Intervention For Parents Of Children Research Articles

Abstract B049: Building rapport in navigator-delivered health insurance literacy interventions: Engagement and tone used by parents of children with cancer and patient navigators

Abstract Purpose: To explore the linguistic elements of engagement and tone used by parents of children with cancer and a patient navigator (PN) during a pilot study of a health insurance literacy (HIL) intervention. Methods: A trained PN delivered a four-session Zoom-based HIL intervention for parents of children with cancer that contained content on: Session 1 (S1) health insurance terms, (S2) using health insurance, (S3) insurance appeals/legislation, and (S4) budgeting and financial strategies. We applied Linguistic Inquiry Word Count (LIWC-22) software to analyze transcriptions of each session regarding engagement and tone. We report, in aggregate, differences in language: analytical language (e.g., formal, logical), clout language (e.g., confidence, leadership), authenticity language (e.g., degree of self-monitoring), and emotional tone (e.g., positive and negative emotion words) (all range 1-99) between S1 and S4 using paired t-tests. We also analyzed language similarities between the PN and the parent using Language Style Matching, which represents the degree to which both speakers are engaged in the conversation. Results: Of 10 participants, 9 completed 4 sessions, and 1 parent completed 3 (39 sessions total); sessions were on average 35.1 (SD=6.4) minutes. Most participants were women (80%), married (90%), white (100%), and non-Hispanic (90%); half had a college degree. The PN spoke more than parents across all four sessions (90% PN vs 8.8% parent); however, parent engagement, as represented by word count, increased as the sessions went on (mean S1: 414 words, S4: 603.8 words, p=0.21). S1 contained the most language exchange between parents and the PN (median word count: 5,533.5). The discussions became increasingly authentic (mean by session: S1:24.2; S4:28.6; p=0.02), held more clout (S1:77.8, S4: 85.8; p=0.009), and increased in emotional tone (S1:49; S4:65, p=0.002). Analytical language decreased over time (S1:24.4; S4:19.8, p=0.05). Language style matching was consistently high and trending upward across sessions (S1:0.80; S4: 0.81, p=0.3). Conclusions: In a pilot test of a HIL intervention, we saw an increase in authentic language, emotional tone, and parent word count coupled with a decrease in analytical language, indicating increased rapport between the PN and parent over the sessions. This suggests there is emotional and supportive value in PN-led interventions as compared to self-directed interventions. PNs can build trust and promote equity by deconstructing and personalizing health insurance information. Future work should explore how rapport built between parents and PNs relates to health insurance literacy and financial toxicity outcomes. Citation Format: Mary K. Killela, Anne C. Kirchhoff, Perla Vaca Lopez, Amy Chevrier, Monique Stefanou, Katie Rogers, Douglas Fair, Echo L. Warner. Building rapport in navigator-delivered health insurance literacy interventions: Engagement and tone used by parents of children with cancer and patient navigators [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B049.

Understanding levels of engagement and readiness for change in an eHealth sleep program for children with neurodevelopmental disorders

BackgroundChildren with neurodevelopmental disorders (NDD) experience high rates of sleep problems. The Better Nights, Better Days for Children with Neurodevelopmental DisordersTM(BNBD-NDDTM) program is an online intervention for parents of children with NDD who have insomnia/insomnia symptoms. The program has recently undergone a national implementation study (recruitment completed; data collection and analysis ongoing), where parental adherence and engagement are being evaluated. Preliminary results have shown that despite high levels of recruitment, there is less utilization of the program than the research team expected. Parental engagement may have been impacted by participants' motivation and readiness for change, as well as indirectly by the COVID-19 pandemic. The objective of the current study is to better understand engagement with the BNBD-NDDTM program concerning parental motivation and readiness for change, while considering the possible impacts of COVID-19.MethodsParents of children with NDD (n = 18) who were enrolled in the BNBD-NDDTM program for a minimum of 4 months completed exit interviews using a researcher-generated, semi-structured interview guide. During the interview, participants were asked about their engagement in the program, perspectives on their own readiness for changing their children's sleep, and the impact of COVID-19 on their engagement. Data were analyzed following an inductive content analysis approach.ResultsSeveral categories of data were generated that explain levels of engagement, including: (1) severity of sleep problems; (2) motivation for change; (3) previous strategies for sleep; (4) confidence in the program; (5) sacrifices made to change sleep; (6) maintenance of change; (7) experience with levels of support provided; and (8) impact of the COVID-19 pandemic.ConclusionParents identified several factors related to their readiness for change as contributors to their engagement level in the BNBD-NDDTM program. The COVID-19 pandemic had varied impacts on engagement for participants in this sample. Understanding parents' engagement levels within the BNBD-NDDTM eHealth program related to their motivation and readiness for change is crucial to optimize uptake and adherence to the program, improve the program's implementation and sustainability, and continue to help children with NDD to sleep better.

