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Glad DM, Pardej SK, Olszewski E, Klein-Tasman BP. Feasibility and acceptability of a telehealth intervention for improving peer relationships for adolescents with neurofibromatosis type 1: a single-arm pilot study. J Pediatr Psychol 2024:jsae050. [PMID: 38908005 DOI: 10.1093/jpepsy/jsae050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/24/2024] Open
Abstract
OBJECTIVE Elevated rates of social difficulties are evident for children and adolescents with neurofibromatosis type 1 (NF1) but the effects of social skills interventions have not been investigated for this population. The Program for the Education and Enrichment of Relational Skills (PEERS®), a widely established social skills intervention in autism spectrum disorders with expansion to other conditions, was recently modified to be offered virtually. This study examined the feasibility and acceptability of this telehealth intervention. METHODS 27 adolescents with NF1 with social skills difficulties and at least 1 caregiver enrolled in the study. 19 of those participants (Mage = 14.21 years, SD = 1.63; 7 females; 79% White) completed PEERS® via telehealth in a single-arm pilot study. Dropout rates, attendance records, helpfulness of the curriculum topics and caregiver-reported acceptability, including ratings on the Treatment Acceptability Questionnaire, were examined. RESULTS Low study drop out (30% of enrolled participants; 14% of participants who began the intervention) and high attendance rates were observed. Caregivers found sessions related to common, everyday interactions most helpful. Adolescents indicated sessions related to having get-togethers and social nuances (e.g., humor) as most helpful. Caregiver ratings indicated acceptability of the intervention. CONCLUSIONS This investigation supported the feasibility and acceptability of telehealth PEERS®, a social skills intervention program, among adolescents with NF1 and their caregivers based on attendance patterns as well as appraisal of the curriculum and telehealth modality.
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Affiliation(s)
- Danielle M Glad
- Department of Psychology, University of Wisconsin, Milwaukee, WI, United States
| | - Sara K Pardej
- Department of Psychology, University of Wisconsin, Milwaukee, WI, United States
| | - Ellen Olszewski
- Department of Psychology, University of Wisconsin, Milwaukee, WI, United States
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Nelson AK, Griest CJ, Munoz LM, Rumaldo N, Miller AC, Soplapuco GM, Lecca L, Shin SS, Acuña LR, Valdivia YV, Ramos AR, Ahumada DG, Ramos BRH, Mejia SA, Serrano EO, Castro WH, Oliva VE, Heyman AS, Hartwell LP, Blackwell RL, Diaz DF, Vibbert MM. Proof of concept of the Universal Baby video innovation for early child development in Lima, Peru. J Pediatr Psychol 2024:jsae035. [PMID: 38872286 DOI: 10.1093/jpepsy/jsae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 05/03/2024] [Accepted: 05/03/2024] [Indexed: 06/15/2024] Open
Abstract
OBJECTIVE Community-based video interventions offer an effective and potentially scalable early interaction coaching tool for caregivers living in low resource settings. We tested the Universal Baby (UB) video innovation; an early interaction coaching tool using video sourced and produced locally with early child development (ECD) expert supervision. METHODS This proof-of-concept study enrolled 40 caregivers of children ages 10-18 months assigned to intervention and control groups by health establishments in Carabayllo, Lima, Peru. Mother/child dyads received 12 weekly group health education sessions with social support. Of those, 16 caregivers also received 6 UB videos featuring brain science education and local clips of responsive, reciprocal interaction, also known as "serve and return" interaction. Survey data assessed feasibility and acceptability of the intervention. We assessed improved quality of mother/child interaction using the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO). RESULTS We found the program feasible. We successfully trained the local team to produce UB videos using locally-sourced footage and delivered the videos as part of a community-based intervention. We also found it to be acceptable in that participants enthusiastically received the UB videos, reporting they enjoyed being videotaped, and learned how to recognize and appropriately respond to their child's nuanced sounds and gestures. The median change in total PICCOLO scores favored the intervention group compared to the control group. CONCLUSIONS UB offers great potential as a sustainable, potentially scalable, and culturally appropriate tool to promote equity for child development among young children living in low resource homes globally.
