scholarly journals A Tailored Web-Based Intervention to Improve Parenting Risk and Protective Factors for Adolescent Depression and Anxiety Problems: Postintervention Findings From a Randomized Controlled Trial (Preprint)

2017 ◽  
Author(s):  
Marie Bee Hui Yap ◽  
Shireen Mahtani ◽  
Ronald M Rapee ◽  
Claire Nicolas ◽  
Katherine A Lawrence ◽  
...  
Keyword(s):  
Protective Factors ◽  
Adolescent Depression ◽  
Controlled Trial ◽  
Risk And Protective Factors ◽  
Secondary Outcome ◽  
Depression And Anxiety ◽  
Web Based ◽  
Child Report ◽  
Adolescent Report ◽  
Intervention Condition

BACKGROUND Depression and anxiety disorders in young people are a global health concern. Parents have an important role in reducing the risk of these disorders, but cost-effective, evidence-based interventions for parents that can be widely disseminated are lacking. OBJECTIVE This study aimed to examine the postintervention effects of the Partners in Parenting (PiP) program on parenting risk and protective factors for adolescent depression and anxiety, and on adolescent depression and anxiety symptoms. METHODS A two-arm randomized controlled trial was conducted with 359 parent-adolescent dyads, recruited primarily through schools across Australia. Parents and adolescents were assessed at baseline and 3 months later (postintervention). Parents in the intervention condition received PiP, a tailored Web-based parenting intervention designed following Persuasive Systems Design (PSD) principles to target parenting factors associated with adolescents’ risk for depression and anxiety problems. PiP comprises a tailored feedback report highlighting each parent’s strengths and areas for improvement, followed by a set of interactive modules (up to nine) that is specifically recommended for the parent based on individually identified areas for improvement. Parents in the active-control condition received a standardized package of five Web-based factsheets about adolescent development and well-being. Parents in both conditions received a 5-min weekly call to encourage progress through their allocated program to completion. Both programs were delivered weekly via the trial website. The primary outcome measure at postintervention was parent-reported changes in parenting risk and protective factors, which were measured using the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS). Secondary outcome measures were the adolescent-report PRADAS, the parent- and child-report Short Mood and Feelings Questionnaire (depressive symptoms), and parent- and child-report Spence Children’s Anxiety Scale (anxiety symptoms). RESULTS Parents in the intervention condition completed a mean of 73.7% of their intended personalized PiP program. A total of 318 parents (88.6%, 318/359) and 308 adolescents (92.8%, 308/332) completed the postintervention assessment. Attrition was handled using mixed model of repeated measures analysis of variance. As hypothesized, we found a significant condition-by-time interaction on the PRADAS, with a medium effect size, Cohen d=0.57, 95% CI 0.34-0.79. No significant differences between conditions were found at postintervention on any of the secondary outcome measures, with adolescent depressive (parent-report only) and anxiety (both parent- and adolescent-report) symptoms decreasing significantly from baseline to postintervention in both conditions. CONCLUSIONS The fully automated PiP intervention showed promising short-term effects on parenting behaviors that are associated with adolescents’ risk for depression and anxiety. Long-term follow-up is required to ascertain whether these effects translate into reduced adolescent depression and anxiety problems. The intervention may be useful as a low-cost universal public health program to increase parenting practices believed to benefit adolescents’ mental health. CLINICALTRIAL Australia New Zealand Clinical Trials Registry: ACTRN12615000328572; https://www.anzctr.org.au/ Trial/Registration/TrialReview.aspx? id=368274 (Archived by WebCite at http://www.webcitation.org/6qgsZ3Aqj)

scholarly journals Medium-Term Effects of a Tailored Web-Based Parenting Intervention to Reduce Adolescent Risk of Depression and Anxiety: 12-Month Findings From a Randomized Controlled Trial

10.2196/13628 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e13628 ◽  
Author(s):  
Marie Bee Hui Yap ◽  
Mairead C Cardamone-Breen ◽  
Ronald M Rapee ◽  
Katherine A Lawrence ◽  
Andrew J Mackinnon ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Protective Factors ◽  
Adolescent Depression ◽  
Controlled Trial ◽  
Intervention Group ◽  
Risk And Protective Factors ◽  
Depression And Anxiety ◽  
Web Based ◽  
Randomized Controlled

