Parenting course for caregivers of children with fetal alcohol spectrum disorder (FASD) versus waitlist: a randomised controlled large-scale feasibility study of the SPECIFiC (Salford parents and carers' education course for improvements in FASD outcomes in children) programme.
Penny A Cook, Alan D Price, Katherine Perryman, Kate Bennett, Paul Earl, Anna Webster, Heather Gage, Peter Williams, Clare S Allely, Jennifer Shields, Raja A S Mukherjee
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引用次数: 0
Abstract
Background: Children with fetal alcohol spectrum disorder (FASD) have difficulties with functioning in daily life, emotions and behaviour. Evidence for FASD-specific parenting interventions is scarce, with few randomised trials of FASD-specific parenting interventions published to date. The Salford Parents' and Carers' Education Course for Improvements in FASD outcomes in Children (SPECIFiC) is a co-designed, seven-session psychoeducation programme co-delivered online. The aim was to evaluate feasibility outcomes of recruitment, retention and acceptability, as well as candidate efficacy outcomes to establish primary outcomes for a definitive trial.
Methods: A two-arm randomised feasibility trial compared SPECIFiC with treatment as usual (TAU). Parents or carers (n = 119) of children (4-16 y) with a confirmed or probable FASD diagnosis were randomised 1:1 to intervention or TAU. Outcomes included parenting stress (Parenting Stress Index-Short Form, PSI-4-SF), parenting self-efficacy (Tool to Measure Parenting Self-Efficacy, TOPSE), child behavioural difficulties (Strengths and Difficulties Questionnaire, SDQ) and parent mental health (Depression Anxiety Stress Scale, DASS-21; Clinical Outcomes in Routine Evaluation, CORE-OM). Health economic analysis used the Client Service Receipt Inventory (CSRI) and quality of life using EuroQol (EQ-5D-5L). Analyses followed an intention-to-treat principle. The trial is registered at www.isrctn.com (ISRCTN14483801).
Results: Recruitment (41%) and retention (85%) met prespecified feasibility thresholds, and satisfaction was high. Parenting stress did not differ significantly between groups (adjusted mean difference - 3.89, 95% CI -11.1 to 3.32). No clear between-group differences were observed for child behaviour, parental mental health or quality of life outcomes. Parenting self-efficacy improved in the intervention group relative to treatment as usual (adjusted mean difference 24.9, 95% CI 5.43-44.4; Cohen's d = .80). The cost per participant ranged from £227-£302. Fidelity checks confirmed consistent delivery.
Conclusions: SPECIFiC demonstrated feasibility and acceptability and showed a promising signal for improving parental self-efficacy. A definitive trial is warranted to determine clinical and cost-effectiveness.
期刊介绍：
The Journal of Child Psychology and Psychiatry (JCPP) is a highly regarded international publication that focuses on the fields of child and adolescent psychology and psychiatry. It is recognized for publishing top-tier, clinically relevant research across various disciplines related to these areas. JCPP has a broad global readership and covers a diverse range of topics, including:
Epidemiology: Studies on the prevalence and distribution of mental health issues in children and adolescents.
Diagnosis: Research on the identification and classification of childhood disorders.
Treatments: Psychotherapeutic and psychopharmacological interventions for child and adolescent mental health.
Behavior and Cognition: Studies on the behavioral and cognitive aspects of childhood disorders.
Neuroscience and Neurobiology: Research on the neural and biological underpinnings of child mental health.
Genetics: Genetic factors contributing to the development of childhood disorders.
JCPP serves as a platform for integrating empirical research, clinical studies, and high-quality reviews from diverse perspectives, theoretical viewpoints, and disciplines. This interdisciplinary approach is a key feature of the journal, as it fosters a comprehensive understanding of child and adolescent mental health.
The Journal of Child Psychology and Psychiatry is published 12 times a year and is affiliated with the Association for Child and Adolescent Mental Health (ACAMH), which supports the journal's mission to advance knowledge and practice in the field of child and adolescent mental health.
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