Protocol for a randomised pilot study of a novel Parent–Child Interaction Therapy (PCIT) ‘re-implementation’ intervention

Abstract

Background Despite a number of clinicians having been trained in Parent–Child Interaction Therapy (PCIT) in Aotearoa/New Zealand, few are regularly delivering the treatment, with barriers to use including a lack of suitable equipment and lack of professional support. This pragmatic, parallel-arm, randomised, controlled pilot trial includes PCIT-trained clinicians who are not delivering, or only rarely utilising, this effective treatment. The study aims to assess the feasibility, acceptability and cultural responsivity of study methods and intervention components and to collect variance data on the proposed future primary outcome variable, in preparation for a future, larger trial. Methods The trial will compare a novel ‘re-implementation’ intervention with a refresher training and problem-solving control. Intervention components have been systematically developed to address barriers and facilitators to clinician use of PCIT using implementation theory, and a draft logic model with hypothesised mechanisms of action, derived from a series of preliminary studies. The intervention includes complimentary access to necessary equipment for PCIT implementation (audio-visual equipment, a ‘pop-up’ time-out space, toys), a mobile senior PCIT co-worker and an optional weekly PCIT consultation group, for a 6-month period. Outcomes will include the feasibility of recruitment and trial procedures; acceptability of the intervention package and data collection methods to clinicians; and clinician adoption of PCIT. Discussion Relatively little research attention has been directed at interventions to resurrect stalled implementation efforts. Results from this pragmatic pilot RCT will refine and shape knowledge relating to what it might take to embed the ongoing delivery of PCIT in community settings, providing more children and families with access to this effective treatment. Trial registration ANZCTR, ACTRN12622001022752, registered on July 21, 2022.

Applying the Theoretical Domains Framework to Develop an Intervention to ‘Re-implement’ Parent–Child Interaction Therapy (PCIT)

“…Possible components of a re-implementation intervention include refresher training with a senior Māori trainer, access to a mobile PCIT co-worker, provision of suitable audio-visual equipment, provision of a portable time-out space, regular group consultation, and access to materials to support PCIT delivery including material to facilitate the use of ‘swoop and go’ (McNeil & Hembree-Kigin, 2011 ) as an alternative to the use of a time-out room. Our intention is to pilot this intervention package and determine the feasibility and acceptability to clinicians, and we have described the parameters of this randomised, controlled trial in detail elsewhere (Woodfield et al, 2023 ).…”