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A randomized controlled trial of technology-enhanced behavioral parent training: sustained parent skill use and child outcomes at follow-up / Justin PARENT in Journal of Child Psychology and Psychiatry, 63-9 (September 2022)
[article]
Titre : A randomized controlled trial of technology-enhanced behavioral parent training: sustained parent skill use and child outcomes at follow-up Type de document : Texte imprimé et/ou numérique Auteurs : Justin PARENT, Auteur ; Margaret T. ANTON, Auteur ; Raelyn LOISELLE, Auteur ; April HIGHLANDER, Auteur ; Nicole BRESLEND, Auteur ; Rex FOREHAND, Auteur ; Megan HARE, Auteur ; Jennifer K. YOUNGSTROM, Auteur ; Deborah J. JONES, Auteur Article en page(s) : p.992-1001 Langues : Anglais (eng) Mots-clés : Attention Deficit and Disruptive Behavior Disorders/therapy Child Child Behavior Disorders/psychology/therapy Child, Preschool Follow-Up Studies Humans Parent-Child Relations Parenting/psychology Parents/education Technology Behavioral parent training child behavior disorders low-income families Index. décimale : PER Périodiques Résumé : BACKGROUND: Early-onset (3-8years old) disruptive behavior disorders (DBDs) have been linked to a range of psychosocial sequelae in adolescence and beyond, including delinquency, depression, and substance use. Given that low-income families are overrepresented in statistics on early-onset DBDs, prevention and early-intervention targeting this population is a public health imperative. The efficacy of Behavioral Parent Training (BPT) programs such as Helping the Noncompliant Child (HNC) has been called robust; however, given the additional societal and structural barriers faced by low-income families, family engagement and retention barriers can cause effects to wane with time. This study extends preliminary work by examining the potential for a Technology-Enhanced HNC (TE-HNC) program to improve and sustain parent skill proficiency and child outcomes among low-income families. METHODS: A randomized controlled trial with two parallel arms was the design for this study. A total of 101 children (3-8-years-old) with clinically significant problem behaviors from low-income households were randomized to HNC (n=54) or TE-HNC (n=47). Participants were assessed at pre-treatment, post-treatment, 3-month, and 6-month follow-ups. Primary outcomes were parent-reported and observed child behavior problems. Secondary outcomes included observed parenting skills use (ClinicalTrials.gov Identifier: NCT02191956). RESULTS: Primary analyses used latent curve modeling to examine treatment differences in the trajectory of change during treatment, maintenance of treatment gains, and levels of outcomes at the 6-month follow-up. Both programs yielded improvements in parenting skills and child problems at post-treatment. However, TE-HNC families evidenced greater maintenance of parent-reported and observed child behavior and observed positive parenting skills at the 6-month follow-up. CONCLUSIONS: Our findings contribute to an ongoing line of work suggesting that technology-enhanced treatment models hold promise for increasing markers of engagement in BPT and sustaining long-term outcomes among low-income families. En ligne : http://dx.doi.org/10.1111/jcpp.13554 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=486
in Journal of Child Psychology and Psychiatry > 63-9 (September 2022) . - p.992-1001[article] A randomized controlled trial of technology-enhanced behavioral parent training: sustained parent skill use and child outcomes at follow-up [Texte imprimé et/ou numérique] / Justin PARENT, Auteur ; Margaret T. ANTON, Auteur ; Raelyn LOISELLE, Auteur ; April HIGHLANDER, Auteur ; Nicole BRESLEND, Auteur ; Rex FOREHAND, Auteur ; Megan HARE, Auteur ; Jennifer K. YOUNGSTROM, Auteur ; Deborah J. JONES, Auteur . - p.992-1001.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 63-9 (September 2022) . - p.992-1001
Mots-clés : Attention Deficit and Disruptive Behavior Disorders/therapy Child Child Behavior Disorders/psychology/therapy Child, Preschool Follow-Up Studies Humans Parent-Child Relations Parenting/psychology Parents/education Technology Behavioral parent training child behavior disorders low-income families Index. décimale : PER Périodiques Résumé : BACKGROUND: Early-onset (3-8years old) disruptive behavior disorders (DBDs) have been linked to a range of psychosocial sequelae in adolescence and beyond, including delinquency, depression, and substance use. Given that low-income families are overrepresented in statistics on early-onset DBDs, prevention and early-intervention targeting this population is a public health imperative. The efficacy of Behavioral Parent Training (BPT) programs such as Helping the Noncompliant Child (HNC) has been called robust; however, given the additional