65.5 and 65.2%). Overall satisfaction toward the game booths was high (4.64 ± 0.60 and 4.54 ± 0.68 out of 5), with females and older adults reporting higher scores. Average personal and family happiness of participants in 2018 were 8.2 and 8.0 (out of 10). 90.3 and 18.4% of participants in 2019 chose one or more personal (e.g. enhance healthy living habits 62.4%, enhance personal happiness 61.6%) and family (e.g. enhance family happiness 15.6%, improve family relationships 10.8%) benefits of the game booth, respectively. Participants showed enthusiasm toward the technologies, and pride in their physical abilities in the fitness challenge. Conclusion Our report on the development and evaluation of brief game interventions with ICT showed high satisfaction and immediate perceived benefits in community participants. Females and older adults reported higher satisfaction. Simple tools measuring happiness and perceived benefits showed positive results. Older adults were receptive and enthusiastic about the new technologies. Our findings can inform researchers and organizers of similar events. More research on simple and enjoyable ICT interventions is needed to attract older adults and promote their well-being. Trial registration The research protocol was registered at the National Institutes of Health (Identifier number: NCT03960372) on May 23, 2019.
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Affiliation(s)
- Shirley Man-Man Sit
- School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Agnes Yuen-Kwan Lai
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Tai-On Kwok
- Technology-Enriched Learning Initiative, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Hoi-Wa Wong
- School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Yiu-Lun Wong
- Technology-Enriched Learning Initiative, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Edward Chow
- Technology-Enriched Learning Initiative, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Yu-Kwong Kwok
- Technology-Enriched Learning Initiative, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Man-Ping Wang
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Sai-Yin Ho
- School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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20
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Migliorini C, Lam DSM, Harvey C. Supporting family and friends of young people with mental health issues using online technology: A rapid scoping literature review. Early Interv Psychiatry 2022; 16:935-957. [PMID: 34729912 DOI: 10.1111/eip.13230] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/20/2021] [Accepted: 10/19/2021] [Indexed: 12/25/2022]
Abstract
AIM Family and friends are often the first and/or only support options used by young people (12-25 years) struggling with mental health issues. The overarching aim of this literature review is to map current practice in online interventions specifically targeting family and friends of young people with mental health issues, especially relevant in light of the current worldwide COVID-19 pandemic. METHODS A rapid scoping literature review was conducted searching health and psychology databases for online interventions targeting family and friends supporting a young person (12-25 years) struggling with a mental health issue. The search strategy was comprehensive and expert librarian endorsed. The final synthesis comprised 13 articles. RESULTS Identified articles were few, reporting a disparate range of research aims, intervention content and delivery modes. Studies addressing caregivers of adolescents with a mental health diagnosis were small-scale, although suggested virtual modalities are positively received and viable alternatives to other delivery methods with potential for equivalent outcomes. Five randomized control trials involving caregivers of 'at-risk' adolescents reported improved parental knowledge, but mixed effects on family functioning. CONCLUSIONS Preliminary evidence suggests flexible online options including professional and peer support, to respond to carers' busy lives are needed to maximize benefits. Content that is sufficiently individualized and targeted to address the diverse needs of parents, as well as other caregivers, is also required. Well-being and self-care, in addition to parenting skills should be given more consideration in online interventions. Examination of the value of support from peers is also warranted.
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Affiliation(s)
- Christine Migliorini
- Psychosocial Research Centre, NorthWestern Mental Health Service, Coburg, Victoria, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Carol Harvey
- Psychosocial Research Centre, NorthWestern Mental Health Service, Coburg, Victoria, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
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21
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Connor C, Mbh Y, Warwick J, Birchwood M, De Valliere N, Madan J, Melvin GA, Padfield E, Patterson P, Petrou S, Raynes K, Stewart-Brown S, Thompson A. An online parenting intervention to prevent affective disorders in high-risk adolescents: the PIPA trial protocol. Trials 2022; 23:655. [PMID: 35971178 PMCID: PMC9376903 DOI: 10.1186/s13063-022-06563-8] [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: 03/22/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescent depression can place a young person at high risk of recurrence and a range of psychosocial and vocational impairments in adult life, highlighting the importance of early recognition and prevention. Parents/carers are well placed to notice changes in their child's emotional wellbeing which may indicate risk, and there is increasing evidence that modifiable factors exist within the family system that may help reduce the risk of depression and anxiety in an adolescent. A randomised controlled trial (RCT) of the online personalised 'Partners in Parenting' programme developed in Australia, focused on improving parenting skills, knowledge and awareness, showed that it helped reduce depressive symptoms in adolescents who had elevated symptom levels at baseline. We have adapted this programme and will conduct an RCT in a UK setting. METHODS In total, 433 family dyads (parents/carers and children aged 11-15) will be recruited through schools, social media and parenting/family groups in the UK. Following completion of screening measures of their adolescent's depressive symptoms, parents/carers of those with elevated scores will be randomised to receive either the online personalised parenting programme or a series of online factsheets about adolescent development and wellbeing. The primary objective will be to test whether the personalised parenting intervention reduces depressive symptoms in adolescents deemed at high risk, using the parent-reported Short Mood & Feelings Questionnaire. Follow-up assessments will be undertaken at 6 and 15 months and a process evaluation will examine context, implementation and impact of the intervention. An economic evaluation will also be incorporated with cost-effectiveness of the parenting intervention expressed in terms of incremental cost per quality-adjusted life year gained. DISCUSSION Half of mental health problems emerge before mid-adolescence and approximately three-quarters by mid-20s, highlighting the need for effective preventative strategies. However, few early interventions are family focused and delivered online. We aim to conduct a National Institute for Health and Care Research (NIHR) funded RCT of the online personalised 'Partners in Parenting' programme, proven effective in Australia, targeting adolescents at risk of depression to evaluate its effectiveness, cost-effectiveness and usability in a UK setting. TRIAL REGISTRATION {2A}: ISRCTN63358736 . Registered 18 September 2019.
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Affiliation(s)
- C Connor
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK.
| | - Yap Mbh
- Monash University, Melbourne, Australia
| | - J Warwick
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - M Birchwood
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - N De Valliere
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - J Madan
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | | | - E Padfield
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - P Patterson
- Birmingham Women's & Children's NHS Foundation Trust, Birmingham, UK
| | - S Petrou
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - K Raynes
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - S Stewart-Brown
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - A Thompson
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
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22
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Marinova N, Rogers T, MacBeth A. Predictors of adolescent engagement and outcomes - A cross-sectional study using the togetherall (formerly Big White Wall) digital mental health platform. J Affect Disord 2022; 311:284-293. [PMID: 35588912 DOI: 10.1016/j.jad.2022.05.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Online mental health platforms can improve access to, and use of, mental health support for young people who may find it difficult to engage with face-to-face delivery. OBJECTIVE We modelled predictors of engagement and symptom change in adolescent users of the Togetherall (formerly "Big White Wall") anonymous digital mental health peer-support platform. METHODS We report a retrospective analysis of longitudinal user data from UK 16-18 year Togetherall users, referred from mental health services (N = 606). Baseline demographics were reported for participants who logged anxiety and depression measures. Number of log-ins, mean session duration, total usage time, number of guided support courses and self-help materials accessed were our usage metrics. Participant characteristics and symptoms were used to predict engagement. For n = 245 users with symptom measures at >1 timepoint we modelled the effect of predictors on symptom scores. RESULTS Mean logins was 5.11 and mean usage time was 64.22 mins. Participants with one log-in represented 33.5% of the sample. Total time accessing Togetherall predicated greater usage of self-help materials and courses. Females made greater use of materials and courses than males. In a subsample, higher baseline depression and anxiety, longer total usage time and mean session duration predicted final depression scores, whereas higher baseline depression and anxiety and greater accessed self-help materials predicted lower final anxiety scores. LIMITATIONS A naturalistic design was used and symptom modelling should be interpreted with caution. CONCLUSIONS Findings suggest adolescents can engage with the Togetherall platform. Baseline symptoms and characteristics can inform user engagement with digital platforms.
