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Danford CA, Mooney-Doyle K, Deatrick JA, Feetham S, Gross D, Knafl KA, Kobayashi K, Moriarty H, Østergaard B, Swallow V. Building Family Interventions for Scalability and Impact. J Fam Nurs 2024; 30:94-113. [PMID: 38629802 DOI: 10.1177/10748407241231342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Family nursing researchers are charged with addressing the conceptual and methodological underpinnings of family research when developing family-focused interventions. Step-by-step guidance is needed that integrates current science of intervention development with family science and helps researchers progress from foundational work to experimental work with policy integration. The purpose of this manuscript is to provide pragmatic, evidence-based guidance for advancing family intervention research from foundational work through efficacy testing. Guidance regarding the development of family interventions is presented using the first three of Sidani's five-stage method: (a) foundational work to understand the problem targeted for change; (b) intervention development and assessment of acceptability and feasibility; and (c) efficacy testing. Each stage of family intervention development is described in terms of process, design considerations, and policy and practice implications. Examples are included to emphasize the family lens. This manuscript provides guidance to family scientists for intervention development and implementation to advance family nursing science and inform policy.
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Affiliation(s)
| | | | | | - Suzanne Feetham
- University of Illinois Chicago, Chicago, IL USA
- Children's National Hospital, Washington, DC, USA
| | | | - Kathleen A Knafl
- The University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | | | - Helene Moriarty
- Villanova University, PA, Villanova, USA
- Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
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Hawk BN, Timmer SG, Armendariz LAF, Boys DK, Urquiza AJ, Fernández Y Garcia E. Improving Children's Behavior in Seven Sessions: A Randomized Controlled Trial of Parent-Child Care (PC-CARE) for Children Aged 2-10 Years. Child Psychiatry Hum Dev 2024; 55:336-349. [PMID: 35951209 PMCID: PMC9366815 DOI: 10.1007/s10578-022-01406-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2022] [Indexed: 11/03/2022]
Abstract
Parent-Child Care (PC-CARE) is a brief intervention for children with externalizing behaviors designed to address issues with their access to and retention in treatment. A growing evidence base of open trials and comparison studies support PC-CARE's benefits, but no randomized controlled trials (RCTs) of its effectiveness exist. The current study presents the first RCT of PC-CARE, a 7-session dyadic parenting intervention (trial number removed for blind review). Participants included a racially/ethnically diverse sample of 49 children (29% female) aged 2-10 years and their caregivers. Participants were randomly assigned to PC-CARE or waitlist control. Families participating in PC-CARE showed greater reductions in children's externalizing behaviors, improvements in children's adaptive skills, declines in parental stress, and increases in parents' positive communication skills, compared to families on the waitlist. The results of this first RCT of PC-CARE support the effectiveness of this brief intervention in improving children's behaviors.
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Affiliation(s)
- Brandi N Hawk
- University of California, Davis Children's Hospital, 3671 Business Dr., Ste 110, 95820, Sacramento, CA, USA.
| | - Susan G Timmer
- University of California, Davis Children's Hospital, 3671 Business Dr., Ste 110, 95820, Sacramento, CA, USA
| | - Lindsay A F Armendariz
- University of California, Davis Children's Hospital, 3671 Business Dr., Ste 110, 95820, Sacramento, CA, USA
| | - Deanna K Boys
- University of California, Davis Children's Hospital, 3671 Business Dr., Ste 110, 95820, Sacramento, CA, USA
| | - Anthony J Urquiza
- University of California, Davis Children's Hospital, 3671 Business Dr., Ste 110, 95820, Sacramento, CA, USA
| | - Erik Fernández Y Garcia
- University of California, Davis Children's Hospital, 3671 Business Dr., Ste 110, 95820, Sacramento, CA, USA
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Sampaio F, Nystrand C, Feldman I, Mihalopoulos C. Evidence for investing in parenting interventions aiming to improve child health: a systematic review of economic evaluations. Eur Child Adolesc Psychiatry 2024; 33:323-355. [PMID: 35304645 PMCID: PMC10869412 DOI: 10.1007/s00787-022-01969-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 03/03/2022] [Indexed: 12/01/2022]
Abstract
A comprehensive review of the economic evidence on parenting interventions targeting different aspects of child health is lacking to support decision-making. The aim of this review is to provide an up to date synthesis of the available health economic evidence for parenting interventions aiming to improve child health. A systematic review was conducted with articles identified through Econlit, Medline, PsychINFO, and ERIC databases. Only full economic evaluations comparing two or more options, considering both costs and outcomes were included. We assessed the quality of the studies using the Drummond checklist. We identified 44 studies of varying quality that met inclusion criteria; 22 targeting externalizing behaviors, five targeting internalizing problems, and five targeting other mental health problems including autism and alcohol abuse. The remaining studies targeted child abuse (n = 5), obesity (n = 3), and general health (n = 4). Studies varied considerably and many suffered from methodological limitations, such as limited costing perspectives, challenges with outcome measurement and short-time horizons. Parenting interventions showed good value for money in particular for preventing child externalizing and internalizing behaviors. For the prevention of child abuse, some programs had the potential of being cost-saving over the longer-term. Interventions were not cost-effective for the treatment of autism and obesity. Future research should include a broader spectrum of societal costs and quality-of-life impacts on both children and their caregivers.
