United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, Japan.
Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba City, Chiba, Japan.
BMC Psychiatry. 2024 Nov 14;24(1):806. doi: 10.1186/s12888-024-06264-3.
School-based cognitive behavioral therapy (CBT) programs could contribute toward preventing anxiety disorders in children. However, setting aside class time for such programs is difficult. Internet-based CBT (I-CBT) is an efficient way to provide CBT. However, studies on I-CBT for anxiety prevention remain scarce, including I-CBT for school-based universal prevention programs. Therefore, we developed an e-learning version of a school-based anxiety-prevention CBT program, "Journey of the Brave," which was effective in Japan, to make it more flexible and accessible. This study evaluated its feasibility.
We conducted a single-arm study based on 44 parents and children. Children aged 10-12 years took the e-learning program at home. Parents and children responded to a questionnaire three times: before the learning (Pre), after the learning (Post), and three months later (FU: Follow-up). Feasibility was comprehensively evaluated through dropout rates, satisfaction and learning records, and changes in scores on psychological scales assessing anxiety symptoms, emotion-regulation skills, and children's emotional and behavioral problems.
Of the 44 children, 42 started the e-learning, and 32 continued it (dropout rate of 23.8%). Furthermore, 83.9% of the children and 96.8% of the parents responded "agree" or "somewhat agree" regarding overall satisfaction. The parent-rated Spence Children's Anxiety Scale(SCAS) (SCAS-P) showed a significant decrease between Pre and FU (p = 0.014, 95% CI = (-9.22, -0.84)); however, the child-rated SCAS (SCAS-C) reduction was not significant (p = 0.08). The Emotion‑Regulation Skills Questionnaire (ERSQ) also increased significantly between Pre and FU (p = 0.045, 95% CI = (0.18, 18.31)). The Total Difficulties Score of the Strengths and Difficulties Questionnaire(SDQ) decreased significantly from Pre to Post (p = 0.025, 95% CI = (-3.62, -0.19)); however, it was not significantly different between Pre and FU (p = 0.67).
The e-learning version showed low dropout rates and high satisfaction ratings from parents and children. Moreover, this study did not rule out the possibility that the program reduced children's anxiety and improved their emotional-regulation skills. Therefore, its potential and feasibility were indicated.
UMIN, UMIN000049182, Registered 11 October 2022.
学校为基础的认知行为疗法（CBT）项目可以帮助预防儿童焦虑症。然而，为这类项目留出课堂时间很困难。基于互联网的 CBT（I-CBT）是提供 CBT 的有效方法。然而，针对焦虑预防的 I-CBT 研究仍然很少，包括针对学校基础普遍预防计划的 I-CBT。因此，我们开发了一种基于日本有效的学校焦虑预防 CBT 项目“勇敢之旅”的电子学习版本，使其更灵活和更易于获取。本研究评估了其可行性。
我们进行了一项基于 44 名父母和儿童的单臂研究。10-12 岁的儿童在家中参加电子学习课程。父母和儿童在三次回答问卷：学习前（Pre）、学习后（Post）和三个月后（FU：随访）。通过辍学率、满意度和学习记录，以及评估焦虑症状、情绪调节技能和儿童情绪和行为问题的心理量表评分的变化，全面评估了可行性。
在 44 名儿童中，有 42 名开始了电子学习，有 32 名继续学习（辍学率为 23.8%）。此外，83.9%的儿童和 96.8%的父母对整体满意度表示“同意”或“有些同意”。父母评定的斯宾塞儿童焦虑量表（SCAS）（SCAS-P）显示，Pre 和 FU 之间显著下降（p=0.014，95%CI=-9.22，-0.84）；然而，儿童评定的 SCAS（SCAS-C）的减少并不显著（p=0.08）。情绪调节技能问卷（ERSQ）在 Pre 和 FU 之间也显著增加（p=0.045，95%CI=（0.18，18.31））。长处和困难问卷（SDQ）的总困难评分从 Pre 到 Post 显著下降（p=0.025，95%CI=（-3.62，-0.19））；然而，Pre 和 FU 之间没有显著差异（p=0.67）。
电子学习版本显示出较低的辍学率和来自父母和儿童的高满意度评分。此外，本研究不能排除该项目减轻儿童焦虑和提高情绪调节技能的可能性。因此，表明了其潜力和可行性。
UMIN，UMIN000049182，于 2022 年 10 月 11 日注册。