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Affiliation(s)
| | - Tim Rogers
- Togetherall (formerly Big White Wall), UK
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23
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Ivlev I, Beil TL, Haynes JS, Patnode CD. Rapid Evidence Review of Digital Cognitive-Behavioral Therapy for Adolescents With Depression. J Adolesc Health 2022; 71:14-29. [PMID: 35256238 DOI: 10.1016/j.jadohealth.2022.01.220] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/08/2021] [Accepted: 01/15/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE We conducted a rapid evidence review to explore the benefits and harms of digital cognitive-behavioral therapy (dCBT) and the barriers to and facilitators of implementing dCBT for adolescents. METHODS We searched MEDLINE, PsycINFO, CENTRAL through December 6, 2021, for controlled trials conducted in settings highly applicable to the United States. Additionally, we searched relevant systematic reviews for eligible studies. Results were summarized qualitatively. RESULTS We included 12 trials (n = 1,575) that examined the effects of nine dCBT programs. Overall, dCBT was slightly superior to comparators in improving depression symptoms immediately post-intervention, but not at a longer follow-up. The use of dCBT did not appear to result in an increased risk for suicidal attempts or ideation; however, the number of events was very small. Potential barriers to implementing/maintaining dCBT are challenges engaging/retaining patients, developing infrastructure, and training therapists to facilitate dCBT. Data on harms or unintended negative consequences were not reported in the included studies. CONCLUSIONS A limited body of evidence suggests that dCBT programs might outperform control interventions for reducing depressive symptoms immediately post-intervention, but not at a longer follow-up. The safety of dCBT programs for adolescents with depression is understudied.
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Affiliation(s)
- Ilya Ivlev
- Kaiser Permanente, Kaiser Permanente Evidence-based Practice Center, Portland, Oregon.
| | - Tracy L Beil
- Kaiser Permanente, Kaiser Permanente Evidence-based Practice Center, Portland, Oregon
| | - Jill S Haynes
- Kaiser Permanente, Kaiser Permanente Care Management Institute, Oakland, California
| | - Carrie D Patnode
- Kaiser Permanente, Kaiser Permanente Evidence-based Practice Center, Portland, Oregon
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24
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Khor SPH, Fulgoni CM, Lewis D, Melvin GA, Jorm AF, Lawrence K, Bei B, Yap MBH. Short-term outcomes of the Therapist-assisted Online Parenting Strategies intervention for parents of adolescents treated for anxiety and/or depression: A single-arm double-baseline trial. Aust N Z J Psychiatry 2022; 56:695-708. [PMID: 34231423 DOI: 10.1177/00048674211025695] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study aimed to evaluate whether the Therapist-assisted Online Parenting Strategies programme increased parenting behaviours known to be supportive of adolescents experiencing anxiety and/or depression. Secondary parenting outcomes of parental self-efficacy, parental accommodation, carer burden, parent-adolescent attachment, family functioning and parent distress were also examined, along with adolescent outcomes of anxiety and depression symptoms, suicidal ideation and sleep. METHOD Seventy-one parents (94.4% females) and their adolescents (73.2% females) aged 12-18 years (Mean = 15.02, SD = 1.56) being treated for depression and/or anxiety in Australia were recruited into a single-arm double-baseline open-label trial. Parents received Therapist-assisted Online Parenting Strategies, which comprised up to nine web-based modules each supplemented with coaching sessions via videoconferencing. Outcomes were analysed using latent growth curve modelling to determine if changes to outcomes at post-intervention (4 month post-second baseline) exceeded changes between two baselines measured 1 month apart. RESULTS Sixty-five parents (91.6%) completed at least one module of the online parenting intervention and on average received nine coaching sessions (SD = 2). Parenting behaviours targeted by Therapist-assisted Online Parenting Strategies improved at post-intervention (Cohen's d = 1.16, 95% confidence interval [0.78, 1.51]). Parent-reported parental self-efficacy and parent-adolescent attachment increased (Cohen's d = 1.44 [1.05, 1.82] and 0.39 [0.05, 0.74], respectively), while impairments to family functioning and parent distress decreased (Cohen's d = -0.51 [-0.86, -0.16] and -0.84 [-1.23, -0.44], respectively). Changes to adolescent anxiety, depression and sleep were not significant. CONCLUSION The Therapist-assisted Online Parenting Strategies intervention improved self-reported parenting behaviours, parental self-efficacy, parent levels of distress, parent-adolescent attachment, and family functioning in parents with adolescents being treated for anxiety and/or depression. However, significant changes in adolescent mental health and sleep outcomes at post-intervention were not observed. The usefulness of a therapist-supported online parenting programme in addressing a service gap for parents seeking professional help is indicated. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry Number (ACTRN) 12618000290291, prospectively registered on 26 February 2018; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368031.
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Affiliation(s)
- Sarah Pheik Hoon Khor
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Catherine Margaret Fulgoni
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Deborah Lewis
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Glenn A Melvin
- School of Psychology, Deakin University, Melbourne, VIC, Australia.,Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - Anthony F Jorm
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Katherine Lawrence
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Bei Bei
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Marie Bee Hui Yap
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia.,School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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25
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Canário AC, Byrne S, Creasey N, Kodyšová E, Kömürcü Akik B, Lewandowska-Walter A, Modić Stanke K, Pećnik N, Leijten P. The Use of Information and Communication Technologies in Family Support across Europe: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031488. [PMID: 35162511 PMCID: PMC8834894 DOI: 10.3390/ijerph19031488] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/15/2022] [Accepted: 01/24/2022] [Indexed: 02/05/2023]
Abstract
The COVID-19 pandemic has accelerated the use of information and communication technology (ICT) to deliver parenting and mental health support services to families. This narrative review illustrates the diverse ways in which ICT is being used across Europe to provide family support to different populations. We distinguish between the use of ICT in professional-led and peer-led support and provide implementation examples from across Europe. We discuss the potential advantages and disadvantages of different ways of using ICT in family support and the main developments and challenges for the field more generally, guiding decision-making as to how to use ICT in family support, as well as critical reflections and future research on its merit.
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Affiliation(s)
- Ana Catarina Canário
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal
- Correspondence:
| | - Sonia Byrne
- Department of Evolutionary and Educational Psychology, University of La Laguna, 38200 San Cristóbal de La Laguna, Spain;
| | - Nicole Creasey
- Research Institute of Child Development and Education, University of Amsterdam, 1018 WS Amsterdam, The Netherlands; (N.C.); (P.L.)
| | | | - Burcu Kömürcü Akik
- Department of Psychology, Faculty of Languages and History-Geography, Ankara University, 06100 Ankara, Turkey;
| | | | - Koraljka Modić Stanke
- Department of Social Work, Faculty of Law, University of Zagreb, 10000 Zagreb, Croatia; (K.M.S.); (N.P.)
| | - Ninoslava Pećnik
- Department of Social Work, Faculty of Law, University of Zagreb, 10000 Zagreb, Croatia; (K.M.S.); (N.P.)
| | - Patty Leijten
- Research Institute of Child Development and Education, University of Amsterdam, 1018 WS Amsterdam, The Netherlands; (N.C.); (P.L.)
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26
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Van Meter A, Agrawal N. LovesCompany: evaluating the safety and feasibility of a mental health-focused online community for adolescents. J Child Adolesc Ment Health 2022; 34:83-100. [PMID: 38504652 DOI: 10.2989/17280583.2023.2283030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Background: Adolescents are at risk for mental health (MH) disorders but are unlikely to seek services and may be reluctant to talk about their MH. An anonymous, online MH-focused community could help reduce suffering. However, online forums can also promote negative behaviours such as cyberbullying. This study aimed to evaluate the safety and feasibility of an online community - LovesCompany - to improve MH outcomes for adolescents.Methods: American adolescents (14-17 years) were recruited through social media. Eligible participants were randomised to LovesCompany or a placebo MH resource site. Outcomes were assessed every other week for six months, and at twelve months. Multilevel models assessed group differences in depression, anxiety, and suicidal ideation. A subgroup of participants participated in qualitative interviews.Results: Participants (N = 202) were mostly female (70%), White non-Hispanic (69%), and cisgender (80%). There were no instances of inappropriate behaviour such as bullying or posting explicit content. Symptoms for both groups improved over time. Participants appreciated hearing others' experiences and valued the opportunity to offer support.Conclusion: Although adolescents are often resistant to MH treatment, they appear to be interested in anonymous, online, MH-focused conversation, and can benefit from giving and seeking support. Finding a balance between an appealing user experience, ethical considerations, and resource needs is challenging.
