A tailored web-based intervention to improve parenting risk and protective factors for adolescent depression and anxiety problems: Postintervention findings from a randomized controlled trial

Marie Bee Hui Yap, Shireen Mahtani, Ronald M. Rapee, Claire Nicolas, Katherine A. Lawrence, Andrew MacKinnon, Anthony F. Jorm

Research output: Contribution to journalArticle

Abstract

Background: Depression and anxiety disorders in young people are a global health concern. Parents have an important role in reducing the risk of these disorders, but cost-effective, evidence-based interventions for parents that can be widely disseminated are lacking. Objective: This study aimed to examine the postintervention effects of the Partners in Parenting (PiP) program on parenting risk and protective factors for adolescent depression and anxiety, and on adolescent depression and anxiety symptoms. Methods: A two-Arm randomized controlled trial was conducted with 359 parent-Adolescent dyads, recruited primarily through schools across Australia. Parents and adolescents were assessed at baseline and 3 months later (postintervention). Parents in the intervention condition received PiP, a tailored Web-based parenting intervention designed following Persuasive Systems Design (PSD) principles to target parenting factors associated with adolescents' risk for depression and anxiety problems. PiP comprises a tailored feedback report highlighting each parent's strengths and areas for improvement, followed by a set of interactive modules (up to nine) that is specifically recommended for the parent based on individually identified areas for improvement. Parents in the active-control condition received a standardized package of five Web-based factsheets about adolescent development and well-being. Parents in both conditions received a 5-min weekly call to encourage progress through their allocated program to completion. Both programs were delivered weekly via the trial website. The primary outcome measure at postintervention was parent-reported changes in parenting risk and protective factors, which were measured using the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS). Secondary outcome measures were the adolescent-report PRADAS, the parent-and child-report Short Mood and Feelings Questionnaire (depressive symptoms), and parent-and child-report Spence Children's Anxiety Scale (anxiety symptoms). Results: Parents in the intervention condition completed a mean of 73.7% of their intended personalized PiP program. A total of 318 parents (88.6%, 318/359) and 308 adolescents (92.8%, 308/332) completed the postintervention assessment. Attrition was handled using mixed model of repeated measures analysis of variance. As hypothesized, we found a significant condition-by-Time interaction on the PRADAS, with a medium effect size, Cohen d=0.57, 95% CI 0.34-0.79. No significant differences between conditions were found at postintervention on any of the secondary outcome measures, with adolescent depressive (parent-report only) and anxiety (both parent-and adolescent-report) symptoms decreasing significantly from baseline to postintervention in both conditions. Conclusions: The fully automated PiP intervention showed promising short-Term effects on parenting behaviors that are associated with adolescents' risk for depression and anxiety. Long-Term follow-up is required to ascertain whether these effects translate into reduced adolescent depression and anxiety problems. The intervention may be useful as a low-cost universal public health program to increase parenting practices believed to benefit adolescents' mental health.

LanguageEnglish
Article numbere17
Number of pages19
JournalJournal of Medical Internet Research
Volume20
Issue number1
DOIs
StatePublished - 1 Jan 2018

Keywords

  • Adolescent
  • Anxiety
  • Depression
  • Family
  • Internet
  • Mental health
  • Parenting
  • Preventive health services

