Brief parenting intervention (Triple P) for families of children with eczema: a randomized controlled trial

Author:

Mitchell Amy E123ORCID,Morawska Alina24,Casey Emily5,Forbes Elana67,Filus Ania2,Fraser Jennifer8,Rowell David9,Johnston Aimee9,Birch Stephen9

Affiliation:

1. School of Nursing, Midwifery and Social Work, The University of Queensland , St Lucia, Australia

2. Parenting and Family Support Centre, The University of Queensland , St Lucia, Australia

3. Centre for Mental Health, Griffith University , Mt Gravatt, Australia

4. Australian Research Council Centre of Excellence for Children and Families over the Life Course, Brisbane, Australia

5. Dermatology Service, Queensland Children’s Hospital , Brisbane, Australia

6. Murdoch Children’s Research Institute , Parkville, Australia

7. Monash University , Melbourne, Australia

8. Sydney Nursing School, University of Sydney , Sydney, Australia

9. Centre for the Business and Economics of Health, The University of Queensland , Brisbane, Australia

Abstract

Abstract Objective To evaluate the efficacy and costs of a brief, group-delivered parenting intervention for families of children with eczema. Methods A randomized controlled trial design was used. Families attending the Queensland Children’s Hospital and from the community (n = 257) were assessed for eligibility (child 2–10 years, diagnosed with eczema, prescribed topical corticosteroids). Families who consented to participate (N = 59) were assessed at baseline for clinician-rated eczema severity, parent-reported eczema symptom severity, and electronically-monitored topical corticosteroid adherence (primary outcomes); and parenting behavior, parents’ self-efficacy and task performance when managing eczema, eczema-related child behavior problems, and child and parent quality of life (secondary outcomes). Families were randomized (1:1, unblinded) to intervention (n = 31) or care-as-usual (n = 28). The intervention comprised two, 2-hr Healthy Living Triple P group sessions (face-to-face/online) and 28 intervention families attended one/both sessions. All families were offered standardized eczema education. Families were reassessed at 4-weeks post-intervention and 6-month follow-up, with clinician-raters blinded to condition. Costs of intervention delivery were estimated. Results Multilevel modeling across assessment timepoints showed significant intervention effects for ineffective parenting (d = .60), self-efficacy (d = .74), task performance (d = .81), and confidence with managing eczema-related child behavior (d = .63), but not disease/symptom severity, treatment adherence or quality of life. Mean cost per participating family with parenting behavior (clinically) improved was $159. Conclusions Healthy Living Triple P is effective in reducing ineffective parenting practices and improving parents’ self-efficacy and task performance when managing children’s eczema and eczema-related behavior difficulties. There was no effect on disease/symptom severity, treatment adherence, or quality of life. Clinical Trial Registration ACTRN12618001332213

Funder

Children’s Hospital Foundation Translator

Early Career Fellowships

Australian Research Council Centre of Excellence for Children and Families

Publisher

Oxford University Press (OUP)

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