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Affiliation(s)
- Anna Van Meter
- Department of Child and Adolescent Psychiatry, Grossman School of Medicine, New York University Langone Health, New York, USA
- Feinstein Institutes for Medical Research, Institute for Behavioral Science, Manhasset, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, USA
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA
| | - Neha Agrawal
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA
- Community West Treatment Center, Los Angeles, USA
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27
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Chu JTW, Wadham A, Jiang Y, Stasiak K, Shepherd M, Bullen C. Recruitment and Retention of Parents of Adolescents in a Text Messaging Trial (MyTeen): Secondary Analysis From a Randomized Controlled Trial. JMIR Pediatr Parent 2021; 4:e17723. [PMID: 34932007 PMCID: PMC8726057 DOI: 10.2196/17723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 08/05/2020] [Accepted: 05/19/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Parenting programs are well established as an effective strategy for enhancing both parenting skills and the well-being of the child. However, recruitment for family programs in clinical and nonclinical settings remains low. OBJECTIVE This study aims to describe the recruitment and retention methods used in a text messaging program (MyTeen) trial for parents of adolescents (10-15 years) and identify key lessons learned. We aim to provide insights and direction for researchers who seek to recruit parents and build on the limited literature on recruitment and retention strategies for parenting program trials. METHODS A recruitment plan was developed, monitored, and modified as needed throughout the course of the project. Strategies to facilitate recruitment were identified (eg, program content and recruitment material, staff characteristics, and study procedures). Traditional and web-based recruitment strategies were used. RESULTS Over a 5-month period, 319 parents or caregivers expressed interest in our study, of which 221 agreed to participate in the study, exceeding our recruitment target of 214 participants. Attrition was low at the 1-month (4.5% overall; intervention group: n=5, 4.6%; control group: n=5, 4.5%) and 3-month follow-ups (9% overall; intervention group: n=10, 9.2%; control group: n=10, 8.9%). CONCLUSIONS The use of web-based recruitment strategies appeared to be most effective for recruiting and retaining parents in a text-messaging program trial. However, we encountered recruitment challenges (ie, underrepresentation of ethnic minority groups and fathers) similar to those reported in the literature. Therefore, efforts to engage ethnic minorities and fathers are needed. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12618000117213; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374307.
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Affiliation(s)
- Joanna Ting Wai Chu
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Angela Wadham
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | | | - Christopher Bullen
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
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28
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Sullivan ADW, Forehand R, Acosta J, Parent J, Comer JS, Loiselle R, Jones DJ. COVID-19 and the Acceleration of Behavioral Parent Training Telehealth: Current Status and Future Directions. COGNITIVE AND BEHAVIORAL PRACTICE 2021; 28:618-629. [PMID: 34629838 PMCID: PMC8488182 DOI: 10.1016/j.cbpra.2021.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/12/2021] [Accepted: 06/19/2021] [Indexed: 02/01/2023]
Abstract
The SARS-COV-2 (COVID-19) pandemic and associated social distancing guidelines have accelerated the telehealth transition in mental health. For those providing Behavioral Parent Training (BPT), this transition has called for moving sessions that are traditionally clinic-based, active, and directive to engaging, supporting, and treating families of children with behavior disorders remotely in their homes. Whereas many difficulties accompany this transition, the lessons learned during the current public health crisis have the potential to transform BPT service delivery on a large scale in ways that address many of its long-standing limitations. We describe both challenges and opportunities and consider the possibilities inherent in a large scale BPT service delivery model capable of increasing the reach and impact of evidence-based treatment for all families.
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Affiliation(s)
| | | | - Juliana Acosta
- Center for Children and Families, Florida International University
| | - Justin Parent
- Center for Children and Families, Florida International University
| | - Jonathan S Comer
- Center for Children and Families, Florida International University
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29
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Marzilli E, Cerniglia L, Tambelli R, Trombini E, De Pascalis L, Babore A, Trumello C, Cimino S. The COVID-19 Pandemic and Its Impact on Families' Mental Health: The Role Played by Parenting Stress, Parents' Past Trauma, and Resilience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11450. [PMID: 34769967 PMCID: PMC8583183 DOI: 10.3390/ijerph182111450] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/18/2021] [Accepted: 10/27/2021] [Indexed: 11/25/2022]
Abstract
International research has evidenced the psychological impact of the COVID-19 pandemic on families, and the key role played by parenting stress levels. Although significant associations with parents' past trauma and resilience have been shown, this study aimed to explore their complex interplay on the relationship between parents' peritraumatic distress due to COVID-19, parenting stress, and children's psychopathological difficulties. We recruited 353 parents with children aged two to 16 years via an online survey during the Italian second wave of COVID-19. Parents' peritraumatic distress due to COVID-19, parenting stress, past trauma and resilience, and children's psychological difficulties were assessed through self-report and report-form questionnaires. Parents' past traumas significantly predicted peritraumatic distress due to COVID-19 and children's psychological difficulties. The relationship between past traumas and children's psychological difficulties was serial mediated by parents' peritraumatic distress and parenting stress. Direct and total effects of parent's resilience on parent's peritraumatic distress were not significant, but there were significant indirect effects via parenting stress and via parents' peritraumatic distress and parenting stress, indicating inconsistent mediation. This study evidenced the key risk and protective role played by, respectively, parents' past traumas exposure and resilience on the relationship between parents' psychological difficulties due to COVID-19, parenting stress, and children's psychological difficulties, with important clinical implications.
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Affiliation(s)
- Eleonora Marzilli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, 00186 Rome, Italy; (E.M.); (R.T.)
| | - Luca Cerniglia
- Faculty of Psychology, International Telematic University Uninettuno, 00186 Rome, Italy;
| | - Renata Tambelli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, 00186 Rome, Italy; (E.M.); (R.T.)
| | - Elena Trombini
- Department of Psychology, University of Bologna, 40127 Bologna, Italy; (E.T.); (L.D.P.)
| | - Leonardo De Pascalis
- Department of Psychology, University of Bologna, 40127 Bologna, Italy; (E.T.); (L.D.P.)
| | - Alessandra Babore
- Laboratory of Dynamic Psychology, Department of Psychological Sciences, Health and Territory, Università degli Studi “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (A.B.); (C.T.)
| | - Carmen Trumello
- Laboratory of Dynamic Psychology, Department of Psychological Sciences, Health and Territory, Università degli Studi “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (A.B.); (C.T.)
| | - Silvia Cimino
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, 00186 Rome, Italy; (E.M.); (R.T.)
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Engagement during a Mixed In-Person and Remotely Delivered Psychological Intervention for Youth with Functional Abdominal Pain Disorders and Anxiety. CHILDREN 2021; 8:children8090775. [PMID: 34572207 PMCID: PMC8466519 DOI: 10.3390/children8090775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/19/2021] [Accepted: 08/31/2021] [Indexed: 12/02/2022]
Abstract
Functional abdominal pain disorders (FAPD) are common disabling pain conditions frequently associated with co-occurring mental health problems such as anxiety. Psychological therapies such as cognitive behavioral therapy (CBT) have been shown to be effective. Therefore, it is important to understand participant engagement (i.e., use of intervention tools) to such approaches, and if engagement impacts treatment response. The Aim to Decrease Anxiety and Pain Treatment (ADAPT) is an effective psychological treatment approach using a blend of in-person sessions and interventionist phone support with self-paced web modules to manage pain and anxiety. The current study used a mixed-methods approach to investigate micro-level and macro-level participant engagement during the ADAPT program. In-person/phone session attendance was high (>95%) although scheduling adjustments were common (25.5%). Varied levels of engagement with web tools were observed. Thematic analysis also revealed variability in patterns of use. Additionally, while participants indicated they generally understood how to use certain skills (e.g., problem solving, detective thinking), and these skills were effective in managing symptoms during treatment, these activities were generally underutilized. Further, participant engagement did not predict response to the ADAPT intervention. These findings are important as the demand for accessible psychotherapeutic tools to manage pain and anxiety is likely to remain high.