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Affiliation(s)
- Filipa Sampaio
- Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3 (Entry A11), 751 22, Uppsala, Sweden.
| | - Camilla Nystrand
- Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3 (Entry A11), 751 22, Uppsala, Sweden
| | - Inna Feldman
- Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3 (Entry A11), 751 22, Uppsala, Sweden
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Cathrine Mihalopoulos
- School of Health and Social Development, Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
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Slade EP, Bettencourt AF, Gross DA. Cost-Effectiveness a Parenting Skills Program Implemented in Public PreK Schools in Disadvantaged Urban Communities. Adm Policy Ment Health 2023; 50:888-900. [PMID: 37493933 DOI: 10.1007/s10488-023-01287-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Little is known about the cost-effectiveness of parent training programs when offered universally in U.S. elementary schools in disadvantaged urban communities. OBJECTIVE To estimate the cost-effectiveness of a universal school-based implementation study of the Chicago Parent Program (CPP). METHODS CPP was offered universally from 2014 to 2017 to parents of PreK students in 12 Baltimore City Title 1 schools (n = 380; 61.1% Black/African American, 24.1% Hispanic). CPP program implementation and operating costs were estimated using microcosting methods and data drawn from study records. A Complier Average Causal Effects (CACE) framework was used to estimate an Incremental Cost Effectiveness Ratio (ICER) for CPP's average cost per child per 1% decrease in conduct problem prevalence at follow-up. This ICER was then compared with comparable ICERs for four parenting interventions that have been implemented and evaluated in Europe: Connect, Incredible Years, COPE, and Comet. RESULTS CPP cost $937.51 per child (95% CI: $902.09 to $971.92). Adjusted CACE estimates indicated that CPP resulted in a 31.4% reduction (95% CI: -39.7% to -23.9%) in conduct problem prevalence at follow-up among children whose parents attended CPP. The mean ICER for CPP was $29.86 per each 1% reduction in prevalence (95% CI: $21.05 to $50.71). CPP's ICER was similar to ICERs for Connect ($25.50) and COPE ($29.72), and less than ICERs for Incredible Years ($50.36) and Comet ($59.69). CONCLUSION School-based CPP offered universally to parents of children transitioning to Kindergarten in extremely disadvantaged U.S. urban communities was found to offer relatively good value compared with similar parenting programs that are widely used in Europe.
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Affiliation(s)
- Eric P Slade
- Johns Hopkins School of Nursing, Baltimore, MD, USA.
- Johns Hopkins School of Public Health, Baltimore, MD, USA.