Cite this

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title = "A tailored web-based intervention to improve parenting risk and protective factors for adolescent depression and anxiety problems: Postintervention findings from a randomized controlled trial",
abstract = "Background: Depression and anxiety disorders in young people are a global health concern. Parents have an important role in reducing the risk of these disorders, but cost-effective, evidence-based interventions for parents that can be widely disseminated are lacking. Objective: This study aimed to examine the postintervention effects of the Partners in Parenting (PiP) program on parenting risk and protective factors for adolescent depression and anxiety, and on adolescent depression and anxiety symptoms. Methods: A two-Arm randomized controlled trial was conducted with 359 parent-Adolescent dyads, recruited primarily through schools across Australia. Parents and adolescents were assessed at baseline and 3 months later (postintervention). Parents in the intervention condition received PiP, a tailored Web-based parenting intervention designed following Persuasive Systems Design (PSD) principles to target parenting factors associated with adolescents' risk for depression and anxiety problems. PiP comprises a tailored feedback report highlighting each parent's strengths and areas for improvement, followed by a set of interactive modules (up to nine) that is specifically recommended for the parent based on individually identified areas for improvement. Parents in the active-control condition received a standardized package of five Web-based factsheets about adolescent development and well-being. Parents in both conditions received a 5-min weekly call to encourage progress through their allocated program to completion. Both programs were delivered weekly via the trial website. The primary outcome measure at postintervention was parent-reported changes in parenting risk and protective factors, which were measured using the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS). Secondary outcome measures were the adolescent-report PRADAS, the parent-and child-report Short Mood and Feelings Questionnaire (depressive symptoms), and parent-and child-report Spence Children's Anxiety Scale (anxiety symptoms). Results: Parents in the intervention condition completed a mean of 73.7{\%} of their intended personalized PiP program. A total of 318 parents (88.6{\%}, 318/359) and 308 adolescents (92.8{\%}, 308/332) completed the postintervention assessment. Attrition was handled using mixed model of repeated measures analysis of variance. As hypothesized, we found a significant condition-by-Time interaction on the PRADAS, with a medium effect size, Cohen d=0.57, 95{\%} CI 0.34-0.79. No significant differences between conditions were found at postintervention on any of the secondary outcome measures, with adolescent depressive (parent-report only) and anxiety (both parent-and adolescent-report) symptoms decreasing significantly from baseline to postintervention in both conditions. Conclusions: The fully automated PiP intervention showed promising short-Term effects on parenting behaviors that are associated with adolescents' risk for depression and anxiety. Long-Term follow-up is required to ascertain whether these effects translate into reduced adolescent depression and anxiety problems. The intervention may be useful as a low-cost universal public health program to increase parenting practices believed to benefit adolescents' mental health.",
keywords = "Adolescent, Anxiety, Depression, Family, Internet, Mental health, Parenting, Preventive health services",
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year = "2018",
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A tailored web-based intervention to improve parenting risk and protective factors for adolescent depression and anxiety problems : Postintervention findings from a randomized controlled trial. / Yap, Marie Bee Hui; Mahtani, Shireen; Rapee, Ronald M.; Nicolas, Claire; Lawrence, Katherine A.; MacKinnon, Andrew; Jorm, Anthony F.

In: Journal of Medical Internet Research, Vol. 20, No. 1, e17, 01.01.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A tailored web-based intervention to improve parenting risk and protective factors for adolescent depression and anxiety problems

T2 - Journal of Medical Internet Research

AU - Yap,Marie Bee Hui

AU - Mahtani,Shireen

AU - Rapee,Ronald M.

AU - Nicolas,Claire

AU - Lawrence,Katherine A.

