Minimising Young Children’s Anxiety through Schools (MY-CATS): Protocol for a Cluster Randomised Controlled Trial to Evaluate the Effectiveness and Cost-effectiveness of an Online Parent-led Intervention Compared With Usual School Practice for Young Children Identified as at-risk for Anxiety Disorders

Reardon, Tessa; Dodd, Helen F.; Hill, Claire; Jasper, Bec; Lawrence, Peter; Morgan, Fran; Rapee, Ronald M.; Ukoumunne, Obioha C; Violato, Mara; Davey, Emily; Halliday, Gemma; Jones, Benjamin; Martineau, Lindsey; McCall, Amy; Niekamp, Natascha; Placzek, Anna; Potts, Ruth; Weisser, Tamatha; Creswell, Cathy

doi:10.21203/rs.3.rs-970695/v1

Cited by 3 publications

(5 citation statements)

References 33 publications

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“…This pilot study of a mindful parenting approach meets calls to improve implementation and enhance outcomes for highly stressed parents and young children's mental health needs simultaneously. Anxiety is the most common mental health concern in children and adolescents, and without appropriate intervention increases the risk of poor educational, social and behavioural outcomes and mental health across the lifespan [76]. In sum, this study highlights the preliminary effectiveness of a MPI for parents and for young children with clinical anxiety disorders and describes several avenues for future research and practice.…”

Section: Discussionmentioning

confidence: 87%

Mindful Parenting Group Intervention for Parents of Children with Anxiety Disorders

Farley

Diaz

Emerson

et al. 2023

Child Psychiatry Hum Dev

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Parenting behaviour and rearing style contribute to the intergenerational relationship between parental and child anxiety. Current psychological interventions for child anxiety typically do not adequately address parental mental health, parenting behaviours or the parent–child relationship. The current pilot study examines the effectiveness of a mindful parenting intervention (MPI) for parents of young children with clinical anxiety. It was hypothesised that the intervention would be associated with improvements in parental stress, mental health, and mindfulness, and a reduction in child clinical anxiety symptoms. Twenty-one parents of children aged 3–7 years diagnosed with anxiety disorders participated in an 8-week group MPI program that aimed to increase their intentional moment to moment awareness of the parent–child relationship. Parental (anxiety, depression, hostility, stress, burden, mindfulness, mindful parenting) and child (anxiety diagnoses, anxiety severity, comorbidities) outcomes were assessed at pre- and post-intervention, and at 3-month follow-up. Parents reported a significant increase in mindful parenting and a significant reduction in parent–child dysfunctional interaction, but no change in mental health symptoms. There was a significant reduction in parent-rated child anxiety symptoms, severity of child anxiety diagnosis and number of comorbid diagnoses at post and 3-month follow-up. Limitations include a lack of waitlist control, small sample size, and participants were largely mothers, from intact families and highly educated. There was attrition of 43% and outcomes were predominantly self-report. MPIs offer a novel and potentially effective method of increasing mindful parenting, decreasing dysfunctional parent–child interactions, reducing parenting stress and might also be an effective early intervention for indirectly decreasing young children’s clinical anxiety symptoms. Larger-scale controlled trials of MPIs are needed.

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Section: Discussionmentioning

confidence: 87%

Mindful Parenting Group Intervention for Parents of Children with Anxiety Disorders

Farley

Diaz

Emerson

et al. 2023

Child Psychiatry Hum Dev

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“…Our aim is to recruit primary/junior schools from at least four geographic regions in England that vary in relation to the demographic profile of registered pupils (percentage of pupils eligible for free school meals, percentage of pupils with English as an additional language, percentage of pupils on special education needs support). To recruit schools, we will follow a similar approach to what we have used previously to successfully recruit a large number of primary schools [ 10 , 24 ]. We will identify potential schools to approach using publicly available information provided by the Department for Education, and contact school staff via email and follow-up telephone/video-calls.…”

Section: Methodsmentioning

confidence: 99%

“…Nominated members of school staff will complete a bespoke questionnaire (via an online survey or telephone/video-call interview) at each baseline, and 12 months and 24 months post-randomisation to provide information on activities related to social, emotional, mental health and wellbeing provided for children in Years 4 to 6 and their families. Survey questions are open-ended and based on similar questions used in previous school-based trials [ 24 ], and we will use responses collected at baseline to identify additions or refinements needed for questions used at follow-up. We plan to analyse open-ended responses using a content-analysis approach to provide a description of provision within each school.…”

Section: Methodsmentioning

confidence: 99%

Identifying Child Anxiety Through Schools-identification to intervention (iCATS-i2i): protocol for a cluster randomised controlled trial to compare screening, feedback and intervention for child anxiety problems to usual school practice