- School of Nursing and School of Public Health, Johns Hopkins University, 525 N. Wolfe St, Baltimore, MD, 21205, USA.
| | - Amie F Bettencourt
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Johns Hopkins School of Public Health, Baltimore, MD, USA
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Deborah A Gross
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Johns Hopkins School of Public Health, Baltimore, MD, USA
- Johns Hopkins School of Medicine, Baltimore, MD, USA
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Gray TF, Henderson MD, Barakat LP, Knafl KA, Deatrick JA. Advancing family science and health equity through the 2022-2026 National Institute of Nursing Research strategic plan. Nurs Outlook 2023; 71:102030. [PMID: 37696135 DOI: 10.1016/j.outlook.2023.102030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/25/2023] [Accepted: 08/09/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Consistent with the National Institute of Nursing Research's mission of leading nursing research to address current health challenges, the new Strategic Plan identifies five research lenses: health equity, social determinants of health, population and community health, prevention and health promotion, and systems and models of care. Family research, central to nursing research and practice, is the cornerstone of social ecology and represents a critical intersection of social and structural determinants of health. PURPOSE We argue why family health is essential to the 2022-2026 Strategic Plan and how the lenses can strengthen family research. METHODS Drawing from collective expertise and existing literature in family research, sociology, psychology, and nursing science, the authors present a new conceptual model that integrates structural racism and heteropatriarchy to examine the salience of family structure statuses for family outcomes and discuss approaches to research design, empirical measurement, and interpretation in order to bring this new model into practice. DISCUSSION The NINR Strategic Plan has the potential to dismantle structures that perpetuate racism and health inequity within and across family structures. An underaddressed research area under the new Strategic Plan relates to how social determinants of health influence and are influenced by families. CONCLUSION We challenge all investigators, not just family scientists, to expand the scope of their research to conceptualize the role of family on health inequities.
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Affiliation(s)
- Tamryn F Gray
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA; Division of Palliative Medicine, Brigham and Women's Hospital, Boston, MA; Cancer Outcomes Research and Education Program, Massachusetts General Hospital Cancer Center, Boston, MA.
| | - Marcus D Henderson
- Johns Hopkins School of Nursing, Baltimore, MD; Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA
| | - Lamia P Barakat
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Child and Adolescent Psychiatry and Behavioral Science, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Kathleen A Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Janet A Deatrick
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA
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Greene MM, Schoeny ME, Berteletti J, Keim SA, Neel ML, Patra K, Smoske S, Breitenstein S. ezPreemie study protocol: a randomised controlled factorial trial testing web-based parent training and coaching with parents of children born very preterm. BMJ Open 2022; 12:e063706. [PMID: 35732380 PMCID: PMC9226920 DOI: 10.1136/bmjopen-2022-063706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Children born very preterm (VPT; gestational age <32 weeks) are twice as likely to demonstrate behaviour problems such as aggression, non-compliance, temper tantrums and irritability compared with their term-born peers. While behavioural parent training (BPT), also referred to as behaviour therapy is a gold standard for prevention and treatment of childhood problem behaviours, there are limited accessible and effective BPT interventions for families with children born VPT. The purpose of this paper is to describe a multicentre, randomised controlled protocol for a factorial design trial evaluating the independent and combined effects of the ezParent BPT intervention plus brief, weekly coaching calls on parent and child outcomes for families with toddlers born VPT. METHODS AND ANALYSIS The study employs a 2×2 factorial randomised design. Parents (n=220) of children aged 20-30 months corrected age who were born VPT (<32 weeks) will be recruited from two large metropolitan Neonatal Intensive Care Units follow-up clinics and randomised to one of four conditions: (1) ezParent (2) ezParent +coach, (3) Active control or (4) Active Control +coach. Data on parenting and child behaviour outcomes will be obtained from all participants at baseline and 3, 6 and 12 months postbaseline. All analyses will use an intention-to-treat approach, independent of their actual dose of each intervention. ETHICS AND DISSEMINATION The study protocol has been approved by The Ohio State University Institutional Review Board (IRB) using a single IRB. Study results will be disseminated through presentations at regional and national conferences, publications in peer-reviewed journals, and sharing research reports with participating families and recruiting sites. TRIAL REGISTRATION NUMBER NCT05217615.