societal and structural barriers faced by low-income families, family engagement and retention barriers can cause effects to wane with time. This study extends preliminary work by examining the potential for a Technology-Enhanced HNC (TE-HNC) program to improve and sustain parent skill proficiency and child outcomes among low-income families. METHODS: A randomized controlled trial with two parallel arms was the design for this study. A total of 101 children (3-8-years-old) with clinically significant problem behaviors from low-income households were randomized to HNC (n=54) or TE-HNC (n=47). Participants were assessed at pre-treatment, post-treatment, 3-month, and 6-month follow-ups. Primary outcomes were parent-reported and observed child behavior problems. Secondary outcomes included observed parenting skills use (ClinicalTrials.gov Identifier: NCT02191956). RESULTS: Primary analyses used latent curve modeling to examine treatment differences in the trajectory of change during treatment, maintenance of treatment gains, and levels of outcomes at the 6-month follow-up. Both programs yielded improvements in parenting skills and child problems at post-treatment. However, TE-HNC families evidenced greater maintenance of parent-reported and observed child behavior and observed positive parenting skills at the 6-month follow-up. CONCLUSIONS: Our findings contribute to an ongoing line of work suggesting that technology-enhanced treatment models hold promise for increasing markers of engagement in BPT and sustaining long-term outcomes among low-income families. En ligne : http://dx.doi.org/10.1111/jcpp.13554 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=486 The longitudinal impact of an evidence-based multiple family group intervention (Amaka Amasanyufu) on oppositional defiant disorder and impaired functioning among children in Uganda: analysis of a cluster randomized trial from the SMART Africa-Uganda scale-up study (2016-2022) / Rachel BRATHWAITE in Journal of Child Psychology and Psychiatry, 63-11 (November 2022)
[article]
Titre : The longitudinal impact of an evidence-based multiple family group intervention (Amaka Amasanyufu) on oppositional defiant disorder and impaired functioning among children in Uganda: analysis of a cluster randomized trial from the SMART Africa-Uganda scale-up study (2016-2022) Type de document : Texte imprimé et/ou numérique Auteurs : Rachel BRATHWAITE, Auteur ; Fred M. SSEWAMALA, Auteur ; Ozge SENSOY BAHAR, Auteur ; Mary M. MCKAY, Auteur ; Torsten B. NEILANDS, Auteur ; Phionah NAMATOVU, Auteur ; Joshua KIYINGI, Auteur ; Lily ZMACHINSKI, Auteur ; Josephine NABAYINDA, Auteur ; Keng-Yen HUANG, Auteur ; Apollo KIVUMBI, Auteur ; Arvin BHANA, Auteur ; Abel MWEBEMBEZI, Auteur ; Inge PETERSEN, Auteur ; Kimberly HOAGWOOD, Auteur Article en page(s) : p.1252-1260 Langues : Anglais (eng) Mots-clés : Child Adolescent Humans Adult Uganda Attention Deficit and Disruptive Behavior Disorders/therapy Schools Parents Oppositional defiant disorders Randomized Controlled Trial children and adolescents family relationships intervention sub-Saharan Africa Index. décimale : PER Périodiques Résumé : BACKGROUND: Oppositional Defiant Disorders (ODDs) and other Disruptive Behavior Disorders (DBDs) are common among children and adolescents in poverty-impacted communities in sub-Saharan Africa. Without early intervention, its progression into adulthood can result in dire consequences. We examined the impact of a manualized family strengthening intervention called Amaka Amasanyufu designed to reduce ODDs and other DBDs among school-going children residing in low-resource communities in Uganda. METHODS: We used longitudinal data from the SMART Africa-Uganda study (2016-2022). Public primary schools were randomized to: (1) Control condition (receiving usual care comprising generalized psychosocial functioning literature), 10 schools; (2) intervention delivered via parent peers (Amaka-parents), 8 schools or; (3) intervention delivered via community healthcare workers (Amaka-community), 8 schools. All the participants were blinded. At baseline, 8- and 16-weeks postintervention initiation, caregivers completed the Iowa Conners Scale, which measured Oppositional Defiant Disorder (ODD) and Impairment Rating Scale to evaluate children's overall impairment and impaired functioning with peers, siblings, and parents; impaired academic progress, self-esteem, and family functioning. Three-level linear mixed-effects models were fitted to each outcome. Pairwise comparisons of postbaseline group means within each time point were performed using Sidak's adjustment for multiple comparisons. Only children positive for ODD and other DBDs were analyzed. RESULTS: Six hundred and thirty-six children screened positive for ODDs and other DBDs (Controls: n=243; Amaka-parents: n=194; Amaka-community: