A brief home-based parenting intervention to reduce behavior problems in young children: A pragmatic randomized clinical trial
<strong>Importance:</strong> Behaviour problems are the most common mental health disorder in childhood and can undermine children’s health, education, and employment outcomes into adulthood. There are few effective interventions for early childhood. <br> <strong>Objective:&...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
American Medical Association
2021
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| _version_ | 1826284074877059072 |
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| author | O'Farrelly, C Watt, H Babalis, D Bakermans-Kranenburg, MJ Barker, B Byford, S Ganguli, P Grimas, E Iles, J Mattock, H McGinley, J Phillips, C Ryan, R Scott, S Smith, J Stein, A Stevens, E van IJzendoorn, M Warwick, J Paul, R |
| author_facet | O'Farrelly, C Watt, H Babalis, D Bakermans-Kranenburg, MJ Barker, B Byford, S Ganguli, P Grimas, E Iles, J Mattock, H McGinley, J Phillips, C Ryan, R Scott, S Smith, J Stein, A Stevens, E van IJzendoorn, M Warwick, J Paul, R |
| author_sort | O'Farrelly, C |
| collection | OXFORD |
| description | <strong>Importance:</strong> Behaviour problems are the most common mental health disorder in childhood and can undermine children’s health, education, and employment outcomes into adulthood. There are few effective interventions for early childhood.
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<strong>Objective:</strong> To test the clinical effectiveness of a brief parenting intervention, Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD), in reducing behaviour problems in young children aged 12-36 months.
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<strong>Design:</strong> The Healthy Start, Happy Start study was a two-arm, parallel group, researcher-blind, multisite, randomised controlled trial. Baseline and 5-month follow-up data were collected between July 30, 2015, and April 27, 2018.
<br>
<strong>Setting:</strong> Health visiting services in six National Health Service (NHS) trusts in England.
<br>
<strong>Participants:</strong> Of the 1,430 eligible families, 227 declined to participate, and 300 were randomised into the trial. Target participants were caregivers of children who scored in the top 20% for behaviour problems on the Strengths and Difficulties Questionnaire. Participants were randomly allocated (1:1) to either VIPP-SD (n=151) or usual care (UC) (n=149), stratified by site and number of participating caregivers.
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<strong>Intervention:</strong> All families continued to access usual care. Families allocated to VIPP-SD were offered six home-based, fortnightly video-feedback sessions of 1-2 hours duration.
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<strong>Main outcome(s):</strong> The primary outcome was an early childhood version of the Preschool Parental Account of Children’s Symptoms (PPACS), a structured interview of behaviour symptoms, at 5-months post-randomisation. Secondary outcomes included caregiver-reported behaviour problems on the Child Behavior Checklist (CBCL) and the Strengths and Difficulties Questionnaire (SDQ).
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<strong>Results:</strong> Among 300 participating children (mean age, 23 months; male, 163 [54%]), primary outcome data were available for 140 (93%) VIPP-SD and 146 (98%) UC participants. Using intention-to-treat analysis, there was a mean difference in total PPACS score of 2.03 (95% CI 0.06 to 4.01; p=0.04; Cohen’s d=0.20) between trial arms with fewer behaviour problems in the VIPP-SD group, particularly conduct symptoms (d=0.30, 0.08 to 0.51). Other child behaviour outcomes showed similar evidence favouring VIPP-SD. No treatment or trial-related adverse events were reported.
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<strong>Conclusions and relevance:</strong> VIPP-SD was effective in reducing symptoms of early behaviour problems in young children when delivered in a routine health service context.
