Evaluation of FunFRIENDS program in prevention of anxiety in Brazilian children: a randomized controlled pilot trial

Rivero, Lina Maria Herrera Nunez; Andrade, André Luiz Monezi; Zeggio, Larissa; Pinheiro, Bruno de Oliveira; Micheli, Denise De

doi:10.1590/1413-812320202511.33072018

Cited by 9 publications

(1 citation statement)

References 24 publications

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“…This program focuses on reducing anxiety symptoms and promoting protective factors against the onset of future psychopathology. Recent studies have demonstrated feasibility and positive effects of the program in Australia (Anticich et al, 2013; Barrett et al, 2015; Carlyle, 2014; Fisak et al, 2018; Pahl & Barret, 2010), Brazil (Garcia et al, 2019; Rivero et al, 2020), Mexico (Gallegos-Guajardo et al, 2020, 2013), and the Netherlands (Van der Mheen et al, 2020). Interestingly, a study conducted in Japan using Fun FRIENDS with older children found minimal effects, highlighting the limits of this program among older youth (Kato & Shimizu, 2017) and the need for research in other countries.…”

Section: Introductionmentioning

confidence: 99%

An Ounce of Prevention: Building resilience and targeting anxiety in young children

Lewis

Barrett

Freitag

et al. 2022

Clin Child Psychol Psychiatry

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Background Anxiety disorders are among the most common psychiatric disorders in childhood and can develop as early as the preschool years. Therefore, providing young children who display early signs of anxiety with skills to prevent the development of later psychopathology is invaluable. The current study evaluates the effectiveness of Fun FRIENDS, an anxiety prevention and resilience program for young children. Method Fifty-seven kindergartners across three classrooms participated in a 15-week anxiety prevention program and teachers completed a behavioral screening measure and anxiety questionnaire at pre, post, 3 month, and 10-month follow-up assessment points. Results Anxiety positively correlated with emotional symptoms , peer difficulties, and total difficulties at pre-intervention. Anxiety symptoms decreased from pre-intervention to follow-up. Additionally, prosocial behaviors improved and moderated the relationship between pre-and post-intervention anxiety symptoms. Conclusions These findings yield promising implications regarding the effectiveness of prevention and intervention programs on increasing social emotional skills and reducing anxiety symptoms in young children.

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Section: Introductionmentioning

confidence: 99%

An Ounce of Prevention: Building resilience and targeting anxiety in young children

Lewis

Barrett

Freitag

et al. 2022

Clin Child Psychol Psychiatry

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Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

Purgato,

Prina,

Ceccarelli

et al. 2023

Cochrane Database of Systematic Reviews

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Background There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma. Objectives To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low‐ and middle‐income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs. Search methods We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021. Selection criteria Randomized controlled trials (RCTs) of primary‐level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs. Data collection and analysis Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random‐effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post‐intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2. Main results Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta‐analyses) for inclusion. Nineteen RCTs were conducted in low‐income countries, 27 in low‐middle‐income countries, 2 in middle‐income countries, 58 in upper‐middle‐income countries and 7 in mixed settings. Eighty‐three RCTs included adults and 30 RCTs included children. Cadres of primary‐level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate‐', 'low‐', or 'very low‐'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post‐intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared...

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The FRIENDS preventive programme for reducing anxiety symptoms in children and adolescents: A systematic review and meta‐analysis

Filges,

Smedslund,

Eriksen

et al. 2024

Campbell Systematic Reviews

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BackgroundAnxiety and stress responses are often considered normative experiences, and children and adolescents may benefit from anxiety prevention programmes. One such programme is FRIENDS which is based on a firm theoretical model which addresses cognitive, physiological and behavioural processes. FRIENDS is manualised and can, thus, easily be integrated into school curriculums.ObjectivesWhat are the effects of the FRIENDS preventive programme on anxiety symptoms in children and adolescents? Do the effects differ between participant age groups, participant socio‐economic status, type of prevention, type of provider, country of implementation and/or implementation issues in relation to the booster sessions and parent sessions?Search MethodsThe database searches were carried out in September 2023, and other sources were searched in October 2023. We searched to identify both published and unpublished literature. A date restriction from 1998 and onwards was applied.Selection CriteriaThe intervention was three age‐appropriate preventive anxiety programmes: Fun FRIENDS, FRIENDS for Life, and My FRIENDS Youth. Primary outcome was anxiety symptoms and secondary outcome was self‐esteem. Studies that used a control group were eligible, whereas qualitative approaches were not.Data Collection and AnalysisThe number of potentially relevant studies was 2865. Forty‐two studies met the inclusion criteria. Twenty‐eight studies were used in the data synthesis. Four studies had a critical risk of bias. Six studies did not report data that enabled calculation of effect sizes and standard errors. Two studies had partial overlap of data to other studies used, and two were written in Persian. Meta‐analyses were conducted on each outcome separately. All analyses were inverse variance weighted using random effects statistical models.Main ResultsStudies came from 15 different countries. Intervention start varied from 2001 to 2016. The average number of participants analysed was 240, and the average number of controls was 212. Twenty‐five comparisons reported on anxiety symptoms post‐intervention. The weighted average standardised mean difference (SMD) was 0.13 (95% CI 0.04 to 0.22). There was some heterogeneity. Twelve comparisons reported on anxiety symptoms at 12 months follow‐up. The weighted average SMD was 0.31 (95% CI 0.13 to 0.49). There was a large amount of heterogeneity. Five comparisons reported on self‐esteem post‐intervention with a weighted average SMD of 0.20 (95% CI −0.20 to 0.61) and a large amount of heterogeneity. At follow‐up, we found evidence that programmes implemented by mental health providers appears to perform better than programmes implemented by teachers. The evidence was inconclusive beyond 12 months follow‐up.Authors' ConclusionsOur results indicate that the FRIENDS intervention may reduce anxiety symptoms in children and adolescents when reported by children and adolescents themselves. The majority of trials employed a wait‐list design, implying only a few studies reported on the long‐term effects of the FRIENDS intervention. Our findings suggest that the FRIENDS intervention may increase the reduction in anxiety symptoms 12 months after the intervention. This emphasises the need for future research that apply designs that allows for long‐term follow‐up. We are uncertain about the effects on self‐esteem. The overall certainty of evidence varied from low to very low. There is a need for more rigorously conducted studies.

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Evaluation of FunFRIENDS program in prevention of anxiety in Brazilian children: a randomized controlled pilot trial

Cited by 9 publications

References 24 publications

An Ounce of Prevention: Building resilience and targeting anxiety in young children

An Ounce of Prevention: Building resilience and targeting anxiety in young children

Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

The FRIENDS preventive programme for reducing anxiety symptoms in children and adolescents: A systematic review and meta‐analysis

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