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Child and adolescent behavioral health problems are related to the leading causes of youth morbidity and mortality. Parent-focused interventions effectively prevent behavioral health problems such as depression and conduct disorders and can provide a downstream economic benefit to society by reducing criminal activity, education costs, and health care use.
Unfortunately, parenting programs are not widely available, accessible, nor well-attended.
Pediatric primary care is a non-stigmatizing setting with nearly universal reach and, therefore, an ideal contact point to increase access. However, primary care clinicians (PCCs) often have insufficient training in behavioral health topics and typical referral practices are inadequate.
There are also logistical barriers to attending in-person parenting programs, like the need for childcare and a large time-commitment. There is a need to develop effective referral practices in conjunction with increasing the accessibility of parenting programs. The study long-term goal is to prevent significant behavioral health problems through widespread access to effective and accessible parenting programs through primary care referrals.
In this study there are two trials: First is the primary care clinicians "PCC" trial, testing the effectiveness of referral training (aim 1). Second is the parents "eGen" trial provided by therapists, testing the effectiveness of eGen parenting intervention (aim 2).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Primary care clinicians group 1 | Experimental | PCCs with pediatric patients randomized to experimental group |
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| Primary care clinicians group 2 | Active Comparator | PCCs with pediatric patients randomized to control group |
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| Parent group 1 | Experimental | assigned to receive eGen |
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| Parents group 2 | Active Comparator | assigned to receive one-session control |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Referral and communication skills learning | Behavioral | assigned to receive a brief, live, experiential training on the referral process and communication strategies. |
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| Measure | Description | Time Frame |
|---|---|---|
| Child behavior problems | Child externalizing and internalizing will be measured using the Behavioral Assessment System for Children - Behavioral and Emotional Screening System (BASC-3-BESS; 29 items). | 10 weeks |
| Change in parenting behavior | The Alabama Parenting Questionnaire - Preschool version (APQ; 32 items) has subscales to measure positive parenting, inconsistent parenting, and punitive parenting. | 10 weeks |
| Number of Completed Referrals | This is defined as the number of parents who agree to begin treatment with the therapist after a referral from a primary care provider. | 4 years |
| Parent Attendance | Parent attendance will be reported as the percent of sessions attended. | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Parents mental health: depression | The patient health questionnaire will measure parent depression (PHQ-9; 9 items) | 10 weeks |
| Parents mental health: anxiety | the general anxiety disorder scale (GAD-7) will assess parent anxiety symptoms |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Christopher J Mehus | Contact | 651-785-3660 | cjmehus@umn.edu |
| Name | Affiliation | Role |
|---|---|---|
| Christopher J Mehus | University of Minnesota | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Minnesota | Recruiting | Minneapolis | Minnesota | 55414 | United States |
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| ID | Term |
|---|---|
| D000066553 | Problem Behavior |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D002652 | Child Behavior |
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| ID | Term |
|---|---|
| D012017 | Referral and Consultation |
| ID | Term |
|---|---|
| D011364 | Professional Practice |
| D009934 | Organization and Administration |
| D006298 | Health Services Administration |
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| Written guide to the referral process | Behavioral | assigned to receive only written information about the referral process |
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| Empowered Generations (eGen): parent training | Behavioral | eGen is a six-session parent training program provided by therapists via video chat online to parents with a child between the ages of 3-8 years. |
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| control | Behavioral | The control condition consists of a single scripted session, in which therapists guide the parent to the following resources: (a) a book, Raising Cooperative Kids, by GenPMTO co-developer Marion Forgatch; (b) vetted parenting advice websites; (c) information about Early Childhood and Family Education classes, which are provided for free in Minnesota through public schools; and (d) a list of culturally tailored parenting advice websites. |
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| 10 weeks |
| Parents mental health: absenteeism | the WHO Health and Work Performance Questionnaire - Short Form (HPQ SF, 8 items) will assess parent absenteeism. | 10 weeks |
| Parenting self-efficacy | Parenting self-efficacy will be measured with the Parent Locus of Control measure (PLOC; 24 items). | 10 weeks |
| Intervention Acceptability, Appropriateness, and Feasibility Measure | Average score on the Acceptability of intervention Measure items. These measures are on a 1-5 scale from completely disagree to completely agree. A higher score indicates higher acceptability, appropriateness, or feasibility. | 1 year |
| Readiness to Change - Patient Preferences Subscale Score | Average score on the Readiness to Change Assessment, patient preferences items (Helfrich, Li; Sharp, 2009). This measure is rated on a 1-5 scale from strongly disagree to strongly agree, with a sixth option for not applicable. High scores indicates greater acceptability. | 1 year |