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Alonzi S, Park JE, Pagán A, Saulsman C, Silverstein MW. An Examination of COVID-19-Related Stressors among Parents. Eur J Investig Health Psychol Educ 2021; 11:838-848. [PMID: 34563074 PMCID: PMC8544229 DOI: 10.3390/ejihpe11030061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 11/16/2022] Open
Abstract
The circumstances of the COVID-19 pandemic have taken a psychological toll on parents. Thus, understanding the impact of these contextual stressors on parents is important to help inform the development of family-based health promotion interventions. The present study examined parents' perception of various sources of stress resulting from the COVID-19 pandemic. Participants (N = 294) completed an open-ended question about their primary source of stress during the pandemic, which we coded into one or more of the following categories: family, work, health, and finance. We used chi-square tests to determine whether gender, marital status, financial strain, and education level were significantly related to each of the four primary sources of stress. We found that female, married, and financially strained participants were more likely to report family-related stressors. Further, we found that participants who expressed concern over health-related stressors were more likely to have pre-existing health conditions. Finally, we found that single participants were more likely to express concerns over financial stressors. Our findings shed light on parental concerns following the pandemic and inform new research directions, clinical approaches, and policy issues at the individual, community, and societal levels.
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Affiliation(s)
- Sarah Alonzi
- Department of Psychology, Tulane University, New Orleans, LA 70118, USA;
| | - Jae eun Park
- Department of Psychology, Tulane University, New Orleans, LA 70118, USA;
| | - Angélica Pagán
- Department of Psychology, Loyola University, New Orleans, LA 70118, USA; (A.P.); (C.S.); (M.W.S.)
| | - Courtney Saulsman
- Department of Psychology, Loyola University, New Orleans, LA 70118, USA; (A.P.); (C.S.); (M.W.S.)
| | - Madison W. Silverstein
- Department of Psychology, Loyola University, New Orleans, LA 70118, USA; (A.P.); (C.S.); (M.W.S.)
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Harris M, Andrews K, Gonzalez A, Prime H, Atkinson L. Technology-Assisted Parenting Interventions for Families Experiencing Social Disadvantage: a Meta-Analysis. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 21:714-727. [PMID: 32415543 DOI: 10.1007/s11121-020-01128-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Technology-assisted interventions have been identified as a means to increase accessibility and enhance engagement of parenting programs. The current meta-analytic review examines the effectiveness of these interventions in families experiencing social disadvantage. A literature search was conducted spanning March 2007-June 2019. Nine studies met inclusion criteria (total of 864 participants) which included an evaluation of a parenting intervention for families with at least one of the following demographic challenges, low socioeconomic status, single parenthood, and/or young parenthood. Interventions (or a component of the intervention) were delivered by computer, cell phone, smartphone, and/or tablet. Data were organized into three categories: parental psychological well-being (e.g., self-esteem, social support), parenting (e.g., observed or self-reported parenting behavior), and child behavior (e.g., disruptive behavior). Effect sizes (Hedges' g) were calculated and moderators (i.e., contact with an interventionist, intervention length, publication year, % female parents, mean parent age, parental education, % minority, and child age) were examined through Q-statistics and meta-regression, as appropriate. Intervention showed a near-significant impact on parental psychological well-being (g = .35, p = .051). Furthermore, interventions that did not include direct contact with an interventionist showed no evidence of effectiveness (g = - .02); interventions that incorporated contact were significantly more effective (g = .68). In addition, intervention length moderated intervention effectiveness; shorter interventions yielded greater improvements in well-being, compared with longer interventions. Interventions were also associated with significant improvements in parenting (g = .38) and child behavior (g = .39). These findings provide support for the use of technology-assisted parenting interventions in populations experiencing social disadvantage.
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Affiliation(s)
- Madeleine Harris
- Graduate Neuroscience Program, McMaster University, Hamilton, ON, L8S 4K1, Canada.,Offord Centre for Child Studies, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Krysta Andrews
- Graduate Neuroscience Program, McMaster University, Hamilton, ON, L8S 4K1, Canada.,Offord Centre for Child Studies, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Andrea Gonzalez
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, L8S 4K1, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Heather Prime
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, L8S 4K1, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Leslie Atkinson
- Department of Psychology, Ryerson University, Toronto, ON, M5B 2K3, Canada.
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Laine A, Anttila M, Hirvonen H, Välimäki M. Feasibility of a Web-Based Psychoeducation Course and Experiences of Caregivers Living With a Person With Schizophrenia Spectrum Disorder: Mixed Methods Study. J Med Internet Res 2021; 23:e25480. [PMID: 33890862 PMCID: PMC8105764 DOI: 10.2196/25480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/23/2021] [Accepted: 03/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Schizophrenia is a severe mental illness that burdens both patients and caregivers. OBJECTIVE The aim of this study is to examine the feasibility of a web-based psychoeducation course targeted at caregivers of persons with schizophrenia spectrum disorders (SSDs) and to describe their experiences of living with a person with SSD based on the material caregivers produced during the web-based course. METHODS A convergent, parallel, mixed methods study design was used. First, caregivers' engagement in the course was evaluated quantitatively. Second, the overview of the course feedback was evaluated using quantitative and qualitative methods. Third, the experiences of being a caregiver to a person with SSD were analyzed qualitatively with the thematic analysis of the writings caregivers produced during the web-based course. RESULTS A total of 30 caregivers participated in the study and a web-based psychoeducation course. Less than two-thirds (18/30, 60%) completed the course. Content was most often logged for the first module, Orientation (3465 log-ins), and the lowest number of log-ins was recorded for the Daily life module (1061 log-ins). Feedback on the course varied; over half (10/17, 59%) of the caregivers considered the content to be very good or good, about half (9/17, 53%) considered the website layout to be good, only 6% (1/17) felt that the usability of the website was poor, and no one felt that it was very poor. From the reported experiences of being a caregiver to a person with SSD, 3 themes were formed: the caregiver's own well-being, relationship with the person with SSD, and experience of health care services. CONCLUSIONS The web-based psychoeducation course for caregivers living with a person with SSD seems to be especially suitable for those who have little experience as a caregiver. In the future, more planning and the consideration of aspects related to the needs of specific target groups, course content, practical arrangements, and scheduling should be taken into account. In addition, although caregivers can improve their own well-being in different ways, they need regular support and cooperation from health care professionals.
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Affiliation(s)
- Anna Laine
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Minna Anttila
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Heli Hirvonen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Online parent programs for children's behavioral problems: a meta-analytic review. Eur Child Adolesc Psychiatry 2020; 29:1555-1568. [PMID: 31925545 DOI: 10.1007/s00787-020-01472-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 01/05/2020] [Indexed: 10/25/2022]
Abstract
A recent increase in the development of online parent programs calls for the need to understand how effective these strategies are for improving children's mental health. We meta-analyzed the effects of online parent programs on children's behavioral problems. Moreover, we explored the combinations of program components to yield stronger program effects. Medline, PsycINFO, Web of Science, and the Cochrane Library were searched. We included peer-reviewed randomized studies evaluating the effect of an online parent program. Effect sizes (Hedges' g) were calculated from post intervention means and standard deviations. We used Qualitative Comparative Analysis (QCA) to identify pathways to effectiveness and individual content and delivery components that seem sufficient or necessary for yielding high effectiveness. Of 2941 articles, 12 articles with a total of 2025 participants met the inclusion criteria. Online parent programs have significant effects on children's behavioral problems (g = - 0.32; 95% CI, - 0.47 to - 0.17), emotional problems (g = - 0.22; 95% CI, - 0.31 to - 0.13), and parental mental health problems (g = - 0.30; 95% CI, - 0.42 to - 0.17). In the QCA, sending parents reminders to work on the program was the only one sufficient component. In conclusion, online support programs reduce children's behavioral and emotional problems and improve parental mental health. Sending parents reminders to work on the program seems to contribute to high effectiveness. Review Registration This study was registered with PROSPERO, number CRD42017080051.