Feasibility and acceptability of a parent-child intervention to improve step count in childhood cancer survivors exposed to cardiotoxic therapy: The STEP UP for FAMILIES Study.

Late morbidity after childhood cancer may be mitigated by healthy lifestyle behaviors. We piloted a game-based, parent-child digital intervention to increase activity in sedentary survivors. Survivors aged 10-16 treated with cardiotoxic therapy and not meeting US physical activity guidelines were enrolled in a single-arm study with a parent. Following a 14-day run-in, participants chose a prespecified step goal and wore an accelerometer daily for 24weeks (12-week game-based intervention; 12-week follow-up). Participants completed the Acceptability of Intervention Measure (AIM) at 24weeks; a subset of dyads completed qualitative interviews. Among 129 eligible survivors, 27 enrolled (20.9% participation rate) with a parent. Four dyads were removed during the 14-day run-in period due to noncompliance. Among the 23 dyads who continued to the study, the tracker was worn for 95% of days during the 12-week intervention (95% confidence interval [CI]: 94-96) and 81% during the 12-week follow-up (95% CI: 79-82). Overall, the prespecified step goal was met for 64% (95% CI: 63-66) of days during the intervention and 37% (95% CI: 35-38) during the follow-up. At the end of study, 17/23 dyads responded to AIM; 82% of survivors and 94% of parents reported the intervention as acceptable. During qualitative interviews (n=5), dyads noted that they liked the accountability of the "buddy system," but would have liked more personalized goal-setting. Despite high ratings of acceptability among participants, difficulties with sustained adherence and retention were encountered in this parent-child gamification intervention. Alternate, tailored designs should be considered in the future.

The reliability and validity of the Coder Impressions Questionnaire-Kindergarten for parenting and child behaviors.

Reliable and valid assessment of parenting and child behaviors is critical for clinicians and researchers alike, and observational measures of parenting behaviors are often considered the gold standard for assessing parenting and parent-child interaction quality. The present study sought to evaluate the reliability and validity of the Coder Impressions Questionnaire-Kindergarten (COIMP-K) measure. The present study was a secondary analysis of 274 parents and their children participating in a randomized control trial testing a brief parenting intervention for parents of children entering kindergarten. Families participated in baseline and follow-up assessments and videotaped observational tasks. Graduate and undergraduate coders completed the COIMP-K after achieving reliability. The aims of the present study were to assess COIMP-K's (a) internal consistency using intercorrelations among COIMP-K subscales, (b) construct validity, (c) convergent validity by comparing the COIMP-K subscales to parents' self-report of similar behaviors, (d) discriminant validity by comparing subscales to a parent-teacher communication measure as it is unrelated to parenting or child behaviors, and (e) congruence across time. The authors hypothesized that the COIMP-K would demonstrate adequate internal consistency (Cortina, 1993), adequate construct, convergent, and discriminant validity and find congruence of the measure across time. The results demonstrated that the factors had adequate internal consistency, construct, convergent, and discriminant validity, as well as longitudinal replicability and congruence over time. The study demonstrates that the COIMP-K is a reliable and valid tool for assessing observed family behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Symptom network analysis of parent-child depression and anxiety in treatment-seeking youth.

Youth of parents who are experiencing psychopathology are more likely to develop emotional concerns, and these mental health symptoms can have a deleterious impact on parents' mental health. However, the relationship between the presentation of specific symptoms in parents and youth is infrequently examined. Symptom network analysis is an analytic approach that is increasingly being used to better understand the relationship of symptoms within and between disorders and can also be used to examine symptom relations within a dyad. The present study used symptom network analysis to examine bidirectional relationships among depressive and anxiety psychopathology in a transdiagnostic sample of treatment-seeking youth and their primary caregiver. Parental anhedonia and child worthlessness exhibited the greatest centrality within the network, suggesting that these may act as risk and maintenance factors for parent-child psychopathology and may be important intervention targets. Findings support the use of symptom network analysis to inform an understanding of the complex relationships among parent and child depressive and anxiety symptoms. Future research should consider the use of network analytic methods to examine the temporal relationships between parent and child psychopathology and to inform joint parent-child interventions for those with internalizing concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effects of a Parent-Child Single-Session Growth Mindset Intervention on Adolescent Depression and Anxiety Symptoms: Protocol of a 3-Arm Waitlist Randomized Controlled Trial.

