TY - JOUR
T1 - Translational delivery of Cool Little Kids to prevent child internalising problems
T2 - Randomised controlled trial
AU - Bayer, Jordana K.
AU - Beatson, Ruth
AU - Bretherton, Lesley
AU - Hiscock, Harriet
AU - Wake, Melissa
AU - Gilbertson, Tamsyn
AU - Mihalopoulos, Cathrine
AU - Prendergast, Luke A.
AU - Rapee, Ronald M.
N1 - Funding Information:
This research was supported by the Australian National Health and Medical Research Council (NHMRC) Project Grant 607302 and by the Victorian Government’s Operational Infrastructure Support Program. J.K.B. and H.H. were supported by NHMRC Population Health Capacity Building Grant 436914 and C.M. by NHMRC Capacity Building Grant 456002 and NHMRC Early Career Fellowship 1035887. J.K.B. was also part supported by the Australian Rotary Health. M.W. was supported by NHMRC Senior Research Fellowship 1046518 and Cure Kids New Zealand.
Publisher Copyright:
© 2017, © The Royal Australian and New Zealand College of Psychiatrists 2017.
PY - 2018/2
Y1 - 2018/2
N2 - Objective: To determine whether a population-delivered parenting programme assists in preventing internalising problems at school entry for preschool children at-risk with temperamental inhibition. Methods: Design: a randomised controlled trial was used. Setting: the setting was 307 preschool services across eight socioeconomically diverse government areas in Melbourne, Australia. Participants: a total of 545 parents of inhibited 4-year-old children: 498 retained at 1-year follow up. Early intervention: Cool Little Kids parenting group programme was implemented. Primary outcomes: the primary outcomes were child DSM-IV anxiety disorders (assessor blind) and internalising problems. Secondary outcomes: the secondary outcomes were parenting practices and parent mental health. Results: At 1-year follow up (mean (standard deviation) age = 5.8 (0.4) years), there was little difference in anxiety disorders between the intervention and control arms (44.2% vs 50.2%; adjusted odds ratio = 0.86, 95% confidence interval = [0.60, 1.25], p = 0.427). Internalising problems were reduced in the intervention arm (Strengths and Difficulties Questionnaire: abnormal – 24.2% vs 33.0%; adjusted odds ratio = 0.56, 95% confidence interval = [0.35, 0.89], p = 0.014; symptoms – mean (standard deviation) = 2.5 (2.0) vs 2.9 (2.2); adjusted mean difference = –0.47, 95% confidence interval = [–0.81, –0.13], p = 0.006). Parents’ participation in the intervention was modest (29.4% attended most groups, 20.5% used skills most of the time during the year). A priori interaction tests suggested that for children with anxious parents, the intervention reduced anxiety disorders and internalising symptoms after 1 year. Conclusion: Offering Cool Little Kids across the population for inhibited preschoolers does not impact population outcomes after 1 year. Effects may be emerging for inhibited children at highest risk with parent anxiety. Trial outcomes will continue into mid-childhood.
AB - Objective: To determine whether a population-delivered parenting programme assists in preventing internalising problems at school entry for preschool children at-risk with temperamental inhibition. Methods: Design: a randomised controlled trial was used. Setting: the setting was 307 preschool services across eight socioeconomically diverse government areas in Melbourne, Australia. Participants: a total of 545 parents of inhibited 4-year-old children: 498 retained at 1-year follow up. Early intervention: Cool Little Kids parenting group programme was implemented. Primary outcomes: the primary outcomes were child DSM-IV anxiety disorders (assessor blind) and internalising problems. Secondary outcomes: the secondary outcomes were parenting practices and parent mental health. Results: At 1-year follow up (mean (standard deviation) age = 5.8 (0.4) years), there was little difference in anxiety disorders between the intervention and control arms (44.2% vs 50.2%; adjusted odds ratio = 0.86, 95% confidence interval = [0.60, 1.25], p = 0.427). Internalising problems were reduced in the intervention arm (Strengths and Difficulties Questionnaire: abnormal – 24.2% vs 33.0%; adjusted odds ratio = 0.56, 95% confidence interval = [0.35, 0.89], p = 0.014; symptoms – mean (standard deviation) = 2.5 (2.0) vs 2.9 (2.2); adjusted mean difference = –0.47, 95% confidence interval = [–0.81, –0.13], p = 0.006). Parents’ participation in the intervention was modest (29.4% attended most groups, 20.5% used skills most of the time during the year). A priori interaction tests suggested that for children with anxious parents, the intervention reduced anxiety disorders and internalising symptoms after 1 year. Conclusion: Offering Cool Little Kids across the population for inhibited preschoolers does not impact population outcomes after 1 year. Effects may be emerging for inhibited children at highest risk with parent anxiety. Trial outcomes will continue into mid-childhood.
KW - anxiety disorders
KW - Child
KW - early intervention
KW - internalising problems
KW - prevention
KW - randomised controlled trial
KW - translation
UR - http://www.scopus.com/inward/record.url?scp=85041747296&partnerID=8YFLogxK
U2 - 10.1177/0004867417726582
DO - 10.1177/0004867417726582
M3 - Article
C2 - 28831814
AN - SCOPUS:85041747296
SN - 0004-8674
VL - 52
SP - 181
EP - 191
JO - Australian and New Zealand Journal of Psychiatry
JF - Australian and New Zealand Journal of Psychiatry
IS - 2
ER -