Background Prevention of depression and anxiety disorders early in life is a global health priority. Evidence on risk and protective factors for youth internalizing disorders indicates that the family represents a strategic setting to target preventive efforts. Despite this evidence base, there is a lack of accessible, cost-effective preventive programs for parents of adolescents. To address this gap, we recently developed the Partners in Parenting (PiP) program—an individually tailored Web-based parenting program targeting evidence-based parenting risk and protective factors for adolescent depression and anxiety disorders. We previously reported the postintervention outcomes of a single-blinded parallel-group superiority randomized controlled trial (RCT) in which PiP was found to significantly improve self-reported parenting compared with an active-control condition (educational factsheets). Objective This study aimed to evaluate the effects of the PiP program on parenting risk and protective factors and symptoms of adolescent depression and anxiety using data from the final assessment time point (12-month follow-up) of this RCT. Methods Parents (n=359) and adolescents (n=332) were recruited primarily from secondary schools and completed Web-based assessments of parenting and adolescent depression and anxiety symptoms at baseline, postintervention (3 months later), and 12-month follow-up (317 parents, 287 adolescents). Parents in the PiP intervention condition received personalized feedback about their parenting and were recommended a series of up to 9 interactive modules. Control group parents received access to 5 educational factsheets about adolescent development and mental health. Both groups received a weekly 5-min phone call to encourage progress through their program. Results Intervention group parents completed an average of 73.7% of their intended program. For the primary outcome of parent-reported parenting, the intervention group showed significantly greater improvement from baseline to 12-month follow-up compared with controls, with a medium effect size (Cohen d=0.51; 95% CI 0.30 to 0.72). When transformed data were used, greater reduction in parent-reported adolescent depressive symptoms was observed in the intervention group (Cohen d=−0.21; 95% CI −0.42 to −0.01). Mediation analyses revealed that these effects were mediated by improvements in parenting (indirect effect b=−0.08; 95% CI −0.16 to −0.01). No other significant intervention effects were found for adolescent-reported parenting or adolescent depression or anxiety symptoms. Both groups showed significant reductions in anxiety (both reporters) and depressive (parent reported) symptoms. Conclusions PiP improved self-reported parenting for up to 9 months postintervention, but its effects on adolescent symptoms were less conclusive, and parent-reported changes were not perceived by adolescents. Nonetheless, given its scalability, PiP may be a useful low-cost, sustainable program to empower parents of adolescents. Trial Registration Australian Clinical Trials Registration Number (ACTRN): 12615000328572; http://www.anzctr.org.au/ACTRN12615000328572.aspx (Archived by WebCite at http://www.webcitation.org/6qgsZ3Aqj).

scholarly journals Medium-Term Effects of a Tailored Web-Based Parenting Intervention to Reduce Adolescent Risk of Depression and Anxiety: 12-Month Findings From a Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Marie Bee Hui Yap ◽  
Mairead C Cardamone-Breen ◽  
Ronald M Rapee ◽  
Katherine A Lawrence ◽  
Andrew J Mackinnon ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Protective Factors ◽  
Adolescent Depression ◽  
Controlled Trial ◽  
Intervention Group ◽  
Risk And Protective Factors ◽  
Depression And Anxiety ◽  
Web Based ◽  
Randomized Controlled