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Affiliation(s)
- Michelle M Greene
- Department of Pediatrics, Rush University Medical Center, Chicago, Illinois, USA
| | - M E Schoeny
- College of Nursing, Rush University, Chicago, Illinois, USA
| | | | - Sarah A Keim
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics and Division of Epidemiology, The Ohio State University, Columbus, Ohio, USA
| | - Mary Lauren Neel
- Division of Neonatology & Center for Perinatal Research, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kousiki Patra
- Department of Pediatrics, Rush University Medical Center, Chicago, Illinois, USA
| | - Shea Smoske
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
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7
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Phillips ST, Mychailyszyn MP. Parent-Child Interaction Therapy for Preschool Aged Youth: A Meta-Analysis of Developmental Specificity. Child Youth Care Forum 2022. [DOI: 10.1007/s10566-022-09694-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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Dawson-Squibb JJ, Davids EL, Chase R, Puffer E, Rasmussen JDM, Franz L, de Vries PJ. Bringing Parent-Child Interaction Therapy to South Africa: Barriers and Facilitators and Overall Feasibility-First Steps to Implementation. Int J Environ Res Public Health 2022; 19:ijerph19084450. [PMID: 35457315 PMCID: PMC9031323 DOI: 10.3390/ijerph19084450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/24/2022] [Indexed: 12/26/2022]
Abstract
There is a large assessment and treatment gap in child and adolescent mental health services, prominently so in low- and middle-income countries, where 90% of the world's children live. There is an urgent need to find evidence-based interventions that can be implemented successfully in these low-resource contexts. This pre-pilot study aimed to explore the barriers and facilitators to implementation as well as overall feasibility of Parent-Child Interaction Therapy (PCIT) in South Africa. A reflective and consensus building workshop was used to gather South African PCIT therapist (N = 4) perspectives on barriers, facilitators, and next steps to implementation in that country. Caregiver participants (N = 7) receiving the intervention in South Africa for the first time were also recruited to gather information on overall feasibility. Facilitators for implementation, including its strong evidence base, manualisation, and training model were described. Barriers relating to sustainability and scalability were highlighted. Largely positive views on acceptability from caregiver participants also indicated the promise of PCIT as an intervention in South Africa. Pilot data on the efficacy of the treatment for participating families are a next step. These initial results are positive, though research on how implementation factors contribute to the longer-term successful dissemination of PCIT in complex, heterogeneous low-resource settings is required.
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Affiliation(s)
- John-Joe Dawson-Squibb
- Division of Child and Adolescent Psychiatry, Department of Psychiatry & Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (E.L.D.); (L.F.); (P.J.d.V.)
- Correspondence:
| | - Eugene Lee Davids
- Division of Child and Adolescent Psychiatry, Department of Psychiatry & Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (E.L.D.); (L.F.); (P.J.d.V.)
| | - Rhea Chase
- Judge Baker Children’s Center, Harvard Medical School, Boston, MA 02115, USA;
| | - Eve Puffer
- Department of Psychology & Neuroscience, Duke Global Health Institute, Duke University, Durham, NC 27708, USA; (E.P.); (J.D.M.R.)
| | - Justin D. M. Rasmussen
- Department of Psychology & Neuroscience, Duke Global Health Institute, Duke University, Durham, NC 27708, USA; (E.P.); (J.D.M.R.)
| | - Lauren Franz
- Division of Child and Adolescent Psychiatry, Department of Psychiatry & Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (E.L.D.); (L.F.); (P.J.d.V.)
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioural Sciences, Duke Global Health Institute, Duke University, Durham, NC 27708, USA
| | - Petrus J. de Vries
- Division of Child and Adolescent Psychiatry, Department of Psychiatry & Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (E.L.D.); (L.F.); (P.J.d.V.)
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Baweja R, Soutullo CA, Waxmonsky JG. Review of barriers and interventions to promote treatment engagement for pediatric attention deficit hyperactivity disorder care. World J Psychiatry 2021; 11:1206-1227. [PMID: 35070771 PMCID: PMC8717033 DOI: 10.5498/wjp.v11.i12.1206] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/20/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common and impairing behavioral health disorder, impacting over 5% of children worldwide. There are multiple evidence-based pharmacological and psychosocial treatments for ADHD, and greater service utilization is associated with improved acute and long-term outcomes. However, long-term outcomes are suboptimal as multimodal treatments are often not accessed and most care ends prematurely. This narrative review discusses barriers to engagement for children and adolescents with ADHD and their families as well as interventions to overcome these barriers. Families face a variety of structural and attitudinal barriers, ranging from cost and access to stigma and low self-efficacy to successfully implement change. There are multiple interventions that may enhance engagement with ADHD care including psychoeducation, integration of behavioral services in general medical settings, telehealth as well as specific adaptations to existing ADHD treatments, such as the use of motivational interviewing or shared decision making. Integration of behavioral health into general medical settings and telehealth have been found in controlled studies to increase access by reducing both structural and attitudinal barriers. Adding motivational interviewing, shared decision making and other engagement interventions to evidence-based ADHD treatments has been found to reduce attitudinal barriers that translates into improved participation and satisfaction while enhancing outcomes. However, little is known about how to promote extended engagement with ADHD services even though a chronic care model for ADHD is recommended.