AU - MacKinnon,Andrew

AU - Jorm,Anthony F.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Depression and anxiety disorders in young people are a global health concern. Parents have an important role in reducing the risk of these disorders, but cost-effective, evidence-based interventions for parents that can be widely disseminated are lacking. Objective: This study aimed to examine the postintervention effects of the Partners in Parenting (PiP) program on parenting risk and protective factors for adolescent depression and anxiety, and on adolescent depression and anxiety symptoms. Methods: A two-Arm randomized controlled trial was conducted with 359 parent-Adolescent dyads, recruited primarily through schools across Australia. Parents and adolescents were assessed at baseline and 3 months later (postintervention). Parents in the intervention condition received PiP, a tailored Web-based parenting intervention designed following Persuasive Systems Design (PSD) principles to target parenting factors associated with adolescents' risk for depression and anxiety problems. PiP comprises a tailored feedback report highlighting each parent's strengths and areas for improvement, followed by a set of interactive modules (up to nine) that is specifically recommended for the parent based on individually identified areas for improvement. Parents in the active-control condition received a standardized package of five Web-based factsheets about adolescent development and well-being. Parents in both conditions received a 5-min weekly call to encourage progress through their allocated program to completion. Both programs were delivered weekly via the trial website. The primary outcome measure at postintervention was parent-reported changes in parenting risk and protective factors, which were measured using the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS). Secondary outcome measures were the adolescent-report PRADAS, the parent-and child-report Short Mood and Feelings Questionnaire (depressive symptoms), and parent-and child-report Spence Children's Anxiety Scale (anxiety symptoms). Results: Parents in the intervention condition completed a mean of 73.7% of their intended personalized PiP program. A total of 318 parents (88.6%, 318/359) and 308 adolescents (92.8%, 308/332) completed the postintervention assessment. Attrition was handled using mixed model of repeated measures analysis of variance. As hypothesized, we found a significant condition-by-Time interaction on the PRADAS, with a medium effect size, Cohen d=0.57, 95% CI 0.34-0.79. No significant differences between conditions were found at postintervention on any of the secondary outcome measures, with adolescent depressive (parent-report only) and anxiety (both parent-and adolescent-report) symptoms decreasing significantly from baseline to postintervention in both conditions. Conclusions: The fully automated PiP intervention showed promising short-Term effects on parenting behaviors that are associated with adolescents' risk for depression and anxiety. Long-Term follow-up is required to ascertain whether these effects translate into reduced adolescent depression and anxiety problems. The intervention may be useful as a low-cost universal public health program to increase parenting practices believed to benefit adolescents' mental health.

AB - Background: Depression and anxiety disorders in young people are a global health concern. Parents have an important role in reducing the risk of these disorders, but cost-effective, evidence-based interventions for parents that can be widely disseminated are lacking. Objective: This study aimed to examine the postintervention effects of the Partners in Parenting (PiP) program on parenting risk and protective factors for adolescent depression and anxiety, and on adolescent depression and anxiety symptoms. Methods: A two-Arm randomized controlled trial was conducted with 359 parent-Adolescent dyads, recruited primarily through schools across Australia. Parents and adolescents were assessed at baseline and 3 months later (postintervention). Parents in the intervention condition received PiP, a tailored Web-based parenting intervention designed following Persuasive Systems Design (PSD) principles to target parenting factors associated with adolescents' risk for depression and anxiety problems. PiP comprises a tailored feedback report highlighting each parent's strengths and areas for improvement, followed by a set of interactive modules (up to nine) that is specifically recommended for the parent based on individually identified areas for improvement. Parents in the active-control condition received a standardized package of five Web-based factsheets about adolescent development and well-being. Parents in both conditions received a 5-min weekly call to encourage progress through their allocated program to completion. Both programs were delivered weekly via the trial website. The primary outcome measure at postintervention was parent-reported changes in parenting risk and protective factors, which were measured using the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS). Secondary outcome measures were the adolescent-report PRADAS, the parent-and child-report Short Mood and Feelings Questionnaire (depressive symptoms), and parent-and child-report Spence Children's Anxiety Scale (anxiety symptoms). Results: Parents in the intervention condition completed a mean of 73.7% of their intended personalized PiP program. A total of 318 parents (88.6%, 318/359) and 308 adolescents (92.8%, 308/332) completed the postintervention assessment. Attrition was handled using mixed model of repeated measures analysis of variance. As hypothesized, we found a significant condition-by-Time interaction on the PRADAS, with a medium effect size, Cohen d=0.57, 95% CI 0.34-0.79. No significant differences between conditions were found at postintervention on any of the secondary outcome measures, with adolescent depressive (parent-report only) and anxiety (both parent-and adolescent-report) symptoms decreasing significantly from baseline to postintervention in both conditions. Conclusions: The fully automated PiP intervention showed promising short-Term effects on parenting behaviors that are associated with adolescents' risk for depression and anxiety. Long-Term follow-up is required to ascertain whether these effects translate into reduced adolescent depression and anxiety problems. The intervention may be useful as a low-cost universal public health program to increase parenting practices believed to benefit adolescents' mental health.

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KW - Anxiety

KW - Depression

KW - Family

KW - Internet

KW - Mental health

KW - Parenting

KW - Preventive health services

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