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<strong>Trial registration:</strong> ISRCTN (isrctn.org); number: 58327365. |
| first_indexed | 2024-03-07T01:08:26Z |
| format | Journal article |
| id | oxford-uuid:8c229124-a793-4f1d-b4e7-f808ca7e7ec7 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:08:26Z |
| publishDate | 2021 |
| publisher | American Medical Association |
| record_format | dspace |
| spelling | oxford-uuid:8c229124-a793-4f1d-b4e7-f808ca7e7ec72022-03-26T22:42:47ZA brief home-based parenting intervention to reduce behavior problems in young children: A pragmatic randomized clinical trialJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8c229124-a793-4f1d-b4e7-f808ca7e7ec7EnglishSymplectic ElementsAmerican Medical Association2021O'Farrelly, CWatt, HBabalis, DBakermans-Kranenburg, MJBarker, BByford, SGanguli, PGrimas, EIles, JMattock, HMcGinley, JPhillips, CRyan, RScott, SSmith, JStein, AStevens, Evan IJzendoorn, MWarwick, JPaul, R<strong>Importance:</strong> Behaviour problems are the most common mental health disorder in childhood and can undermine children’s health, education, and employment outcomes into adulthood. There are few effective interventions for early childhood. <br> <strong>Objective:</strong> To test the clinical effectiveness of a brief parenting intervention, Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD), in reducing behaviour problems in young children aged 12-36 months. <br> <strong>Design:</strong> The Healthy Start, Happy Start study was a two-arm, parallel group, researcher-blind, multisite, randomised controlled trial. Baseline and 5-month follow-up data were collected between July 30, 2015, and April 27, 2018. <br> <strong>Setting:</strong> Health visiting services in six National Health Service (NHS) trusts in England. <br> <strong>Participants:</strong> Of the 1,430 eligible families, 227 declined to participate, and 300 were randomised into the trial. Target participants were caregivers of children who scored in the top 20% for behaviour problems on the Strengths and Difficulties Questionnaire. Participants were randomly allocated (1:1) to either VIPP-SD (n=151) or usual care (UC) (n=149), stratified by site and number of participating caregivers. <br> <strong>Intervention:</strong> All families continued to access usual care. Families allocated to VIPP-SD were offered six home-based, fortnightly video-feedback sessions of 1-2 hours duration. <br> <strong>Main outcome(s):</strong> The primary outcome was an early childhood version of the Preschool Parental Account of Children’s Symptoms (PPACS), a structured interview of behaviour symptoms, at 5-months post-randomisation. Secondary outcomes included caregiver-reported behaviour problems on the Child Behavior Checklist (CBCL) and the Strengths and Difficulties Questionnaire (SDQ). <br> <strong>Results:</strong> Among 300 participating children (mean age, 23 months; male, 163 [54%]), primary outcome data were available for 140 (93%) VIPP-SD and 146 (98%) UC participants. Using intention-to-treat analysis, there was a mean difference in total PPACS score of 2.03 (95% CI 0.06 to 4.01; p=0.04; Cohen’s d=0.20) between trial arms with fewer behaviour problems in the VIPP-SD group, particularly conduct symptoms (d=0.30, 0.08 to 0.51). Other child behaviour outcomes showed similar evidence favouring VIPP-SD. No treatment or trial-related adverse events were reported. <br> <strong>Conclusions and relevance:</strong> VIPP-SD was effective in reducing symptoms of early behaviour problems in young children when delivered in a routine health service context. <br> <strong>Trial registration:</strong> ISRCTN (isrctn.org); number: 58327365. |
| spellingShingle | O'Farrelly, C Watt, H Babalis, D Bakermans-Kranenburg, MJ Barker, B Byford, S Ganguli, P Grimas, E Iles, J Mattock, H McGinley, J Phillips, C Ryan, R Scott, S Smith, J Stein, A Stevens, E van IJzendoorn, M Warwick, J Paul, R A brief home-based parenting intervention to reduce behavior problems in young children: A pragmatic randomized clinical trial |
| title | A brief home-based parenting intervention to reduce behavior problems in young children: A pragmatic randomized clinical trial |
| title_full | A brief home-based parenting intervention to reduce behavior problems in young children: A pragmatic randomized clinical trial |
| title_fullStr | A brief home-based parenting intervention to reduce behavior problems in young children: A pragmatic randomized clinical trial |
| title_full_unstemmed | A brief home-based parenting intervention to reduce behavior problems in young children: A pragmatic randomized clinical trial |
| title_short | A brief home-based parenting intervention to reduce behavior problems in young children: A pragmatic randomized clinical trial |
| title_sort | brief home based parenting intervention to reduce behavior problems in young children a pragmatic randomized clinical trial |
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