Study protocol for a Randomized Controlled Trial of Supportive Parents – Coping Kids (SPARCK) - a Transdiagnostic and Personalized Parent Training Intervention to Prevent Childhood Mental Health Problems

Abstract

Background: To meet the scientific and political call for effective prevention of child and youth mental health problems and associated long-term consequences, we have co-created, tested, and optimized a transdiagnostic preventive parent-training intervention, Supportive parents – coping kids (SPARCK), together with and for the municipal preventive frontline services. The target group of SPARCK is parents of children between 4 and 12 years who display symptoms of anxiety, depression, and/or behavioral problems, that is, indicated prevention. The intervention consists of components from various empirically supported interventions representing different theorical models on parent-child interactions and child behavior and psychopathology (i.e., behavioral management interventions, attachment theory, emotion socialization theory, cognitive-behavioral therapy, and family accommodation intervention). The content and target strategies of SPARCK are tailored to the needs of the families and children, and the manual suggests how the target strategies may be personalized and combined throughout the maximum 12 sessions of the intervention. The aim of this project is to investigate the effectiveness of SPARCK on child symptoms, parenting practices, and parent and child stress hormone levels, in addition to later use of specialized services compared with usual care (UC; eg. active comparison group). Methods: We describe a randomized controlled effectiveness trial in the frontline services of child welfare, health, school health and school psychological counselling services in 24 Norwegian municipalities. It is a two-armed parallel group randomized controlled effectiveness and superiority trial with assessment of key variables at pre-, post-, and six-month follow-up. 252 families will be included, and randomly allocated to SPARCK or UC. Discussion: The current study will contribute with knowledge on potential effects of a preventive transdiagnostic parent-training intervention when compared with UC. Our primary objective is to innovate frontline services with a usable, flexible, and effective intervention for prevention of childhood mental health problems to promote equity in access to care for families and children across a heterogeneous service landscape characterized by variations in available resources, personnel, and end user symptomatology. Trial registration: ClinicalTrials.gov ID: NTCT05800522

Implementation of a parent training intervention (SPARCK) to prevent childhood mental health problems: study protocol for a pragmatic implementation trial in Norwegian municipalities

“…What follows provides a brief overview of the co-creation phase and study of the SPARCK intervention (19). The intervention itself is a novel transdiagnostic parent training intervention aimed at preventing mental health problems in children (19)(20)(21). It is tailored to frontline level services in Norwegian municipalities.…”

“…The target group consists of parents of children aged 4 to 12 with elevated, but subclinical levels of internalizing symptoms (i.e., anxiety, depression, and withdrawal) and/or externalizing symptoms (i.e., conduct problems, opposition, and cooperation challenges). The intervention consists of a maximum of 12 sessions delivered individually and contains well-established and effective elements which are tailored to help parents promote coping skills in their children (21).…”

“…The aim was to gain insights from the relevant stakeholders on barriers and facilitators to implementation, to inform intervention optimization and aid choice and adaptation of implementation strategies to overcome identi ed barriers (28). Furthermore, contextual analyses can be used to understand and interpret subsequent effectiveness and implementation outcomes (29), and as such, the secondary aim was to use the contextual analysis as a segue to the current RCT (21) and implementation study. The Consolidated Framework for Implementation Research (CFIR) (30,31) was used to plan the study, construct the interview guides, identify, analyze, and report on implementation determinants.…”

“…In a randomized controlled trial (RCT), SPARCK's clinical effectiveness in preventing and reducing negative outcomes and promoting positive outcomes in children and parents is investigated. A separate study protocol is written for the RCT (21). In order to grant appropriate attention and space to the implementation part of the project, a separate implementation study protocol was deemed warranted.…”

“…This study is a correlational implementation study performed alongside a two-armed RCT (21). The combined study can be described as a hybrid effectiveness-implementation type 2 trial (43,44), although the implementation strategies are not tested per se.…”