Reardon

Ukoumunne

Violato

et al. 2022

Trials

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Background Systematically screening for child anxiety problems, and offering and delivering a brief, evidence-based intervention for children who are identified as likely to benefit would minimise common barriers that families experience in accessing treatment. We have developed a short parent-report child anxiety screening questionnaire, and procedures for administering screening questionnaires, sharing screening outcomes with families, and offering and delivering a brief parent-led online intervention (OSI: Online Support and Intervention for child anxiety) through schools. This trial aims to evaluate clinical and health economic outcomes for (1) children (aged 8–9) who screen positive for anxiety problems at baseline (target population) and (2) the wider population of all children in participating classes (total population) in schools randomly allocated to receive identification-to-intervention procedures and usual school practice (‘screening and intervention’), compared to assessment and usual school practice only (‘usual school practice’). Methods The trial design is a parallel-group, superiority cluster randomised controlled trial, with schools (clusters) randomised to ‘screening and intervention’ or ‘usual school practice’ arms in a 1:1 ratio stratified according to the level of deprivation within the school. We will recruit schools and participants in two phases (a pilot phase (Phase 1) and Phase 2), with progression criteria assessed prior to progressing to Phase 2. In total, the trial will recruit 80 primary/junior schools in England, and 398 children (199 per arm) who screen positive for anxiety problems at baseline (target population). In schools allocated to ‘screening and intervention’: (1) parents/carers will complete a brief parent-report child anxiety screening questionnaire (at baseline) and receive feedback on their child’s screening outcomes (after randomisation), (2) classes will receive a lesson on managing fears and worries and staff will be provided with information about the intervention and (3) parents/carers of children who screen positive for anxiety problems (target population) will be offered OSI. OSI will also be available for any other parents/carers of children in participating classes (total population) who request it. We will collect child-, parent- and teacher-report measures for the target population and total population at baseline (before randomisation), 4 months, 12 months and 24 months post-randomisation. The primary outcome will be the proportion of children who screen positive for anxiety problems at baseline (target population) who screen negative for anxiety problems 12 months post-randomisation. Discussion This trial will establish if systematic screening for child anxiety problems, sharing screening outcomes with families and delivering a brief parent-led online intervention through schools is effective and cost-effective. Trial registration ISRCTN registry ISRCTN76119074. Prospectively registered on 4.1.2022.

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“…Our aim is to recruit primary/junior schools from at least four geographic regions in England that vary in relation to the demographic pro le of registered pupils (percentage of pupils eligible for free school meals, percentage of pupils with English as an additional language, percentage of pupils on special education needs support). To recruit schools, we will follow a similar approach to what we have used previously to successfully recruit a large number of primary schools (10,24). We will identify potential schools to approach using publicly available information provided by the Department for Education, and contact school staff via email and follow-up telephone/video-calls.…”

Section: School Recruitmentmentioning

confidence: 99%

“…Nominated members of school staff will complete a bespoke questionnaire (via an online survey or telephone/video-call interview) at each baseline, and 12months and 24-months post-randomisation to provide information on activities related to social, emotional, mental health and wellbeing provided for children in Years 4 to 6 and their families. Survey questions are open-ended and based on similar questions used in previous school-based trials (24), and we will use responses collected at baseline to identify additions or re nements needed for questions used at follow-up. We plan to analyse open-ended responses using a content-analysis approach to provide a description of provision within each school.…”

Section: Usual School Practicementioning

confidence: 99%

Identifying Child Anxiety Through Schools – identification to intervention (iCATS-i2i): protocol for a cluster randomised controlled trial to compare screening, feedback and intervention for child anxiety problems to usual school practice

Reardon

Ukoumunne

Violato

et al. 2022

Preprint

Self Cite

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Background Systematically screening for child anxiety problems, and offering and delivering a brief, evidence-based intervention for children who are identified as likely to benefit would minimise common barriers that families experience in accessing treatment. We have developed a short parent-report child anxiety screening questionnaire, and procedures for administering screening questionnaires, sharing screening outcomes with families, and offering and delivering a brief parent-led online intervention (OSI: Online Support and Intervention for child anxiety) through schools. This trial aims to evaluate clinical and health economic outcomes for: 1) children (aged 8-9) who screen positive for anxiety problems at baseline (target population), and 2) the wider population of all children in participating classes (total population) in schools randomly allocated to receive identification-to-intervention procedures and usual school practice (‘screening and intervention’), compared to assessment and usual school practice only (‘usual school practice’). Methods The trial design is a parallel group, superiority cluster randomised controlled trial, with schools (clusters) randomised to ‘screening and intervention’ or ‘usual school practice’ arms in a 1:1 ratio stratified according to the level of deprivation within the school. We will recruit schools and participants in two phases (a pilot phase (Phase 1) and Phase 2), with progression criteria assessed prior to progressing to Phase 2. In total, the trial will recruit 80 primary/junior schools in England, and 398 children (199 per arm) who screen positive for anxiety problems at baseline (target population). In schools allocated to ‘screening and intervention’: 1) parents/carers will complete a brief parent-report child anxiety screening questionnaire (at baseline) and receive feedback on their child’s screening outcomes (after randomisation), 2) classes will receive a lesson on managing fears and worries and staff will be provided with information about the intervention, and 3) parents/carers of children who screen positive for anxiety problems (target population) will be offered OSI. OSI will also be available for any other parents/carers of children in participating classes (total population) who request it. We will collect child-, parent-, and teacher-report measures for the target population and total population at baseline (before randomisation), 4-months, 12-months and 24-months post-randomisation. The primary outcome will be the proportion of children who screen positive for anxiety problems at baseline (target population) who screen negative for anxiety problems 12-months post-randomisation. Discussion This trial will establish if systematic screening for child anxiety problems, sharing screening outcomes with families, and delivering a brief parent-led online intervention through schools is effective and cost-effective. Trial registration: ISRCTN registry: ISRCTN76119074. Prospectively registered on 4.1.2022 https://www.isrctn.com/ISRCTN76119074

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Cited by 3 publications

References 33 publications

Mindful Parenting Group Intervention for Parents of Children with Anxiety Disorders

Mindful Parenting Group Intervention for Parents of Children with Anxiety Disorders

Identifying Child Anxiety Through Schools-identification to intervention (iCATS-i2i): protocol for a cluster randomised controlled trial to compare screening, feedback and intervention for child anxiety problems to usual school practice

Identifying Child Anxiety Through Schools – identification to intervention (iCATS-i2i): protocol for a cluster randomised controlled trial to compare screening, feedback and intervention for child anxiety problems to usual school practice

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