BACKGROUND Prevention of depression and anxiety disorders early in life is a global health priority. Evidence on risk and protective factors for youth internalizing disorders indicates that the family represents a strategic setting to target preventive efforts. Despite this evidence base, there is a lack of accessible, cost-effective preventive programs for parents of adolescents. To address this gap, we recently developed the Partners in Parenting (PiP) program—an individually tailored Web-based parenting program targeting evidence-based parenting risk and protective factors for adolescent depression and anxiety disorders. We previously reported the postintervention outcomes of a single-blinded parallel-group superiority randomized controlled trial (RCT) in which PiP was found to significantly improve self-reported parenting compared with an active-control condition (educational factsheets). OBJECTIVE This study aimed to evaluate the effects of the PiP program on parenting risk and protective factors and symptoms of adolescent depression and anxiety using data from the final assessment time point (12-month follow-up) of this RCT. METHODS Parents (n=359) and adolescents (n=332) were recruited primarily from secondary schools and completed Web-based assessments of parenting and adolescent depression and anxiety symptoms at baseline, postintervention (3 months later), and 12-month follow-up (317 parents, 287 adolescents). Parents in the PiP intervention condition received personalized feedback about their parenting and were recommended a series of up to 9 interactive modules. Control group parents received access to 5 educational factsheets about adolescent development and mental health. Both groups received a weekly 5-min phone call to encourage progress through their program. RESULTS Intervention group parents completed an average of 73.7% of their intended program. For the primary outcome of parent-reported parenting, the intervention group showed significantly greater improvement from baseline to 12-month follow-up compared with controls, with a medium effect size (Cohen d=0.51; 95% CI 0.30 to 0.72). When transformed data were used, greater reduction in parent-reported adolescent depressive symptoms was observed in the intervention group (Cohen d=−0.21; 95% CI −0.42 to −0.01). Mediation analyses revealed that these effects were mediated by improvements in parenting (indirect effect b=−0.08; 95% CI −0.16 to −0.01). No other significant intervention effects were found for adolescent-reported parenting or adolescent depression or anxiety symptoms. Both groups showed significant reductions in anxiety (both reporters) and depressive (parent reported) symptoms. CONCLUSIONS PiP improved self-reported parenting for up to 9 months postintervention, but its effects on adolescent symptoms were less conclusive, and parent-reported changes were not perceived by adolescents. Nonetheless, given its scalability, PiP may be a useful low-cost, sustainable program to empower parents of adolescents. CLINICALTRIAL Australian Clinical Trials Registration Number (ACTRN): 12615000328572; http://www.anzctr.org.au/ACTRN12615000328572.aspx (Archived by WebCite at http://www.webcitation.org/6qgsZ3Aqj).

Evaluating the role of engagement in a web-based intervention to improve parenting risk and protective factors for adolescent depression and anxiety disorders (Preprint)

2020 ◽  
Author(s):  
Claire C Nicolas ◽  
Anthony F Jorm ◽  
Katherine A Lawrence ◽  
Marie BH Yap
Keyword(s):  
Protective Factors ◽  
Adolescent Depression ◽  
Large Body ◽  
Parenting Programs ◽  
Depression And Anxiety ◽  
Post Intervention ◽  
Web Based ◽  
Multiple Measures

BACKGROUND A large body of evidence highlights the important role of parental behavior in reducing the risk of, and increasing the protective factors for, adolescent internalizing disorders. The possible benefits offered by preventive parenting programs may be undermined by low rates of engagement by parents. Online interventions have the potential to mitigate the common barriers to participation and engagement in face-to-face preventive parenting programs. However, there is a surprising lack of studies that report on the relationship between intervention engagement and improvement in target outcomes. OBJECTIVE This study evaluated the predictive power of several measures of engagement in a Web-based intervention aimed at increasing parental protective factors and reducing risk factors for adolescent depression and anxiety. We aimed to ascertain which measures of program engagement best predict 3-month post-intervention and 12-month follow-up scores on preventive parenting, parental self-efficacy (PSE), and adolescent depressive and anxiety symptoms. METHODS Our sample comprised 176 parents who received the Partners in Parenting (‘PiP’) intervention and their adolescents. Engagement was measured through multiple measures derived from server logs on a web database. Potential predictors included total modules completed, percentage of intended modules completed, percentage of quiz questions answered correctly, and percentage of goals completed. RESULTS Hierarchical multiple regressions indicated that the total modules completed predicted parent rated preventive parenting at post-intervention, and a combination of the total modules completed, percentage of intended modules completed, and percentage of quiz questions answered predicted PSE scores at post-intervention. At 12-month follow up, a combination of engagement measures predicted preventive parenting scores, and the percentage of intended modules completed predicted PSE scores. The percentage of intended modules completed predicted parent report of adolescent depressive symptoms at 12-month follow-up. None of the engagement measures predicted adolescent report of preventive parenting or their own symptoms. CONCLUSIONS Our findings suggest that future programs will benefit from including multiple measures of engagement and reinforce the importance of examining the longer-term effects of engagement. Our study provides evidence for the benefits of including goal-setting exercises as a persuasive feature and ensuring quiz questions are challenging. The implications of these findings for future program development, as well as our understanding of improvement in behavior and symptoms through intervention, are discussed.

