Stepping up to COVID-19: A Clinical Trial of a Telepsychology Positive Parenting Program Targeting Behavior Problems in Children With Neurological Risk

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Abstract

Objective

To evaluate the feasibility, acceptability, and preliminary efficacy of a stepped-care parenting program implemented during COVID-19 among families of behaviorally at-risk children with neurological or neurodevelopmental disorders aged 3–9 years.

Methods

Stepped-care I-InTERACT-North increased psychological support across 3 steps, matched to family needs: (1) guided self-help (podcast), (2) brief support, and (3) longer-term parent support. The intervention was provided by clinicians at The Hospital for Sick Children. Recruitment occurred via hospital and research cohort referral. A single-arm trial using a pragmatic prospective pre–post mixed-method design was utilized to assess accrual, engagement, acceptability, and preliminary efficacy.

Results

Over 15 months, 68 families enrolled (83% consent rate) and 56 families completed stepped-care (Step 1 = 56; Step 2 = 39; Step 3 = 28), with high adherence across Steps (100%, 98%, and 93%, respectively). Parents reported high acceptability, reflected in themes surrounding accessibility, comprehension, effectiveness, and targeted care. Positive parenting skill increases were documented, and robust improvement in child behavior problems was apparent upon Step 3 completion ( p =.001, d = .390). Stepped-care was as effective as traditional delivery, while improving consent and completion rates within a pandemic context.

Conclusions

This stepped-care telepsychology parenting program provides a compelling intervention model to address significant gaps in accessible mental health intervention while simultaneously balancing the need for efficient service. Findings inform program scalability beyond COVID-19 and emphasize the value of stepped-care intervention in delivering and monitoring mental health treatment.

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Most cited references 56

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Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science

Emily A. Holmes, Rory C O'Connor, V. Perry … (2020)

Summary The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK's world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.

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The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories

P.F. Lovibond, S.H. Lovibond (1995)

The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in a normal sample of N = 717 who were also administered the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The DASS was shown to possess satisfactory psychometric properties, and the factor structure was substantiated both by exploratory and confirmatory factor analysis. In comparison to the BDI and BAI, the DASS scales showed greater separation in factor loadings. The DASS Anxiety scale correlated 0.81 with the BAI, and the DASS Depression scale correlated 0.74 with the BDI. Factor analyses suggested that the BDI differs from the DASS Depression scale primarily in that the BDI includes items such as weight loss, insomnia, somatic preoccupation and irritability, which fail to discriminate between depression and other affective states. The factor structure of the combined BDI and BAI items was virtually identical to that reported by Beck for a sample of diagnosed depressed and anxious patients, supporting the view that these clinical states are more severe expressions of the same states that may be discerned in normals. Implications of the results for the conceptualisation of depression, anxiety and tension/stress are considered, and the utility of the DASS scales in discriminating between these constructs is discussed.

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Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample.

Martin Antony, Peter Bieling, Brian J Cox … (1998)

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Author and article information

Contributors

Angela Deotto: Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: VisualizationRole: Writing - original draftRole: Writing - review & editing

Giulia F Fabiano: Role: Formal analysisRole: Project administrationRole: ValidationRole: VisualizationRole: Writing - original draftRole: Writing - review & editing

Beryl Y T Chung: Role: Data curationRole: Funding acquisitionRole: Project administrationRole: SupervisionRole: Visualization

Shari L Wade: Role: ConceptualizationRole: Funding acquisitionRole: ResourcesRole: SupervisionRole: Writing - review & editing

Evdokia Anagnostou: Role: Funding acquisitionRole: ResourcesRole: SupervisionRole: Writing - review & editing

Jennifer Crosbie: Role: ResourcesRole: Writing - review & editing

Elizabeth Kelley: Role: MethodologyRole: ResourcesRole: Writing - review & editing

Rob Nicolson: Role: InvestigationRole: MethodologyRole: Writing - review & editing

Brendan F Andrade: Role: MethodologyRole: SupervisionRole: Writing - review & editing

Steven P Miller: Role: ConceptualizationRole: Funding acquisitionRole: ResourcesRole: Writing - review & editing

Tricia S Williams: Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: ResourcesRole: SoftwareRole: SupervisionRole: Writing - original draftRole: Writing - review & editing

Journal

Journal ID (nlm-ta): J Pediatr Psychol

Journal ID (iso-abbrev): J Pediatr Psychol

Journal ID (publisher-id): jpepsy

Title: Journal of Pediatric Psychology

Publisher: Oxford University Press

ISSN (Print): 0146-8693

ISSN (Electronic): 1465-735X

Publication date Collection: June 2023

Publication date (Electronic): 14 June 2023

Publication date PMC-release: 14 June 2023

Volume: 48

Issue: 6

Pages: 523-536

Affiliations

Division of Neurology, Department of Psychology, The Hospital for Sick Children , Toronto, ON, Canada

Department of Psychology, Faculty of Health, York University , Toronto, ON, Canada

Division of Neurology, Department of Psychology, The Hospital for Sick Children , Toronto, ON, Canada

Schulich School of Medicine & Dentistry, Western University , London, ON, Canada

Division of Physical Medicine and Rehabilitation, Cincinnati Children’s Hospital Medical Center , Cincinnati, OH, USA

Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH, USA

Department of Pediatrics, Faculty of Medicine, University of Toronto , Toronto, ON, Canada

Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital , Toronto, ON, Canada

Department of Psychiatry, The Hospital for Sick Children Toronto , ON, Canada

Department of Psychiatry, University of Toronto , Toronto, Canada

Department of Psychology, Queens University , Kingston, ON, Canada

Department of Psychiatry, Western University , London, ON, Canada

Lawson Health Research Institute, London Health Sciences Centre , London, ON, Canada

Department of Psychiatry, University of Toronto , Toronto, Canada

Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health , Toronto, ON, Canada

Faculty of Medicine, BC Children’s Hospital , Vancouver, BC, Canada

Department of Pediatrics, Faculty of Medicine, University of British Columbia , Vancouver, BC, Canada

Division of Neurology, Department of Psychology, The Hospital for Sick Children , Toronto, ON, Canada

Department of Psychology, Faculty of Health, York University , Toronto, ON, Canada

Department of Psychiatry, University of Toronto , Toronto, Canada

Author notes

All correspondence concerning this article should be addressed to Tricia Williams, PhD, Division of Neurology, Department of Psychology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. E-mail: tricia.williams@ 123456sickkids.ca

Article

Publisher ID: jsad032

DOI: 10.1093/jpepsy/jsad032

PMC ID: 10321395

PubMed ID: 37316980

SO-VID: 22c86ef5-422a-4201-b5ca-9a6c88daa2f8

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence ( https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

History

Date received : 30 November 2022

Date revision received : 19 May 2023

Date accepted : 19 May 2023

Page count

Pages: 14

Funding

Funded by: Canadian Institutes of Health Research, DOI 10.13039/501100000024;

Award ID: 178854

Funded by: COVID-19 Grant from the Garry Hurvitz-Centre for Brain and Mental Health;

Funded by: Edwin S.H. Leong Centre for Healthy Children;

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Positive parenting practices support children at neurological risk during COVID-19: a call for accessible parenting interventions
Authors: Rivka Green, Janaksha Linga-Easwaran, Carly Goodman …

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Stepping up to COVID-19: A Clinical Trial of a Telepsychology Positive Parenting Program Targeting Behavior Problems in Children With Neurological Risk

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Abstract

Objective

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Novel Coronavirus Disease COVID-19

Most cited references 56

Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science

The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories

Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample.

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Cited by 1

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