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Marchetti D, Fontanesi L, Mazza C, Di Giandomenico S, Roma P, Verrocchio MC. Parenting-Related Exhaustion During the Italian COVID-19 Lockdown. J Pediatr Psychol 2020; 45:1114-1123. [PMID: 33068403 PMCID: PMC7665691 DOI: 10.1093/jpepsy/jsaa093] [Citation(s) in RCA: 159] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/08/2020] [Accepted: 09/12/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Worldwide, the coronavirus disease 2019 (COVID-19) pandemic has generated significant worry, uncertainty, anxiety, sadness, and loneliness. In Italy, these effects have been particularly pronounced. While research on the COVID-19 outbreak has mainly focused on the clinical features of infected patients and the psychological impact on the general population and health professionals, no investigation has yet assessed the psychological impact of the pandemic on parents. In the present research, we conducted a web-based survey of Italian parents to examine the prevalence of parenting-related exhaustion-and to identify its associated risk and protective factors-4 weeks into the lockdown. METHODS A total of 1,226 parents provided their consent to participate in the study and completed a demographic questionnaire, information relating to particular COVID-19 experiences, and measures of emotional exhaustion, parental resilience, social connections, and psychological distress during the lockdown. RESULTS Seventeen percent of our sample experienced significant parenting-related exhaustion, with mothers more severely affected. Multiple regression analyses showed that greater parenting-related exhaustion was predicted by psychological distress, lower parental resilience, motherhood, fewer perceived social connections, and being single, as well as having a child with special needs, having a large number of children, and having younger children. CONCLUSION The findings add further support to the call for preventive programs to support parents throughout the COVID-19 pandemic. Mental health professionals and social workers should be warned of the effects of lockdown and social distancing on parenting and, consequently, the well-being of children.
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Affiliation(s)
- Daniela Marchetti
- Department of Psychological, Health and Territorial Sciences, G. d’Annunzio University of Chieti-Pescara
| | - Lilybeth Fontanesi
- Department of Psychological, Health and Territorial Sciences, G. d’Annunzio University of Chieti-Pescara
| | - Cristina Mazza
- Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti-Pescara
| | - Serena Di Giandomenico
- Department of Psychological, Health and Territorial Sciences, G. d’Annunzio University of Chieti-Pescara
| | - Paolo Roma
- Department of Human Neuroscience, Sapienza University of Rome
| | - Maria Cristina Verrocchio
- Department of Psychological, Health and Territorial Sciences, G. d’Annunzio University of Chieti-Pescara
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Christ C, Schouten MJ, Blankers M, van Schaik DJ, Beekman AT, Wisman MA, Stikkelbroek YA, Dekker JJ. Internet and Computer-Based Cognitive Behavioral Therapy for Anxiety and Depression in Adolescents and Young Adults: Systematic Review and Meta-Analysis. J Med Internet Res 2020; 22:e17831. [PMID: 32673212 PMCID: PMC7547394 DOI: 10.2196/17831] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/23/2020] [Accepted: 06/21/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Anxiety and depressive disorders are prevalent in adolescents and young adults. However, most young people with mental health problems do not receive treatment. Computerized cognitive behavior therapy (cCBT) may provide an accessible alternative to face-to-face treatment, but the evidence base in young people is limited. OBJECTIVE The objective was to perform an up-to-date comprehensive systematic review and meta-analysis of the effectiveness of cCBT in treating anxiety and depression in adolescents and young adults compared with active treatment and passive controls. We aimed to examine posttreatment and follow-up effects and explore the moderators of treatment effects. METHODS We conducted systematic searches in the following six electronic databases: PubMed, EMBASE, PsycINFO, CINAHL, Web of Science, and Cochrane Central Register of Controlled Trials. We included randomized controlled trials comparing cCBT with any control group in adolescents or young adults (age 12-25 years) with anxiety or depressive symptoms. The quality of included studies was assessed using the Cochrane risk-of-bias tool for randomized trials, version 2.0. Overall quality of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Posttreatment means and SDs were compared between intervention and control groups, and pooled effect sizes (Hedges g) were calculated. Random-effects meta-analyses were conducted using Comprehensive Meta-Analysis software. Subgroup analyses and meta-regression analyses were conducted to explore whether age, guidance level, and adherence rate were associated with treatment outcome. RESULTS The search identified 7670 papers, of which 24 studies met the inclusion criteria. Most included studies (22/24) had a high risk of bias owing to self-report measures and/or inappropriate handling of missing data. Compared with passive controls, cCBT yielded small to medium posttreatment pooled effect sizes regarding depressive symptoms (g=0.51, 95% CI 0.30-0.72, number needed to treat [NNT]=3.55) and anxiety symptoms (g=0.44, 95% CI 0.23-0.65, NNT=4.10). cCBT yielded effects similar to those of active treatment controls regarding anxiety symptoms (g=0.04, 95% CI -0.23 to 0.31). For depressive symptoms, the nonsignificant pooled effect size favored active treatment controls (g=-0.70, 95% CI -1.51 to 0.11, P=.09), but heterogeneity was very high (I2=90.63%). No moderators of treatment effects were identified. At long-term follow-up, cCBT yielded a small pooled effect size regarding depressive symptoms compared with passive controls (g=0.27, 95% CI 0.09-0.45, NNT=6.58). No other follow-up effects were found; however, power was limited owing to the small number of studies. CONCLUSIONS cCBT is beneficial for reducing posttreatment anxiety and depressive symptoms in adolescents and young adults compared with passive controls. Compared with active treatment controls, cCBT yielded similar effects regarding anxiety symptoms. Regarding depressive symptoms, however, the results remain unclear. More high-quality research involving active controls and long-term follow-up assessments is needed in this population. TRIAL REGISTRATION PROSPERO CRD42019119725; https://tinyurl.com/y5acfgd9.
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Affiliation(s)
- Carolien Christ
- Department of Psychiatry, GGZ inGeest, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Research, Arkin Mental Health Care, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Maria Je Schouten
- Department of Research, Arkin Mental Health Care, Amsterdam, Netherlands
| | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Amsterdam, Netherlands
- Trimbos institute-The Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - Digna Jf van Schaik
- Department of Psychiatry, GGZ inGeest, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Aartjan Tf Beekman
- Department of Psychiatry, GGZ inGeest, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marike A Wisman
- Department of Youth and Family, Arkin Mental Health Care, Amsterdam, Netherlands
| | - Yvonne Aj Stikkelbroek
- Department of Child and Adolescent Studies, Universiteit Utrecht, Utrecht, Netherlands
- Depression Expert Center for Youth, Mental Health Care Oost-Brabant, Boekel, Netherlands
| | - Jack Jm Dekker
- Department of Research, Arkin Mental Health Care, Amsterdam, Netherlands
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Jansen R, Reid M. Communication Technology Use by Caregivers of Adolescents With Mental Health Issues: Systematic Review. JMIR Mhealth Uhealth 2020; 8:e13179. [PMID: 32663143 PMCID: PMC7468639 DOI: 10.2196/13179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 12/11/2019] [Accepted: 05/14/2020] [Indexed: 11/22/2022] Open
Abstract
Background Caregivers of adolescents with mental health issues experience challenges that may result in the caregivers having a variety of unmet needs. There is a growing need to support these caregivers. Effective support to strengthen positive caregiving behavior in caregivers may address their challenges. Communication technologies offer novel opportunities to assist these caregivers and may contribute to strengthening caregiver behavior. However, little is known about the use of communication technologies among caregivers of adolescents with mental health issues. Objective The study aimed to answer the question: “What is the best evidence available to strengthen positive behavior of caregivers of adolescents with mental health issues using communication technology.” Methods A systematic review of articles published between January 2007 and August 2018 was conducted. Searches included articles of multiple study designs from EBSCO Host and Scopus platforms with prespecified eligibility criteria. Methodological quality was evaluated using the applicable Critical Appraisal Skills Programme and Joanna Briggs Institute assessment tools. Results The search yielded 1746 articles. Altogether, 5 articles met the eligibility criteria and were included in the review for data synthesis. Data analysis and synthesis identified three thematic conclusions reflecting the types of communication technologies used, caregivers as the target population, and strengthening of positive behavior through determinants of the Integrated Model of Behavior Prediction. Conclusions The review reported the usefulness of communication technology by caregivers. Caregivers also demonstrated improvement in self-efficacy, knowledge, parent-child communication, and parental skills reflecting positive behavior. Although the use of communication technology is expanding as a supportive intervention to address caregivers’ needs, the evidence for usefulness among caregivers of adolescents with mental health issues is still scarce. More research and information related to preferred methods of communication delivery among caregivers of adolescents is still needed.
