PRO-DIALOG-the effect of a novel dialogue-based parent-teacher conference on mental health in kindergarten children: a cluster randomized controlled trial.

Background: Mental health difficulties in preschool children often go unnoticed and may result in delayed access to potentially beneficial services. In Norwegian kindergartens, teachers get to know the children well over time and have parent-teacher conferences once or twice a year. Kindergarten is thus a well-suited arena for early identification and intervention of mental health difficulties. To address the need for a kindergarten-specific method for secondary prevention, we have developed Dialogue-Based Early Detection (DBED) in close collaboration with educators and parents in eight different kindergartens. Results from a feasibility study indicate that DBED works well as a parent-teacher collaborative screening method and is well accepted by the users. In the PRO-DIALOG project, we will examine the potential of DBED and explore its possible long-term effects in a randomized controlled trial.

Methods: Ten kindergartens will be randomly selected to implement DBED, while ten will act as controls, offering ordinary parent-teacher conferences. Parents of at least 100 + 100 children will be recruited. The primary outcome will be children's mental health in the intervention group as assessed by the Strengths and Difficulties Questionnaire (SDQ), during the 5-year follow-up, compared to the control group. Secondary outcomes will be (i) the effect of DBED on parental stress as measured by the Parental Stress Scale (PSS) and (ii) time to activation of support, as measured by the duration from the first parent-teacher conference to activation of any support, comparing the two groups. We will also assess (iii) socio-demographic predictors for mental health development, parent and teacher concern for the child, parental stress, and parent satisfaction with DBED, (iv) screening properties of DBED compared to SDQ, and (v) social validity of DBED as measured by user-satisfaction questionnaires and interviews with both parents and teachers.

Discussion: This complex intervention study includes a wide range of outcomes beyond the mental health scores of kindergarten children. If the intervention is well accepted and has a positive influence on the children's mental health, the DBED method has a potential for a wide dissemination. This study will produce new knowledge on kindergarten as an arena for the promotion of mental health among young children.

Trial registration: ClinicalTrials.gov NCT06471816. Registered on 2024-06-22 16:06. Retrospectively registered.