Depression and anxiety are common mental health problems among adolescents worldwide. Extant research has found that intelligence, emotion, and failure-is-debilitating beliefs (fixed mindsets) are closely related to more depression and anxiety symptoms, hopelessness, and suicidality. Recent research also points to the importance of parental mindset, which can strongly influence children's affect, behavior, and mental health. However, the effects of parent-child mindset interventions on a child's internalizing problems have not yet been empirically examined. As recent evidence has shown the promise of single-session interventions in reducing and preventing youth internalizing problems, this study develops and examines a parent and child single-session intervention on mindsets of intelligence, failure, and emotion (PC-SMILE) to tackle depression and anxiety in young people. Using a 3-arm randomized controlled trial, this study will examine the effectiveness of PC-SMILE in reducing depression and anxiety symptoms among children. We hypothesize that compared to the waitlist control group, the PC-SMILE group and child single-session intervention on mindsets of intelligence, failure, and emotion (C-SMILE) group will significantly improve child depression and anxiety (primary outcome) and significantly improve secondary outcomes, including children's academic self-efficacy, hopelessness, psychological well-being, and parent-child interactions and relationships, and the PC-SMILE is more effective than the C-SMILE. A total of 549 parent-child dyads will be recruited from 8 secondary schools and randomly assigned to either the PC-SMILE intervention group, the C-SMILE intervention group, or the no-intervention waitlist control group. The 45-minute interventions include parent-version and child-version. Both parents and students in the PC-SMILE group receive the intervention. Students in C-SMILE group receive intervention and their parents will receive intervention after all follow-up ends. Students in 3 groups will be assessed at 3 time points, baseline before intervention, 2 weeks post intervention, and 3 months post intervention, and parents will be assessed in baseline and 3-month follow-up. The intention-to-treat principle and linear-regression-based maximum likelihood multilevel models will be used for data analysis. Recruitment started in September 2023. The first cohort of data collection is expected to begin in May 2024 and the second cohort will begin in September 2024. The final wave of data is expected to be collected by the end of the first quarter of 2025. The results are expected to demonstrate improved anxiety and depression among students assigned to the intervention condition, as well as the secondary outcomes compared to those in the control group. The efficacy and effectiveness of the intervention will be discussed. This study is the first attempt to develop a web-based single-session intervention for students and their parents to enhance their well-being in Hong Kong and beyond, which potentially contributes to providing evidence-based recommendations for the implementation of brief digital parent-child interventions. PRR1-10.2196/63220.

E-Health Family Interventions for Parents of Children With Autism Aged 0-6 Years: A Scoping Review.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with onset in infancy. Early intervention is critical to improve the prognosis for these children. E-health interventions have tremendous potential. This review aimed to determine the status and effectiveness of family interventions for parents of children aged 0-6 years with ASD in the context of e-health. The review methodology was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. PubMed, Web of Science, and China National Knowledge Infrastructure were searched from inception to June 2022. The searches were limited to children with ASD of the age range between 0 and 6 years. We collated the available information and used descriptive statistics to analyze the synthesized data. Our initial search identified 3,672 articles, of which 30 studies met the inclusion criteria. The 30 articles selected were released between 2012 and 2022. All articles are in English. Most articles reviewed were from high-income countries (27/30, 90.0%), especially from the United States (16/30, 53.3%). Four major themes emerged from the 30 studies that matched the inclusion criteria, as follows: 1) type of e-health interventions, 2) duration of interventions, 3) clinical aspects of e-health interventions, and 4) evidence for intervention effectiveness, looking into the positive, negative, and mixed findings of previous studies. These findings suggest that a wide variety of e-health interventions may actually help support both children with ASD aged 0-6 years and their parents.