n=199). At 8 weeks, Amaka-parents' children had significantly lower mean scores for overall impairment compared to controls, (mean difference: -0.71, p=.001), while Amaka-community children performed better on ODD (mean difference: -0.84, p=.016). At 16 weeks, children in both groups were performing better on ODD and IRS than controls, and there were no significant differences between the two intervention groups. CONCLUSIONS: The Amaka Amasanyufu intervention was efficacious in reducing ODD and impaired functioning relative to usual care. Hence, the Amaka Amasanyufu intervention delivered either by Amaka-community or Amaka-parents has the potential to reduce negative behavioral health outcomes among young people in resource-limited settings and improve family functioning. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03081195. Registered on 16 March 2017. En ligne : http://dx.doi.org/10.1111/jcpp.13566 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=490
in Journal of Child Psychology and Psychiatry > 63-11 (November 2022) . - p.1252-1260[article] The longitudinal impact of an evidence-based multiple family group intervention (Amaka Amasanyufu) on oppositional defiant disorder and impaired functioning among children in Uganda: analysis of a cluster randomized trial from the SMART Africa-Uganda scale-up study (2016-2022) [Texte imprimé et/ou numérique] / Rachel BRATHWAITE, Auteur ; Fred M. SSEWAMALA, Auteur ; Ozge SENSOY BAHAR, Auteur ; Mary M. MCKAY, Auteur ; Torsten B. NEILANDS, Auteur ; Phionah NAMATOVU, Auteur ; Joshua KIYINGI, Auteur ; Lily ZMACHINSKI, Auteur ; Josephine NABAYINDA, Auteur ; Keng-Yen HUANG, Auteur ; Apollo KIVUMBI, Auteur ; Arvin BHANA, Auteur ; Abel MWEBEMBEZI, Auteur ; Inge PETERSEN, Auteur ; Kimberly HOAGWOOD, Auteur . - p.1252-1260.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 63-11 (November 2022) . - p.1252-1260
Mots-clés : Child Adolescent Humans Adult Uganda Attention Deficit and Disruptive Behavior Disorders/therapy Schools Parents Oppositional defiant disorders Randomized Controlled Trial children and adolescents family relationships intervention sub-Saharan Africa Index. décimale : PER Périodiques Résumé : BACKGROUND: Oppositional Defiant Disorders (ODDs) and other Disruptive Behavior Disorders (DBDs) are common among children and adolescents in poverty-impacted communities in sub-Saharan Africa. Without early intervention, its progression into adulthood can result in dire consequences. We examined the impact of a manualized family strengthening intervention called Amaka Amasanyufu designed to reduce ODDs and other DBDs among school-going children residing in low-resource communities in Uganda. METHODS: We used longitudinal data from the SMART Africa-Uganda study (2016-2022). Public primary schools were randomized to: (1) Control condition (receiving usual care comprising generalized psychosocial functioning literature), 10 schools; (2) intervention delivered via parent peers (Amaka-parents), 8 schools or; (3) intervention delivered via community healthcare workers (Amaka-community), 8 schools. All the participants were blinded. At baseline, 8- and 16-weeks postintervention initiation, caregivers completed the Iowa Conners Scale, which measured Oppositional Defiant Disorder (ODD) and Impairment Rating Scale to evaluate children's overall impairment and impaired functioning with peers, siblings, and parents; impaired academic progress, self-esteem, and family functioning. Three-level linear mixed-effects models were fitted to each outcome. Pairwise comparisons of postbaseline group means within each time point were performed using Sidak's adjustment for multiple comparisons. Only children positive for ODD and other DBDs were analyzed. RESULTS: Six hundred and thirty-six children screened positive for ODDs and other DBDs (Controls: n=243; Amaka-parents: n=194; Amaka-community: n=199). At 8 weeks, Amaka-parents' children had significantly lower mean scores for overall impairment compared to controls, (mean difference: -0.71, p=.001), while Amaka-community children performed better on ODD (mean difference: -0.84, p=.016). At 16 weeks, children in both groups were performing better on ODD and IRS than controls, and there were no significant differences between the two intervention groups. CONCLUSIONS: The Amaka Amasanyufu intervention was efficacious in reducing ODD and impaired functioning relative to usual care. Hence, the Amaka Amasanyufu intervention delivered either by Amaka-community or Amaka-parents has the potential to reduce negative behavioral health outcomes among young people in resource-limited settings and improve family functioning. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03081195. Registered on 16 March 2017. En ligne : http://dx.doi.org/10.1111/jcpp.13566 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=490