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Affiliation(s)
- Ronelle Jansen
- School of Nursing, Faculty of Health Science, University of the Free State, Bloemfontein, South Africa
| | - Marianne Reid
- School of Nursing, Faculty of Health Science, University of the Free State, Bloemfontein, South Africa
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Estrada Y, Lee TK, Wagstaff R, M Rojas L, Tapia MI, Velázquez MR, Sardinas K, Pantin H, Sutton MY, Prado G. eHealth Familias Unidas: Efficacy Trial of an Evidence-Based Intervention Adapted for Use on the Internet with Hispanic Families. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 20:68-77. [PMID: 29748900 DOI: 10.1007/s11121-018-0905-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
While substance use and sexual risk behaviors among Hispanic youth continue to be public health concerns, few evidence-based preventive interventions are developed for and implemented with Hispanic/Latino youth. The objective of this study was to evaluate the efficacy of eHealth Familias Unidas, an Internet adaptation of an evidence-based family intervention for Hispanics. A randomized controlled trial design (n = 230) was used to evaluate intervention effects on substance use and condomless sex among a sample of Hispanic eighth graders with behavioral problems. Participants were randomized to eHealth Familias Unidas (n = 113) or prevention as usual (n = 117) and assessed at baseline and 3 and 12 months post baseline. We trained mental health school personnel and community mental health professionals to recruit and deliver the Internet-based intervention with Hispanic families. It was hypothesized that, over time, eHealth Familias Unidas would be more efficacious than prevention as usual in reducing drug use (marijuana, cocaine, inhalants, and other drugs), prescription drug use, cigarette use, alcohol use, and condomless sex and that these changes would be mediated by family functioning. Significant intervention effects were found across time for drug use, prescription drug use, and cigarette use. While eHealth Familias Unidas positively affected family functioning, mediation effects were not found. This study demonstrated that family-based eHealth interventions can be efficacious among Hispanic populations when delivered in community settings.
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Affiliation(s)
- Yannine Estrada
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA.
| | - Tae Kyoung Lee
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Rachel Wagstaff
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Lourdes M Rojas
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Maria I Tapia
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Maria Rosa Velázquez
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Krystal Sardinas
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Hilda Pantin
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | - Madeline Y Sutton
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Guillermo Prado
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
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Chu JTW, Wadham A, Jiang Y, Whittaker R, Stasiak K, Shepherd M, Bullen C. Development of MyTeen Text Messaging Program to Support Parents of Adolescents: Qualitative Study. JMIR Mhealth Uhealth 2019; 7:e15664. [PMID: 31746767 PMCID: PMC6893562 DOI: 10.2196/15664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/30/2019] [Accepted: 09/02/2019] [Indexed: 12/02/2022] Open
Abstract
Background Parents play an important role in the lives of adolescents, and supporting and addressing the needs of families continue to be the focus of many researchers and policy makers. Mobile health interventions have great potential for supporting parents at a population level because of their broad reach and convenience. However, limited evidence exists for such interventions for parents of adolescents. This study reports on the formative work conducted with parents and/or primary caregivers to identify their needs and preferences for the development of MyTeen—an SMS text messaging program on promoting parental competence and mental health literacy for parents of adolescents (aged 10-15 years). Objective The aim of this qualitative study was to explore parents and/or primary caregivers’ perspectives around youth well-being, parenting, and parenting support and their input on the development of MyTeen SMS text messaging parenting intervention. Methods A total of 5 focus groups (n=45) were conducted with parents or primary caregivers of adolescents aged 10 to 15 years between October and December 2017 in New Zealand. A semistructured interview guideline and prompts were used. Data were audiotaped, transcribed, and analyzed using inductive thematic analysis. Results Participants were concerned about youth mental health (ie, stigma and increasing demand on adolescents), and a number of parenting challenges (ie, social expectations, time, impact of technology, changes in family communication pattern, and recognizing and talking about mental health issues) were noted. Importantly, participants reported the lack of services and support available for families, and many were not aware of services for parents themselves. A number of recommendations were given on the style, content, and frequency of developing the text messaging program. Conclusions Findings from this qualitative work informed the development of MyTeen, an SMS text messaging program designed to increase parental competence and improve mental health literacy for parents of adolescents.
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Affiliation(s)
- Joanna Ting Wai Chu
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Angela Wadham
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Robyn Whittaker
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | | | - Christopher Bullen
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
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Chu JTW, Wadham A, Jiang Y, Whittaker R, Stasiak K, Shepherd M, Bullen C. Effect of MyTeen SMS-Based Mobile Intervention for Parents of Adolescents: A Randomized Clinical Trial. JAMA Netw Open 2019; 2:e1911120. [PMID: 31509210 PMCID: PMC6739724 DOI: 10.1001/jamanetworkopen.2019.11120] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 07/23/2019] [Indexed: 11/24/2022] Open
Abstract
Importance There is global pressure to respond to the burden posed by adolescent mental health problems. The National Mental Health Commission has made a call for investment in mobile health services directed at prevention and early intervention to relieve the demand on targeted mental health services that are costly to provide. Parents and primary caregivers play a significant role in the lives of adolescents and are important targets for such efforts. Currently, there is no evidence for the effectiveness of programs delivered solely via text message for parents of adolescents. Objective To evaluate the effects of a text-messaging program (MyTeen) on promoting parental competence and mental health literacy for parents of adolescents. Design, Setting, and Participants A parallel 2-group randomized clinical trial was conducted in New Zealand. A total of 221 parents and primary caregivers of adolescents aged 10 to 15 years were recruited from March 19 to August 17, 2018, via community outreach and social media and were randomly allocated 1:1 into the control or the intervention group. Statistical analysis was performed on the principle of intention to treat with adjustment for baseline factors and ethnicity. Intervention A text-messaging program for parents of adolescents (age 10-15 years) to promote parental competence and mental health literacy. Participants received 1 daily text message over 4 weeks. Main Outcomes and Measures Parental competence, assessed at 1 month after randomization by the Parenting Sense of Competence Scale. Results In total, 221 participants (214 [96.8%] female) were randomized, 109 to the intervention group and 112 to the control group; 201 participants (91%) completed the trial at 3 months. Significant group difference was observed on the primary outcome at the end of 1 month of intervention, with participants reporting a higher level of parental competence than those in the control group (estimated mean difference, 3.33 points; 95% CI, 1.37-5.29 points; P = .002). Except for knowledge about mental health, all secondary outcomes were significant, including continued improvement in parental competence at 3 months (estimated mean difference, 4.08 points; 95% CI, 1.96-6.20 points; P < .001), knowledge of help seeking (estimated mean difference, 0.99 points; 95% CI, 0.49-1.50 points; P < .001), parental distress (estimated mean difference, -2.39 points; 95% CI, -4.37 to -0.40 points; P = .02), and parent-adolescent communication (estimated mean difference, 2.21 points; 95% CI, 0.48-3.95 points; P = .01), with participants in the intervention group reporting better parenting-related outcomes than the control group at 1 and 3 months after the intervention. Conclusions and Relevance This text-messaging program for parents of adolescents appears to be an effective and feasible way to facilitate the implementation and delivery of evidence-based information to populations that are not easily reached with other intervention modalities. The program can be easily scaled up for delivery as an early preventive intervention and may represent a less expensive option for service delivery. Trial Registration anzctr.org.au Identifier: ACTRN12618000117213.