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Affiliation(s)
- Raman Baweja
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA 17033, United States
| | - Cesar A Soutullo
- Louis A. Faillace, MD Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77054, United States
| | - James G Waxmonsky
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA 17033, United States
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Dong F, Liu J, Hodgson NA, Medoff-Cooper B. Early life factors of schizotypal personality disorder in adolescents: A systematic review. J Psychiatr Ment Health Nurs 2021; 28:1092-1112. [PMID: 33502097 DOI: 10.1111/jpm.12733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/28/2020] [Accepted: 01/18/2021] [Indexed: 12/25/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: The complexity and high prevalence of schizotypal personality disorders (SPD) pose serious challenges for mental health practice in its management, and also bring severe consequences for the patients. The identification of the specific early life factors (ELFs) that confer risk to SPD has become a major focus of clinical research on schizophrenia-spectrum disorders which aligns well with the mental health nursing's responsibility in health promotion, prevention and treatment. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Adolescents may experience certain ELFs, which contribute to the occurrence of SPD, but no systematic review has been conducted to identify ELF among them. And nursing literature addressing modifiable ELF is very limited. Two clusters of ELF and SPD in adolescents were identified: prenatal and early postnatal factors; childhood trauma and parental factors. The findings also show that more research is needed to determine the specificity and cumulative effects of ELF on the development of SPD by using rigorous and comprehensive measurements and a longitudinal design. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses, especially nurses in the primary care, should be aware of potentially modifiable ELFs and incorporate more comprehensive and valid instrument for assessing cumulative ELF and SPD. These findings may serve to inform possible future interventions for SPD, such as parent education and support to mitigate these risk factors. ABSTRACT INTRODUCTION: Schizotypal personality disorder (SPD) affects 4% of the general population in the United States. The identification of early life factors (ELFs) that confer risk to SPD in adolescents (ages 10-24 years old) has become a major focus of clinical research on schizophrenia-spectrum disorders. AIM This systematic review aims to determine what ELFs contribute to the onset of SPD in the adolescent population. METHODS A systematic search of PubMed, PsycINFO, Psychiatry online, Scopus, Web of Science, EMBASE and CINAHL databases was conducted using relevant keywords. Data were extracted using a standardized form following PRISMA guidelines. RESULTS Twenty-four studies met the criteria for inclusion. ELFs in the development of SPD were grouped into two important clusters: (a) prenatal and early postnatal factors; (b) childhood trauma and parental factors. CONCLUSION Mental health nurses, especially nurses in primary care, should be aware of potentially modifiable ELF. Longitudinal research is needed to determine the causative roles of these ELF play in the occurrence of SPD by using rigorous measurements. IMPLICATIONS FOR PRACTICE These findings call for awareness of the modifiable ELF for SPD and also inform possible future interventions to reduce these risks, such as parent-training or environmental enrichment programmes.
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Affiliation(s)
- Fanghong Dong
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Jianghong Liu
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Nancy A Hodgson
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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Abstract
Behavior disorders (BD) in children can lead to delinquency, antisocial behavior, and mental disorders in adulthood. Evidence-based behavioral parent training (BPT) programs have been developed to treat early-onset BDs, yet cost analyses of BPT are deficient. We provide updated estimates of cost and cost-effectiveness of Helping the Noncompliant Child (HNC), a mastery-based BPT, delivered to low-income families. The cost of research-specific activities was $1,152 per family. HNC program delivery costs were $293 per family from a payer perspective, including the cost of therapist time ($275 per family) and non-labor resources, such as supplies and toys ($18 per family). It costs an average of $6 to improve the Eyberg Child Behavior Inventory intensity score by each additional point or $171 to improve it by one standard deviation. The cost of delivering the HNC program appears to compare favorably with the costs of similar BPT programs.