Feasibility of a brief online mindfulness intervention for parents of children with developmental disabilities

Parents of children with developmental disabilities often experience increased levels of distress but have difficulty accessing face-to-face mental health care due to parenting demands. A brief, online mindfulness intervention was designed to improve accessibility for these families. Ten mothers completed a 2-week intervention in addition to pre-post measures of mood and mindfulness. Six participants provided 3-month follow-up data. Immediate reductions in distress and improvements in mindfulness were reported, with gains maintained over time. Despite difficulties with recruitment, satisfaction ratings and user-end data suggested good engagement. Online mindfulness training may help to alleviate distress as well as enhance wellbeing for parents of children with a developmental disability. These promising findings require confirmation with an adequately powered randomised controlled trial.

Characteristics of effective parent-mediated interventions for parents of children with neurodevelopmental disorders in rural areas: a systematic review protocol

IntroductionParent-mediated interventions are therapeutic approaches that use parent training to enable parents to provide primary support and intervention to their child through the development of necessary skills, knowledge, and resources.Parent-mediated...

The efficacy of interventions designed for parents of children with developmental disabilities in Türkiye: A systematic review and meta-analysis

Previous studies have revealed that parents of children with developmental disabilities (DD) experience various mental health problems. The number of intervention studies has increased for parents of children with DD to reduce symptoms of mental health conditions and increase positive functioning in recent years in Türkiye. The main purpose of this systematic and meta-analytical review is to address the efficacy of interventions for parents of children with DD on symptoms of mental health conditions and positive functioning in Türkiye. The second purpose of this study is to examine the effect of the potential moderators on the efficacy of the interventions in symptoms of mental health conditions and positive functioning. For these purposes, studies published between 2000 and October 2022 were searched in various databases. As a result of the literature search, 61 studies met the inclusion criteria, and 23 studies with 17 independent effect sizes for symptoms of mental health conditions and 12 independent effect sizes for positive functioning were included in the current study. Cohen’s d effect size index was used to calculate the efficacy of intervention studies included in the meta-analysis on symptoms of mental health conditions and positive functioning. Results revealed that the overall mean effect size for the 17 mental health studies was −1.15 and for the 12 positive functioning studies was 2.03 in favor of experimental group. Moderator analyses showed that the study design (experimental vs. quasi-experimental) was a statistically significant moderator of positive functioning. The average effect size for experimental studies was higher than that of quasi-experimental studies. However, other moderators (the gender of the participants, publication type, the type of intervention, the disability type of children, the sample size, and the number of sessions) were not statistically significant for symptoms of mental health conditions and positive functioning. Although the current study has some limitations, the findings revealed that the interventions designed for parents of children with DD result in an increase in positive functioning and a reduction in symptoms of mental health conditions in favor of experimental group.

Early parent-child intervention with Dialogic Book-Sharing: effects on child communicative and socio-emotional development and on parenting. Study protocol for a multicentre randomised controlled trial in Italy

BackgroundResearch in the neurosciences has highlighted the importance of intersubjective relationships in promoting neuromental development of the child. Children’s learning in early childhood occurs mainly in a dyadic context of an interaction with their parents: from this perspective, good dialogic parent–child communication is required to be promoted also through good educational practices. Dialogic Book-Sharing (DBS), a dialogic form of parent–child communication through the use of wordless picture books, provides a privileged ‘intersubjective’ space and is highly effective in promoting communication, language, attention, behavioural development and the parent–child relationship. DBS programme, successfully previously trialled in South Africa and the UK, will be applied for the first time in Italy for research purposes in Italian health, educational and maternal-child centres.MethodsA multicentre randomised controlled trial is being conducted to evaluate DBS parenting intervention for children aged between 14 and 20 months. Parent–child dyads are randomly allocated to a book-sharing intervention group or to a wait-list control group. In the intervention, parents are trained in supportive book-sharing with their children by local staff of the centres. DBS intervention is carried out in small groups over a period of 4 weeks. Data are collected at baseline, post-intervention and at 6 months post-intervention with a questionnaire and video recording of parent–child interaction.DiscussionDBS programme in early childhood could enhance the educational resources offered by Italian health, educational and maternal-child centres, in support of child’s development and parenting. DBS represents a strategic opportunity for bringing about positive effects, also in terms of prevention of socio-emotional and cognitive difficulties. As such it represents a promising response to the new social, health and educational needs of the post-COVID-19 pandemic era caused by the social isolation measures. Furthermore, the application of the DBS methodology is a way to promote the use of books, and thereby counteract the excessive use of technological devices already present in early childhood.Trial registrationThe trial is registered on the International Standard Randomised Controlled Trial Number database, registration number ISRCTN11755019 Registered on 2 November 2023. This is version 1 of the protocol for the trial.

