Specific phobias in children with moderate to severe intellectual disabilities: SPIRIT, an adaptation and feasibility study.

IF 3.5 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Kylie M Gray, Magdalena M Apanasionok, Emma Scripps, Karen Bunning, Christine Burke, Malwina Filipczuk, Richard P Hastings, Ashley Liew, Rachel McNamara, Atiyya Nisar, Rebecca Playle, Tim Williams, Peter E Langdon
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引用次数: 0

Abstract

Background: There is a lack of interventions for specific phobia in children and adolescents with moderate to severe intellectual disabilities.

Objectives: The objectives were to: (a) develop an intervention for specific phobia, together with an intervention fidelity checklist and logic model, and evaluate candidate outcome measures, together with parents/carers and clinicians; (b) describe treatment as usual; (c) model the intervention to determine the acceptability and feasibility for all stakeholders, judge the appropriateness of outcome measures, explore recruitment pathways, and examine the feasibility and acceptability of consent and associated processes; and (d) describe factors that facilitate or challenge the intervention.

Design: Phase 1a: using consensus methods, an Intervention Development Group was established who met to develop the intervention, review candidate outcome measures and contribute to the development of the intervention fidelity checklists and logic model. Phase 1b: a national online survey was conducted with parents and professionals to describe treatment as usual. Phase 2: a single-group non-randomised feasibility study was designed to model the intervention and to test intervention feasibility and acceptability, outcome measures and aspects of the research process.

Setting: Phase 2: participants were recruited from National Health Service community child learning disabilities teams and special schools in England. Treatment was delivered in the child learning disabilities teams.

Participants: Children aged 5-15 years with moderate to severe learning disability and specific phobia, and their parents/carers.

Interventions: The SPIRIT intervention comprised two half-day workshops and eight support sessions plus treatment as usual.

Main outcomes: The feasibility and acceptability of the intervention and research processes, recruitment, outcome measure completion rates and acceptability, and intervention adherence. Parents completed all of the outcome measures, with very low rates of missing data. The recruitment of sites and participants was impacted by the COVID-19 pandemic.

Results: The intervention was successfully developed and modelled with 15 participants with moderate to severe learning disabilities and their parents. The intervention was judged to be feasible and acceptable by parents/carers and therapists. Parents/carers and therapists suggested minor intervention revisions.

Limitations: Randomisation was not modelled within this feasibility study, although the majority of parents and therapists indicated that this would be acceptable.

Conclusions: The SPIRIT intervention and associated study processes were judged to be feasible and acceptable. The intervention requires minor revisions.

Future work: The SPIRIT intervention should be tested further within a clinical trial.

Study registration: Current Controlled Trials ISRCTN34766613.

Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: NIHR130177) and is published in full in Health Technology Assessment; Vol. 28, No. 64. See the NIHR Funding and Awards website for further award information.

中重度智障儿童的特定恐惧症:SPIRIT,一项适应性和可行性研究。
背景:针对中重度智障儿童和青少年的特殊恐惧症缺乏干预措施:缺乏针对中重度智障儿童和青少年特定恐惧症的干预措施:目的是(目标:目标是:(a)与家长/照护者和临床医生一起,制定针对特定恐惧症的干预措施,以及干预措施忠实性检查表和逻辑模型,并评估候选结果测量指标;(b)描述通常的治疗方法;(c)建立干预措施模型,以确定所有利益相关者的可接受性和可行性,判断结果测量指标的适当性,探索招募途径,并检查同意和相关程序的可行性和可接受性;以及(d)描述促进或挑战干预措施的因素:第 1a 阶段:采用协商一致的方法,成立干预措施开发小组,小组成员开会制定干预措 施,审查候选结果测量指标,并协助制定干预措施忠实性核对表和逻辑模型。第 1b 阶段:在全国范围内对家长和专业人员进行在线调查,以了解通常的治疗方法。第 2 阶段:设计了一项单组非随机可行性研究,以建立干预模型,并测试干预的可行性和可接受性、结果测量和研究过程的各个方面:第二阶段:从英格兰国家卫生服务社区儿童学习障碍小组和特殊学校招募参与者。治疗在儿童学习障碍小组进行:干预措施:干预措施:SPIRIT 干预措施包括两个为期半天的研讨会和八个支持课程,以及常规治疗:主要结果:干预和研究过程的可行性和可接受性、招募、结果测量的完成率和可接受性以及干预的坚持性。家长完成了所有结果测量,数据缺失率非常低。结果:成功开发了干预措施,并对 15 名中重度学习障碍参与者及其家长进行了模拟。家长/照护者和治疗师认为该干预措施是可行和可接受的。家长/照护者和治疗师建议对干预措施稍作修改:局限性:虽然大多数家长和治疗师表示可以接受随机化,但这项可行性研究并未模拟随机化:SPIRIT干预和相关研究过程被认为是可行和可接受的。今后的工作:研究注册:研究注册:Current Controlled Trials ISRCTN34766613:该奖项由美国国家健康与护理研究所(NIHR)健康技术评估项目资助(NIHR奖项编号:NIHR130177),全文发表于《健康技术评估》第28卷第64期。如需了解更多奖项信息,请访问 NIHR Funding and Awards 网站。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health technology assessment
Health technology assessment 医学-卫生保健
CiteScore
6.90
自引率
0.00%
发文量
94
审稿时长
>12 weeks
期刊介绍: Health Technology Assessment (HTA) publishes research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS.
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