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Affiliation(s)
- Joanna Ting Wai Chu
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Angela Wadham
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Robyn Whittaker
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | | | - Chris Bullen
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
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Flujas-Contreras JM, García-Palacios A, Gómez I. Technology-based parenting interventions for children's physical and psychological health: a systematic review and meta-analysis. Psychol Med 2019; 49:1787-1798. [PMID: 30977462 DOI: 10.1017/s0033291719000692] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Parenting interventions have important consequences for the wellbeing and emotional competences of parents and their children. Technology provides an opportunity with advantages for psychological intervention. The aim of this systematic review and meta-analysis is to analyze the characteristics and effectiveness of technology-based interventions for parents to promote children's physical health or psychological issues. METHODS We conducted a systematic review and meta-analysis for articles about parenting skills for prevention or treatment of children's physical or psychological concerns using technology. We explore the aim of the intervention with parents, kind of problem with children, intervention model, instruments, methodological quality, and risk of bias. A random-effects meta-analysis was conducted. RESULTS Twenty-four studies were included in the systematic review and a meta-analysis of 22 studies was performed to find out the effects of intervention depending on the kind of problem, intervention model, follow-up, type of intervention, type of control condition, and type of outcome data. Results show the usefulness of technology-based therapy for parenting interventions with moderate effect sizes for intervention groups with statistically significant differences from control groups. CONCLUSIONS Technology-based parenting programs have positive effects on parenting and emotional wellbeing of parents and children. Attendance and participation level in technology-based treatment increase compared with traditional parenting intervention.
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Affiliation(s)
| | - Azucena García-Palacios
- Department of Basic Psychology,Clinical and Psychobiology - Personality, Evaluation and Psychological Treatments,University Jaume I,Castellon,Spain
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Van Meter AR, Birnbaum ML, Rizvi A, Kane JM. Online help-seeking prior to diagnosis: Can web-based resources reduce the duration of untreated mood disorders in young people? J Affect Disord 2019; 252:130-134. [PMID: 30981056 PMCID: PMC6529208 DOI: 10.1016/j.jad.2019.04.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 02/26/2019] [Accepted: 04/07/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Mood and anxiety disorders typically begin in adolescence or early adulthood, but those at the age of highest risk are among those least likely to access mental health services. However, they may be more likely than other demographic groups to seek help online. The goal of the present study was to investigate the online help- and information-seeking activity of young people newly diagnosed with mood and anxiety disorders in order to better understand how digital resources might serve this population. METHOD Participants, aged 15 to 35, with a diagnosis of a mood or anxiety disorder were eligible if they had received their first mental health diagnosis within 24 months. Participants were interviewed with the Pathways to Care Questionnaire, which inquires about online activity prior to one's first interaction with mental healthcare providers. RESULTS Forty people participated (depression n = 30, bipolar disorder n = 5, generalized anxiety disorder n = 5); average age 21 years (SD=3.2), 60% female. Eighty-one percent reported seeking help and/or information about their symptoms online. The gap between symptom onset and in-person help seeking was 91.90 weeks (SD=133.7). Most participants (85%) reported they would be open to communicating with a mental health professional online. CONCLUSION A majority of young people experiencing clinically-significant symptoms seek help online. However, the gap between symptom onset and treatment initiation remains unacceptably long. Better strategies are needed to translate young people's interest in online resources into meaningful care, whether through web-based services or facilitated pathways to traditional treatment.
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Affiliation(s)
- Anna R. Van Meter
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA,Hofstra Northwell School of Medicine, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA,The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Michael L. Birnbaum
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA,Hofstra Northwell School of Medicine, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA,The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Asra Rizvi
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA
| | - John M. Kane
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA,Hofstra Northwell School of Medicine, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA,The Feinstein Institute for Medical Research, Manhasset, NY, USA
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43
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Grist R, Croker A, Denne M, Stallard P. Technology Delivered Interventions for Depression and Anxiety in Children and Adolescents: A Systematic Review and Meta-analysis. Clin Child Fam Psychol Rev 2019; 22:147-171. [PMID: 30229343 PMCID: PMC6479049 DOI: 10.1007/s10567-018-0271-8] [Citation(s) in RCA: 141] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Depression and anxiety are common during adolescence. Whilst effective interventions are available treatment services are limited resulting in many adolescents being unable to access effective help. Delivering mental health interventions via technology, such as computers or the internet, offers one potential way to increase access to psychological treatment. The aim of this systematic review and meta-analysis was to update previous work and investigate the current evidence for the effect of technology delivered interventions for children and adolescents (aged up to 18 years) with depression and anxiety. A systematic search of eight electronic databases identified 34 randomized controlled trials involving 3113 children and young people aged 6-18. The trials evaluated computerized and internet cognitive behavior therapy programs (CBT: n = 17), computer-delivered attention bias modification programs (ABM: n = 8) cognitive bias modification programs (CBM: n = 3) and other interventions (n = 6). Our results demonstrated a small effect in favor of technology delivered interventions compared to a waiting list control group: g = 0.45 [95% CI 0.29, 0.60] p < 0.001. CBT interventions yielded a medium effect size (n = 17, g = 0.66 [95% CI 0.42-0.90] p < 0.001). ABM interventions yielded a small effect size (n = 8, g = 0.41 [95%CI 0.08-0.73] p < 0.01). CBM and 'other' interventions failed to demonstrate a significant benefit over control groups. Type of control condition, problem severity, therapeutic support, parental support, and continuation of other ongoing treatment significantly influenced effect sizes. Our findings suggest there is a benefit in using CBT based technology delivered interventions where access to traditional psychotherapies is limited or delayed.
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Affiliation(s)
- Rebecca Grist
- Department for Health, University of Bath, 6.19 Wessex House, Bath, BA2 7AY, UK.
- School of Applied Social Science, University of Brighton, Mayfield House, Falmer, Brighton, BN1 9PH, UK.
| | - Abigail Croker
- Oxford Health NHS Foundation Trust, Child, and Adolescent Mental Health Service, Temple House, Keynsham, UK
| | - Megan Denne
- Oxford Health NHS Foundation Trust, Child, and Adolescent Mental Health Service, Temple House, Keynsham, UK
| | - Paul Stallard
- Department for Health, University of Bath, 6.19 Wessex House, Bath, BA2 7AY, UK
- Oxford Health NHS Foundation Trust, Child, and Adolescent Mental Health Service, Temple House, Keynsham, UK
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Van Meter A, Cosgrove VE. Overhauling technology-based interventions for young people with bipolar disorder: Lessons learned from adults. Bipolar Disord 2019; 21:86-87. [PMID: 30387928 DOI: 10.1111/bdi.12716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Anna Van Meter
- The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Glen Oaks, New York
| | - Victoria E Cosgrove
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California
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45
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Chu JTW, Whittaker R, Jiang Y, Wadham A, Stasiak K, Shepherd M, Bullen C. Evaluation of MyTeen - a SMS-based mobile intervention for parents of adolescents: a randomised controlled trial protocol. BMC Public Health 2018; 18:1203. [PMID: 30367613 PMCID: PMC6204020 DOI: 10.1186/s12889-018-6132-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 10/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parents play an important role in the lives of adolescents and efforts aimed at strengthening parenting skills and increasing knowledge on adolescent development hold much promise to prevent and mitigate adolescent mental health problems. Innovative interventions that make use of technology-based platforms might be an effective and efficient way to deliver such support to parents. This protocol presents the design of a randomised controlled trial to investigate the effectiveness of a SMS-based mobile intervention (MyTeen) for parents of adolescents on promoting parental competence and mental health literacy. METHODS A parallel two-arm randomised controlled trial will be conducted in New Zealand, aiming to recruit 214 parents or primary caregivers of adolescents aged 10-15 years via community outreach and social media. Eligible participants will be allocated 1:1 into the control or the intervention group, stratified by ethnicity. The intervention group will receive a tailored programme of text messages aimed at improving their parental competence and mental health literacy, over 4 weeks. The control group (care-as-usual) will receive no intervention from the research team, but can access alternative services if they wish, and will be offered the intervention programme upon completion of a 3-month post-randomisation follow-up assessment. Data will be obtained at baseline, post intervention (1-month), and 3-month follow up. The primary outcome is parental competence assessed by the Parental Sense of Competence Scale at 1-month follow up. Secondary outcomes include: mental health literacy; knowledge of help-seeking; parental distress; parent-adolescent communication; and programme satisfaction. DISCUSSION To our knowledge this is the first randomised controlled trial on the effectiveness of delivering a parenting support intervention for parents of adolescents solely via a SMS-based mobile intervention. If effective, it could have great potential to reach and support parents of adolescents. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry ( ACTRN12618000117213 ) Registered on 29/01/2018.