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Affiliation(s)
- Adrianne K Nelson
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, United States
| | | | | | | | - Ann C Miller
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States
- Blavatnik Institute, Harvard Medical School, Boston, MA, United States
| | | | | | - Sonya S Shin
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, United States
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States
| | | | | | | | | | | | - Sarah A Mejia
- Wheelock College of Education and Human Development, Boston University, Boston, MA, United States
| | | | | | | | - Annie S Heyman
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Lauren P Hartwell
- Boston University School of Public Health, Boston, MA, United States
| | - Ronnie L Blackwell
- Wheelock College of Education and Human Development, Boston University, Boston, MA, United States
| | | | - Martha M Vibbert
- Boston Medical Center, Boston, MA, United States
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
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Modi AC, Patel AD, Mara CA, Schmidt M, Tenney JR, Stevens J. Pilot randomized controlled clinical trial of an adherence social norms intervention for adolescents with epilepsy. Epilepsy Behav 2023; 140:109082. [PMID: 36731289 PMCID: PMC9998352 DOI: 10.1016/j.yebeh.2022.109082] [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: 11/07/2022] [Revised: 12/21/2022] [Accepted: 12/31/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Non-adherence to anti-seizure medications (ASMs) is common for adolescents with epilepsy, with potentially devastating consequences. Existing adherence interventions in epilepsy do not meet the unique challenges faced by adolescents. Leveraging social norms capitalizes on the increased importance of peer influence while simultaneously targeting the low motivation levels of many adolescents. The current study examined the feasibility, acceptability, and satisfaction of a social norms adherence intervention in adolescents with epilepsy. METHODS A pilot RCT of a mHealth social norms intervention was conducted with adolescents with epilepsy who demonstrated non-adherence (≤95% adherence) during baseline. Adolescents were randomized to either (1) mHealth social norms (reminders, individualized and social norms adherence feedback) or (2) control (reminders and individualized adherence feedback). Primary outcomes included feasibility, acceptability, and satisfaction. Exploratory outcomes included electronically monitored adherence, seizure severity, and health-related quality of life (HRQOL). RESULTS One hundred four adolescents were recruited (53% female; Mage = 15.4 ± 1.4 years; 81% White: Non-Hispanic; 5% Black, 10% Bi/Multiracial; 2% White: Hispanic; 1% Other: Hispanic; 1% Bi/Multiracial-Hispanic). Forty-five percent screen-failed due to high adherence, 16% withdrew, and 38% were randomized to treatment (n = 19) or control (n = 21). Recruitment (75%), retention (78%), and treatment satisfaction were moderately high. Engagement with the intervention was moderate, with 64% of participants engaging with intervention notifications. Exploratory analyses revealed that after controlling for COVID-19 impact, the social norms intervention group maintained higher adherence over time compared to the control group. Small to moderate effect sizes were noted for seizure severity and HRQOL between groups. CONCLUSION This pilot intervention appeared feasible and acceptable. Increases in adherence in the treatment versus control group were modest, but a future larger more adequately powered study is needed to detect effects. Notably, it appeared the COVID pandemic influenced adherence behaviors during our trial.
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Affiliation(s)
- Avani C Modi
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, 3333 Burnet Ave., Cincinnati, OH 45229, United States; University of Cincinnati, College of Medicine, Cincinnati, OH, United States.
| | - Anup D Patel
- Nationwide Children's Hospital, 700 Children's Drive, Near East Office Building, 3rd Floor, Columbus, OH 43205, United States; The Ohio State, Department of Pediatrics, 700 Children's Drive, Near East Office Building, 3rd Floor, Columbus, OH 43205, United States.
| | - Constance A Mara
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, 3333 Burnet Ave., Cincinnati, OH 45229, United States; University of Cincinnati, College of Medicine, Cincinnati, OH, United States.
| | - Matthew Schmidt
- College of Education, University of Florida, 2423 Normal Hall, Gainesville, FL 32611, United States.
| | - Jeffrey R Tenney
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, 3333 Burnet Ave., Cincinnati, OH 45229, United States; University of Cincinnati, College of Medicine, Cincinnati, OH, United States.
| | - Jack Stevens
- Nationwide Children's Hospital, 700 Children's Drive, Near East Office Building, 3rd Floor, Columbus, OH 43205, United States; The Ohio State, Department of Pediatrics, 700 Children's Drive, Near East Office Building, 3rd Floor, Columbus, OH 43205, United States.
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5
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Palermo TM. Editor’s Vale Dictum: The Journal of Pediatric Psychology, 2018–2022. J Pediatr Psychol 2022; 47:1091-1095. [DOI: 10.1093/jpepsy/jsac072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Tonya M Palermo
- Department of Anesthesiology & Pain Medicine, Seattle Children’s Research Institute, University of Washington , USA
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Bouchard EG, Epstein LH, Patel H, Vincent PC, LaValley SA, Devonish JA, Wadium J, Wen X, Kelly KM. Behavioral parenting skills as a novel target for improving medication adherence in young children: Feasibility and acceptability of the CareMeds intervention. Pediatr Hematol Oncol 2022; 39:529-539. [PMID: 35139726 PMCID: PMC9363525 DOI: 10.1080/08880018.2022.2025964] [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: 11/10/2021] [Accepted: 12/29/2021] [Indexed: 10/19/2022]
Abstract
In pediatric cancer care, medication non-adherence is a significant driver of avoidable suffering and death. There is a lack of interventions designed for families of young children, where patient medication refusal/avoidance is a common barrier to adherence. We developed the CareMeds intervention which focuses on caregiver skills training to help young children take medicine calmly and without use of restraint techniques. The goal of this preliminary study was to assess the acceptability and feasibility of the CareMeds intervention. Caregivers of pediatric cancer patients (ages 2-10) whose children were on a home-based oral medication regimen were recruited to participate. Feasibility was examined through study enrollment and retention rates as well as reasons for refusal and drop out. Acceptability was evaluated through usability of and engagement with intervention components and an acceptability questionnaire. Feasibility: We recruited N = 9 caregivers to participate in this intervention pilot study and had a 75% enrollment rate. Reasons for declining included scheduling concerns (n = 2) and lack of interest (n = 1). The participant retention rate was 100% with 100% adherence to intervention sessions. Acceptability: Parents rated the sessions and resource materials as acceptable and reported frequent use of skills taught in the intervention. The CareMeds intervention is an acceptable and feasible strategy for caregivers of pediatric cancer patients and warrants future research to examine the efficacy of behavioral parenting skills interventions to improve medication adherence in young children.
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Affiliation(s)
- Elizabeth G. Bouchard
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center
| | | | - Hital Patel
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center
| | - Paula C. Vincent
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center
| | - Susan A. LaValley
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center
| | - Julia A. Devonish
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center
- Department of Medicine, Division of General Internal Medicine, University at Buffalo
| | | | - Xiaozhong Wen
- Division of Behavioral Medicine, University at Buffalo
| | - Kara M. Kelly
- Department of Pediatric Oncology, Roswell Park Comprehensive Cancer Center
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