Considerations in cultural adaptation of parent-child interventions for African American mothers and children exposed to intimate partner violence.

African American women are at disproportionate risk of experiencing intimate partner violence (IPV) and consistently report more severe and recurrent IPV victimization in comparison to their White and Hispanic counterparts. IPV is more likely to occur in families with children than in couples without children. Parenting in the wake of IPV is a challenging reality faced by many African American women in the United States. Despite the urgent need to support mothers who have survived IPV, there is currently no culturally adapted parenting intervention for African American mothers following exposure to IPV. The aim of this review is to summarize and integrate two disparate literatures, hitherto unintegrated; namely the literature base on parenting interventions for women and children exposed to IPV and the literature base on parenting interventions through the lens of African American racial and cultural factors. Our review identified 7 questions that researchers may consider in adapting IPV parenting interventions for African American women and children. These questions are discussed as a possible roadmap for the adaptation of more culturally sensitive IPV parenting programs.

Practitioners' experiences of delivering parenting interventions remotely: A mixed‐methods study

AbstractGroup Stepping Stones Triple P (GSSTP), is an evidence‐based intervention for parents of children with intellectual disability that aims to improve child behavioural difficulties. GSSTP was designed to be delivered face‐to‐face, but during the COVID‐19 pandemic some services started delivering it remotely. The evidence base for remote intervention is growing, but few studies have focused on the experiences of practitioners delivering the interventions and the consequences of their service provision. We aimed to explore UK practitioners' experiences of delivering remotely GSSTP. The objectives were to identify the advantages and disadvantages of remote GSSTP, to determine whether adjustments were made to enable delivery, and to assess perceived acceptability. Participants were identified using consecutive sampling from the Triple P UK practitioner network. Eleven practitioners, who had experience of delivering GSSTP remotely and face‐to‐face, reported their experiences in an online survey. Ten participants also took part in semi‐structured interviews. Interviews were transcribed verbatim and analysed using thematic analysis. According to 55% of practitioners, parent attendance had increased with remote delivery, and 73% of practitioners found remote GSSTP equally or more effective than face‐to‐face. Survey findings about managing parent engagement remotely were mixed and building rapport with patients was considered equally or more difficult remotely. The key themes from the thematic analysis were the practitioners' ‘sincere enthusiasm’ over the advantages of the remote GSSTP provision, the ‘person‐centered strategies’ that characterised their practice, the emergence of ‘remote delivery as the way forward’ for parenting services and finally, the ‘challenges of remote delivery’. Remote GSSTP was perceived to be acceptable to participants and practitioners; the advantages of remote delivery appeared to outweigh the disadvantages. Practitioners reported strategies to prompt engagement and recreate group interactions in the remote setting that could be integrated in the practice of other group parenting providers.

Acceptance and utilization of web-based self-help for caregivers of children with externalizing disorders

BackgroundWeb-based self-help interventions for parents of children with ADHD and other externalizing disorders have been proven to be effective. In order to recommend individualized and optimized interventions, a better understanding of the acceptance and utilization of this innovative treatment approach is needed. Previous research has frequently employed subjective reports of utilization, but the validity of these studies may be limited.MethodsData from the German WASH study were used. Participants (n = 276) were randomly assigned to the intervention condition (a) web-based self-help or (b) web-based self-help with optional telephone-based support calls. Data collection took place at baseline (T1) and 12 weeks later (T2). Utilization data were tracked using a log file generated for each participant at T2. Prediction models were calculated using CART (Classification and Regression Trees), a method known mostly from the field of machine learning.ResultsAcceptance, of the intervention as defined in this paper was very high on objective (89.4% have taken up the intervention) and subjective measures (91.4% reported having used the intervention and 95.3% reported they would recommend the intervention to a friend). The average number of logins corresponded to recommendations. Predictors of acceptance and predictors of utilization were similar and included, e.g., child’s externalizing symptoms, parental psychopathology, and above all additional telephone-based support by counselors.ConclusionsThrough a detailed identification of acceptance and utilization, and the predictors thereof, we were able to gain a better understanding of the acceptance and utilization of web-assisted self-help for a parent management intervention in the treatment of children with ADHD and ODD. These findings can be used to recommend web-based interventions to particularly suitable families. It should be noted that some form of support is required for an intensive engagement with the content of the program.Trial RegistrationThe protocol of the study (German Clinical Trials Register DRKS00013456 conducted on January 3rd, 2018) was approved by the Ethics Committee of the University Hospital, Cologne.