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Affiliation(s)
- Olga Khavjou
- Corresponding author: Olga Khavjou, RTI International, 3040 Cornwallis Rd, Durham, NC 27709, tel: 919-541-6689,
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12
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Burrell TL, Postorino V, Scahill L, Rea HM, Gillespie S, Evans AN, Bearss K. Feasibility of Group Parent Training for Children with Autism Spectrum Disorder and Disruptive Behavior: A Demonstration Pilot. J Autism Dev Disord 2020; 50:3883-3894. [DOI: 10.1007/s10803-020-04427-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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13
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Spruijt AM, Dekker MC, Ziermans TB, Swaab H. Educating parents to improve parent-child interactions: Fostering the development of attentional control and executive functioning. Br J Educ Psychol 2019; 90 Suppl 1:158-175. [PMID: 31392719 PMCID: PMC7380015 DOI: 10.1111/bjep.12312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 07/01/2019] [Indexed: 11/28/2022]
Abstract
Background Parent–child interaction is essential in the development of attentional control (AC) and executive functioning (EF). Educating parents in AC and EF development may help them to respond more adaptively to their child's developmental needs. Aim This study aimed to investigate whether parents can be educated to improve interactions with their child through a compact psycho‐educational programme that focuses on fostering the development of AC and EF. Sample Parents and their children in a low‐risk sample of four‐ to eight‐year‐olds were randomly assigned to either the educational programme condition (N = 34) or the control condition (N = 36). Methods Parental supportive presence and intrusiveness were observed during home visits, and children's performance‐based AC and EF were assessed before and after the four‐session programme. Result Parents in the educational programme improved significantly in support (ηp2 = .19) and intrusiveness (ηp2 = .09) compared to controls. There was no short‐term programme mediation effect on child AC and EF through parental support and intrusiveness. This study showed, however, that parents who improved after the educational programme had children who improved on AC and EF. Conclusion Parent–child interaction can be enhanced in a low‐risk sample of four‐ to eight‐year‐olds using a compact educational group programme within the school community. Future studies should aim at examining variations in programme responsiveness and assessing associations between parent–child interaction and AC and EF over time.
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Affiliation(s)
- Andrea M Spruijt
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Marielle C Dekker
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, The Netherlands
| | - Tim B Ziermans
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, The Netherlands.,Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Hanna Swaab
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
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Stein MA. Editorial: Is Less Parent Training "Not Inferior" to More? J Am Acad Child Adolesc Psychiatry 2019; 58:565-566. [PMID: 30797039 DOI: 10.1016/j.jaac.2018.09.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 09/18/2018] [Accepted: 01/23/2019] [Indexed: 10/27/2022]
Abstract
Persistent and early-onset externalizing behavior problems are associated with a wide range of impairments.1 Parent management training (PMT) is frequently recommended as either a prevention strategy in at-risk children, or as first -line treatment. Although several group-based and individually based models of PMT have demonstrated efficacy in reducing preschool behavior problems, there is a paucity of comparative effectiveness studies to help guide treatment selection.
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Abstract
Although financial incentives are a well-accepted strategy for raising parent participation rates in prevention studies, they are rarely employed in practice due to concerns about their ethics, sustainability, and public acceptability. We sought to address these common concerns in the context of a larger prevention study using financial incentives to boost parent participation in a group-based parenting program implemented in an urban school district. We examined the extent to which the financial incentives delivered via bank debit cards ($15 for attending weekly group sessions, $5 for completing weekly practice assignments) motivated parents to enroll in the program and were associated with higher attendance and practice completion but poorer participation quality in group sessions, and how parents used the extra cash. Over 3 years, 67.4% (n = 372) of eligible families enrolled in a parenting program called the Chicago Parent Program. Most parents were African American (68%) or Latinx (24%); 67% reported annual household incomes < $20,000. Although 71.2% of parents reported that the financial incentives motivated their enrollment, the most important motivators pertained to wanting to be a better parent. Parents citing incentives as motivating their enrollment had higher attendance than those who did not (p = .01). Quality of parent participation was high and unrelated to whether financial incentives motivated enrollment. Parents reported using the extra cash to purchase items for their children (92%) and groceries (56%). Results suggest that financial incentives targeting low-income families of young children may improve parent participation rates without diminishing their intrinsic motivation to improve their parenting.
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