scholarly journals A Single-Session, Web-Based Parenting Intervention to Prevent Adolescent Depression and Anxiety Disorders: Randomized Controlled Trial

2018 ◽  
Vol 20 (4) ◽  
pp. e148 ◽  
Author(s):  
Mairead C Cardamone-Breen ◽  
Anthony F Jorm ◽  
Katherine A Lawrence ◽  
Ronald M Rapee ◽  
Andrew J Mackinnon ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Anxiety Disorders ◽  
Adolescent Depression ◽  
Controlled Trial ◽  
Parenting Intervention ◽  
Depression And Anxiety ◽  
Single Session ◽  
Web Based ◽  
Randomized Controlled

scholarly journals A Single-Session, Web-Based Parenting Intervention to Prevent Adolescent Depression and Anxiety Disorders: Randomized Controlled Trial (Preprint)

2017 ◽  
Author(s):  
Mairead C Cardamone-Breen ◽  
Anthony F Jorm ◽  
Katherine A Lawrence ◽  
Ronald M Rapee ◽  
Andrew J Mackinnon ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Parenting Practices ◽  
Adolescent Depression ◽  
Controlled Trial ◽  
Depression And Anxiety ◽  
Single Session ◽  
Self Assessment ◽  
Web Based ◽  
Symptoms Of Depression

BACKGROUND Depression and anxiety disorders are significant contributors to burden of disease in young people, highlighting the need to focus preventive efforts early in life. Despite substantial evidence for the role of parents in the prevention of adolescent depression and anxiety disorders, there remains a need for translation of this evidence into preventive parenting interventions. To address this gap, we developed a single-session, Web-based, tailored psychoeducation intervention that aims to improve parenting practices known to influence the development of adolescent depression and anxiety disorders. OBJECTIVE The aim of this study was to evaluate the short-term effects of the intervention on parenting risk and protective factors and symptoms of depression and anxiety in adolescent participants. METHODS We conducted a single-blind, parallel group, superiority randomized controlled trial comparing the intervention with a 3-month waitlist control. The intervention is fully automated and consists of two components: (1) completion of an online self-assessment of current parenting practices against evidence-based parenting recommendations for the prevention of adolescent depression and anxiety disorders and (2) an individually tailored feedback report highlighting each parent’s strengths and areas for improvement based on responses to the self-assessment. A community sample of 349 parents, together with 327 adolescents (aged 12-15 years), were randomized to either the intervention or waitlist control condition. Parents and adolescents completed online self-reported assessments of parenting and adolescent symptoms of depression and anxiety at baseline, 1-month (parent-report of parenting only), and 3-month follow-up. RESULTS Compared with controls, intervention group parents showed significantly greater improvement in parenting risk and protective factors from baseline to 1-month and 3-month follow-up (F2,331.22=16.36, P<.001), with a small to medium effect size at 3-month follow-up (d=0.33). There were no significant effects of the intervention on adolescent-report of parenting or symptoms of depression or anxiety in the adolescents (all P>.05). CONCLUSIONS Findings suggest that a single-session, individually tailored, Web-based parenting intervention can improve parenting factors that are known to influence the development of depression and anxiety in adolescents. However, our results do not support the effectiveness of the intervention in improving adolescent depression or anxiety symptoms in the short-term. Long-term studies are required to adequately assess the relationship between improving parenting factors and adolescent depression and anxiety outcomes. Nonetheless, this is a promising avenue for the translation of research into a low-cost, sustainable, universal prevention approach. CLINICALTRIAL Australian New Zealand Clinical Trials Registry: ACTRN12615000247572; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12615000247572 (Archived by WebCite at http://www.webcitation.org/6v1ha19XG)

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