Effects of a Nurse-Led Cognitive Behavioral Intervention for Parents of Children With Epilepsy

BackgroundThis study aimed to evaluate the effects of a nurse-led cognitive behavioral intervention for parents of children with epilepsy (CWE). MethodsThe study recruited 238 CWE from the neurology ward of Xiangya Hospital from March 2019 to August 2022. According to the interventions after discharge, the children and their parents were randomly divided into 117 parent-child dyads in the intervention group and 121 parent-child dyads in the control group. The seizure severity and treatment compliance in CWE as well as the parents’ psychological states and satisfaction with the care provided by nurses were compared before and after intervention. ResultsThe follow-up six months after discharge showed that the seizure frequency among CWE in the intervention group was significantly less than the controls (P = 0.048). Compared with the controls, the intervention group also reported fewer symptoms of anxiety and depression, better sleep quality, and more positive attitudes toward epilepsy, as well as higher nursing satisfaction (P < 0.001). The correlation analysis indicated the correlation of CWE’s seizure severity was correlated with the compliance, parents' psychological states, and parents' satisfaction with the care provided by nurses. ConclusionsThe adoption of the nurse-led cognitive behavioral intervention on parents of CWE can improve the parents’ mental health status and their satisfaction with the nurses, which can have a positive association with the seizure severity of CWE. In light of this information, this nursing intervention may be a new method for the long-term disease management of CWE.

Correctly identifying and reacting to others’ sadness: investigating three parent-child interventions for limited prosocial emotions

ABSTRACT Recognizing and appropriately responding to others’ emotional expressions is important for children’s moral and social development. Impairments in the emotion recognition of individuals high on Callous-Unemotional (CU) traits are thought to explain their reduced empathic responding, interpersonal problems, and persistent antisocial behaviour. The current study uses accuracy ratings and physiological measures to assess changes in identifying and reacting to others’ sadness, respectively, among children high on CU traits who received one of three brief parenting interventions designed to address their emotional deficits. Participants were 68 children (M age = 7.50 years, SD = 1.49, 46% female), selected from a larger screening sample (N = 1,283). The study assessed emotional accuracy and skin conductance reactivity during the presentation of sad video scenes pre- and post-intervention. Parents and children participated in three intervention programmes (i.e., Parent-Child Interaction Therapy-CU, Coaching and Rewarding Emotional Skills, Emotional Engagement) designed to target the emotional deficits of children with CU traits. Findings support the amenability of emotional deficits related to empathic responding to others’ sad expressions among children high on CU traits. Specifically, children showed improved ability to accurately identify sad emotions as well as increased autonomic reactivity (i.e., skin conductance) to sad expressions at post-intervention. Our findings draw attention to the importance of parenting interventions aiming to enhance the emotional functioning of children high on CU traits.

Coaching for parents of children with type 1 diabetes: A randomized controlled trial

ObjectiveTo assess the effectiveness of a standardized bi-weekly six-month telephone coaching intervention for parents of children with type 1 diabetes. MethodsThis single-blind randomized controlled trial followed participants for 12 months. The primary outcome was children’s health-related quality of life. Secondary outcomes included treatment adherence, diabetes-related family conflict, and hemoglobin A1c. Data was collected using validated questionnaires and health records. We compared groups using a linear mixed effects model. Results102 families were randomized (control: n = 49; intervention: n = 53). Coaching had no impact on children’s overall health-related quality of life or overall secondary outcomes; however, there were patterns in subsections that suggest the possible impact of coaching. Coaching was perceived as a positive addition to routine care by 80% of families and 82% would recommend working with a coach to another family. 58% of participants would continue coaching beyond the study. ConclusionCoaching did not impact overall quality of life or secondary outcomes; however, coaching was well received by families who perceived significant benefits. Patterns in subsections warrant further study. Practice implicationsAdding a health coach into diabetes multidisciplinary care supports families in a way that is unique from their routine clinical care.

