Accare Child Study Center, Groningen, The Netherlands.
Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
BMC Psychiatry. 2024 Mar 12;24(1):203. doi: 10.1186/s12888-024-05649-8.
The access to and uptake of evidence-based behavioral parent training for children with behavioral difficulties (i.e., oppositional, defiant, aggressive, hyperactive, impulsive, and inattentive behavior) are currently limited because of a scarcity of certified therapists and long waiting lists. These problems are in part due to the long and sometimes perceived as rigid nature of most evidence-based programs and result in few families starting behavioral parent training and high dropout rates. Brief and individually tailored parenting interventions may reduce these problems and make behavioral parent training more accessible. This protocol paper describes a two-arm, multi-center, randomized controlled trial on the short- and longer-term effectiveness and cost-effectiveness of a brief, individually tailored behavioral parent training program for children with behavioral difficulties.
Parents of children aged 2-12 years referred to a child mental healthcare center are randomized to (i) three sessions of behavioral parent training with optional booster sessions or (ii) care as usual. To evaluate effectiveness, our primary outcome is the mean severity of five daily ratings by parents of four selected behavioral difficulties. Secondary outcomes include measures of parent and child behavior, well-being, and parent-child interaction. We explore whether child and parent characteristics moderate intervention effects. To evaluate cost-effectiveness, the use and costs of mental healthcare and utilities are measured. Finally, parents' and therapists' satisfaction with the brief program are explored. Measurements take place at baseline (T0), one week after the brief parent training, or eight weeks after baseline (in case of care as usual) (T1), and six months (T2) and twelve months (T3) after T1.
The results of this trial could have meaningful societal implications for children with behavioral difficulties and their parents. If we find the brief behavioral parent training to be more (cost-)effective than care as usual, it could be used in clinical practice to make parent training more accessible.
The trial is prospectively registered at ClinicalTrials.gov (NCT05591820) on October 24th, 2022 and updated throughout the trial.
由于合格治疗师的短缺和漫长的等待名单，目前获得和采用针对行为困难儿童（即对立、反抗、攻击、多动、冲动和注意力不集中行为）的循证行为家长培训的机会有限。这些问题部分归因于大多数循证项目的冗长性，有时被认为是僵化的性质，导致很少有家庭开始行为家长培训并出现高辍学率。简短和个性化的育儿干预措施可能会减少这些问题，并使行为家长培训更容易获得。本研究方案描述了一项为期双臂、多中心、随机对照试验，旨在评估针对行为困难儿童的简短、个性化行为家长培训计划的短期和长期效果以及成本效益。
被转介到儿童心理健康保健中心的 2-12 岁儿童的父母被随机分为（i）接受三节课的行为家长培训，可选择参加强化课程或（ii）接受常规护理。为了评估有效性，我们的主要结果是父母对四项选定行为困难的五个日常评分的平均严重程度。次要结果包括父母和儿童行为、幸福感和父母-子女互动的衡量标准。我们探索了儿童和家长特征是否会调节干预效果。为了评估成本效益，测量了心理健康保健的使用和成本以及效用。最后，还探讨了家长和治疗师对简短方案的满意度。测量在基线（T0）、简短家长培训后一周（T1）或在常规护理的情况下在基线后八周（T1）以及六个月（T2）和十二个月（T3）进行。
该试验的结果可能对行为困难的儿童及其父母的社会产生有意义的影响。如果我们发现简短的行为家长培训比常规护理更有效（成本效益更高），则可以在临床实践中使用它来使家长培训更容易获得。
该试验于 2022 年 10 月 24 日在 ClinicalTrials.gov（NCT05591820）前瞻性注册，并在试验过程中进行了更新。