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Affiliation(s)
- Joanna Ting Wai Chu
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Robyn Whittaker
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Angela Wadham
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Matthew Shepherd
- School of Counselling, Human Services & Social Work School of Counselling, University of Auckland, Auckland, New Zealand
| | - Chris Bullen
- The National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
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Dadds MR, Sicouri G, Piotrowska PJ, Collins DA, Hawes DJ, Moul C, Lenroot RK, Frick PJ, Anderson V, Kimonis ER, Tully LA. Keeping Parents Involved: Predicting Attrition in a Self-Directed, Online Program for Childhood Conduct Problems. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2018; 48:881-893. [DOI: 10.1080/15374416.2018.1485109] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Paul J. Frick
- Department of Psychology, Louisiana State University
| | - Vicki Anderson
- Child Neuropsychology, Murdoch Children’s Research Institute Psychology, Royal Children’s Hospital
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Kramer EN, Chard CA, Walters K, Barr-Anderson DJ. Weight-Dependent Disparities in Adolescent Girls: The Impact of a Brief Pilot Intervention on Exercise and Healthy Eater Identity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1411. [PMID: 29973565 PMCID: PMC6068924 DOI: 10.3390/ijerph15071411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/25/2018] [Accepted: 07/03/2018] [Indexed: 11/16/2022]
Abstract
Adolescent girls report low participation in healthy behaviors (e.g., nutritious eating and exercise), and are disproportionately affected by obesity. Short-term interventions, such as behavioral summer camps, may positively influence psychological underpinnings of healthy behavior, particularly exercise identity (EI) and healthy eater identity (HEI). The present study investigates disparities and changes in identity and subsequent health behavior in two cohorts of adolescent girls following a brief, multicomponent intervention. A sample of normal-weight adolescent girls from a health promotion camp and an elevated body mass index (BMI) sample from an obesity treatment camp participated in the study. Both camps ran one-week in duration and delivered comparable intervention components. All families were given access to the same eight-week eHealth program post-camp. Significant EI and HEI role-identity disparities between the health promotion and obesity treatment cohorts were apparent at baseline. Following the one-week camp intervention, EI and HEI scores increased in both groups. At follow-up, the treatment group had increased EI and HEI role-identities in such that the groups no longer significantly differed. Positive changes in health behaviors were experienced in each group. This pilot study demonstrates that EI and HEI differ between normal-weight and obese adolescent girls and weight-dependent identity disparities may be mitigated following brief, multicomponent interventions.
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Affiliation(s)
- Eydie N Kramer
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Christine A Chard
- Department of Health and Exercise Science, Colorado School of Public Health, Colorado State University, Fort Collins, CO 80523, USA.
| | - Kellie Walters
- Department of Kinesiology, California State University, Long Beach, CA 90840, USA.
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Canter KS, Christofferson J, Scialla MA, Kazak AE. Technology-Focused Family Interventions in Pediatric Chronic Illness: A Systematic Review. J Clin Psychol Med Settings 2018; 26:68-87. [DOI: 10.1007/s10880-018-9565-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Schinke S, Schwinn TM. Computer-Based Prevention and Intervention to Reduce Substance Use in Youth. CURRENT ADDICTION REPORTS 2017; 4:410-421. [PMID: 29354389 DOI: 10.1007/s40429-017-0171-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Purpose of Review Computer-based programs for substance use prevention and intervention among youth are on the ascendancy. Whether delivered by computer per se or by electronic tablet or smartphone, technology-driven programs are harmonious with how young people access information and interact with their worlds. This review examines recent evidence on computer-based programs aimed at substance use among youth, with particular attention to results from randomized trials. Recent Findings Outcome studies of computer-based, substance use-related programs published over the past 5 years reveal mixed results amidst diverse intervention approaches and delivery settings. Many studies are marred by high attrition. Notable in the recent literature is the international nature of technology-driven substance use prevention and intervention programs. With some exceptions, most programs appear to not have been customized for their recipient populations. Though few in number, the highest-quality studies of computer-based programs show positive outcomes in reduced substance use rates. Summary Based on recent findings, considerable work needs to happen before computer-delivered approaches are a proven means for reducing substance use among youth. Original programs, expressly developed for subgroups of youth, are in short supply. Though controlled designs are becoming commonplace, too many studies of computer-based programs suffer from flaws-including high rates of attrition-that limit the discovery of positive outcomes.
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Affiliation(s)
- Steven Schinke
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY 10027
| | - Traci Marie Schwinn
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY 10027
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Estrada Y, Molleda L, Murray A, Drumhiller K, Tapia M, Sardinas K, Rosen A, Pantin H, Perrino T, Sutton M, Cano MÁ, Dorcius D, Wendorf Muhamad J, Prado G. eHealth Familias Unidas: Pilot Study of an Internet Adaptation of an Evidence-Based Family Intervention to Reduce Drug Use and Sexual Risk Behaviors Among Hispanic Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E264. [PMID: 28273862 PMCID: PMC5369100 DOI: 10.3390/ijerph14030264] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 02/25/2017] [Accepted: 02/27/2017] [Indexed: 11/16/2022]
Abstract
This paper describes the Internet adaptation of an evidenced-based intervention for Hispanic families, eHealth Familias Unidas, and explores whether an Internet-based format is feasible and acceptable to Hispanic families. Core intervention components from the evidence-based intervention, Familias Unidas, were transposed into a video format and edited for content. Additionally, interactive exercises and a soap opera series were incorporated to reinforce intervention content and optimize participant engagement and retention. To understand the feasibility and acceptability of eHealth Familias Unidas, we conducted a pilot study and examined findings from: (1) session completion rates for both e-parent group sessions and family sessions (n = 23 families); and (2) qualitative data collected from Hispanic parents (n = 29) that received the eHealth intervention. Engagement and attendance in the intervention showed that 83% of families engaged in the intervention and that there was an overall session completion rate of 78%. Qualitative interviews were conducted mid and post intervention with a combined total of 29 participants. A general inductive approach was used to derive themes from the collected data. Overall, parents expressed positive feedback in regards to the intervention and stated that there were multiple lessons learned from participating in eHealth Familias Unidas. Findings indicate that an Internet-based family intervention is not only feasible and acceptable for Hispanic families, but also offers a viable option to ameliorate barriers to participation and implementation of preventive interventions.
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Affiliation(s)
- Yannine Estrada
- Department of Public Health Sciences, University of Miami, Miami, FL 33136, USA.
| | - Lourdes Molleda
- Department of Public Health Sciences, University of Miami, Miami, FL 33136, USA.
| | - Ashley Murray
- Division of HIV/AIDS Prevention, NCHHSTP, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
| | - Kathryn Drumhiller
- Division of HIV/AIDS Prevention, NCHHSTP, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
- Lifesource Biomedical, Herndon, VA 20170, USA.
| | - Maria Tapia
- Department of Public Health Sciences, University of Miami, Miami, FL 33136, USA.
| | - Krystal Sardinas
- Department of Pediatrics, University of Miami, Miami, FL 33136, USA.
| | | | - Hilda Pantin
- Department of Public Health Sciences, University of Miami, Miami, FL 33136, USA.
| | - Tatiana Perrino
- Department of Public Health Sciences, University of Miami, Miami, FL 33136, USA.
| | - Madeline Sutton
- Division of HIV/AIDS Prevention, NCHHSTP, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
| | - Miguel Ángel Cano
- Department of Epidemiology, Florida International University, Miami, FL 33199, USA.
| | - Daphney Dorcius
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA.
| | | | - Guillermo Prado
- Department of Public Health Sciences, University of Miami, Miami, FL 33136, USA.
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