Family‐based preventive intervention for children of parents with severe mental illness: A randomized clinical trial

AbstractBackgroundChildren of parents with a severe mental illness have an increased risk of developing a lifetime mental illness. We aimed to compare the effects of a preventive family‐based intervention, VIA Family, with treatment as usual (TAU) on these children's global functioning.MethodsBetween 2017 and 2021, we conducted a pragmatic, rater‐blinded, two‐arm parallel‐group superiority trial in Denmark. Families with at least one child aged 6–12 years and at least one biological parent with schizophrenia spectrum disorder, bipolar disorder, or recurrent major or moderate depression were included. We randomly allocated 95 families with their 113 children to VIA Family or TAU (ratio 1:1). VIA Family was individually tailored and based on case management. The intervention included options for psychoeducation, parental support, and treatment for emerging child psychiatric symptoms. Blinded raters assessed children and their families at baseline and after 18 months. The primary outcome was the difference in change between groups at end‐of‐treatment in daily global functioning measured with the Children's Global Assessment Scale. Secondary outcomes were emotional and behavioral problems and days absent from school. We analyzed data blinded to allocation.ResultsAt post‐intervention, differences in mean change from baseline between VIA Family and TAU were non‐significant (CGAS: −1.20, 95% CI = −6.61; 4.21, p = 0.66), as were the differences on the secondary and exploratory outcomes.ConclusionContrary to our hypothesis, we did not find a superior effect of VIA Family compared with TAU. The short follow‐up period and large sample heterogeneity might explain the null findings. Therefore, a possible long‐term, preventive treatment effect has yet to be explored.

Effect of Foot Reflexology Massage on Sleep Habits in Children with Autistic Spectrum Disorder: A Randomized Clinical Trial

Background: Sleep plays a crucial role in children's motor, mental, and cognitive development. Due to the significant prevalence of sleep problems in children with autism and the side effects of pharmacological therapy, complementary interventions should be considered. Objectives: This study aimed to investigate the effect of foot reflexology massage on sleep habits in children with autistic spectrum disorder. Methods: This randomized clinical trial was conducted on 60 children with autistic spectrum disorder in Mashhad, Iran. The control group received routine care from the family. In the intervention group, in addition to the routine family care, a foot reflexology massage was performed for 15 min by parents for 30 nights before bedtime for children. The standard Children's Sleep Habits Questionnaire (CSHQ) was completed 3 times in both groups. In the control group, the questionnaire was completed at the beginning of the study, on the 15th day, and on the 30th day after entering the study. In the intervention group, the questionnaire was completed before the intervention, on the 15th day after the intervention, and on the 30th day after the intervention. Data were analyzed using SPSS version 16 by the independent t-test, Mann-Whitney test, and repeated measures analysis of variance (ANOVA). Results: Among the children included in the study, 78.3% were male, and their mean age was 8.56 ± 2.4 years. The mean total score of children's sleep habits before the intervention was not significantly different between the control and intervention groups (P = 0.71). After the intervention, the mean total score of children's sleep habits was significantly different between the control and intervention groups (P = 0.001). The foot reflexology massage, with a score reduction of 8.13 ± 3.95 points, had a significant impact on the score of sleep habits in the intervention group (P = 0.002). Conclusions: Foot reflexology massage improves the quality of sleep in children with autism and can be recommended as a safe intervention for parents of children with autism.

Meta-Analysis of Positive Psychotherapy Interventions for Parents of Children with Special Needs in Iran

Objective: The purpose of this research was to conduct a meta-analysis of positive psychotherapy interventions for parents of children with special needs in Iran. Method: This study determined the effect size of positive psychotherapy interventions for these parents by synthesizing the results of various studies. The data sources included the National Publication Database, the Academic Jihad Science Information Center, and the Noor Specialized Journals Database. Out of 18 studies, 12 met the inclusion criteria and were selected, utilizing a meta-analysis checklist as the research tool. The study was based on 348 samples and 12 effect sizes. Findings: The meta-analysis revealed that the effect size of positive psychotherapy interventions for parents of children with special needs is d = 1.19 (p = 0.05), which is considered high according to Cohen's scale. The highest effect size was reported by Rezaei Kalantari et al. (2019), with a d = 2.31, titled "Effect of positive psychotherapy on perceived stress and life purposes in mothers of children with autism," and the smallest effect sizes were found in the study by Nili et al. (2019), with d = 0.2 and d = 0.23, titled "Effectiveness of positive training on irrational beliefs and happiness in mothers of deaf children." Conclusion: Overall, the results indicate that positive psychotherapy interventions are effective for parents of children with special needs, and researchers can utilize this program to enhance mental health components.