This report should be referenced as follows:Bee P, Bower P, Byford S, Churchill R, Calam R, Stallard P, et al. The clinical effectiveness, cost-effectiveness and acceptability of community-based interventions aimed at improving or maintaining quality of life in children of parents with serious mental illness: a systematic review. Health Technol Assess 2014;18(8). This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/). Health Technology Assessment is indexed and abstracted inEditorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.ukCriteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: www.hta.ac.uk/ This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 09/117/02. The contractual start date was in November 2010. The draft report began editorial review in June 2012 and was accepted for publication in November 2012. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not nec...

Parenting self-efficacy (PSE) describes a parent’s belief in their ability to perform the parenting role successfully. Higher levels of PSE have consistently been shown to be correlated with a wide range of parenting and child outcomes. Consequently, many parenting interventions aim to improve PSE. PSE measurement has typically been via self-report measures. However, the wide range of available measures has resulted in their limited use, inconsistent terminology and ambiguous theoretical grounding. The purpose of this systematic review was to examine the psychometric and administrative qualities of the available PSE measures and offer clarity to the terminology and the theory underpinning their use so that the future use of PSE measures can be appropriate. Eleven electronic databases were searched. Articles were included if they introduced a new measure or were psychometric evaluations of an available measure of PSE for parents of children (from infancy until 18 years of age). Thirty-four measures were identified and their psychometric and administrative qualities were examined. Overall, the quality of the available measures was varied. Whilst this review makes recommendations regarding PSE measures for parents of infants through to adolescents, some caution should be applied when choosing the most appropriate measure. The theoretical grounding of each measure was clarified so that appropriate measures can be chosen under the relevant circumstances. The implications of refinement of the available measures are discussed and further research into improving PSE measurement is identified.

These results indicate the relevance of both EE and attributions in mothers of children with problem behaviour and suggest that maternal depressed mood is an important factor which is related to both of these.

Many children in developing countries are at risk of emotional and behavioral difficulties, which are likely to be elevated due to the effects of poverty. Parenting programs have shown to be effective preventative strategies in high-income countries, but to date the research on their effectiveness in lower-income countries is limited. International organizations such as the World Health Organization have called for the implementation of programs to prevent behavioral difficulties through the development of stable relationships between children and their parents. The aim of the present paper was to review the literature on parenting programs in developing countries in order to identify challenges, opportunities and directions for further research. First, reports of international organizations were reviewed in order to gain a preliminary overview of the field. In a second stage, a non-systematic review was carried out. Databases were searched in order to identify empirical evaluations of parenting programs in low-income countries. Finally, a systematic review was carried out to specifically identify evaluations of programs targeting emotional or behavioral outcomes. Only one study had a strong methodology among those designed to prevent emotional and behavioral outcomes. Opportunities for further program development and research are identified.

Objectives Internationally, public health strategies encourage health care professionals to deliver opportunistic behaviour change interventions. The present study: (1) examines the barriers and enablers to delivering interventions during routine consultations, and (2) provides recommendations for the design of interventions to increase delivery of opportunistic behaviour change interventions. Design Qualitative interview study. Methods Twenty‐eight semi‐structured interviews were conducted with patient‐facing health care professionals. The Behaviour Change Wheel informed a framework analysis in which findings were mapped onto the Theoretical Domains Framework (TDF). Intervention functions and behaviour change techniques (BCTs) targeting each TDF domain were identified. Results Health care professionals understood the importance of opportunistic behaviour change interventions (beliefs about consequences), but were sceptical about their capabilities to facilitate behaviour change with patients (beliefs about capabilities). Some clinicians were unwilling to discuss behaviours perceived as unrelated to the patient's visit (social/professional role and identity). Discipline‐specific tasks were prioritized, and delivering interventions was perceived as psychologically burdensome. One‐to‐one contact was favoured over busy hospital settings (environmental context and resources). Seven intervention functions (training, restriction, environmental restructuring, enablement, education, persuasion, and modelling) and eight BCT groupings (antecedents, associations, comparison of outcomes, covert learning, feedback and monitoring, natural consequences, reward and threat, and self‐belief) were identified. Conclusions Across disciplines, health care professionals see the value of opportunistic behaviour change interventions. Barriers related to workload, the clinical environment, competence, and perceptions of the health care professional role must be addressed, using appropriate intervention functions and BCTs, in order to support health care professionals to increase the delivery of interventions in routine practice. What is already known on this subject? Brief, opportunistic interventions can be a cost effective way of addressing population health problems. Public health policies compel health care professionals to deliver behaviour change interventions opportunistically. Health care professionals do not always deliver interventions opportunistically during routine medical consultations; however the barriers and enablers are currently unclear. What does this study add? This is the first study to examine cross‐disciplinary barriers and enablers to delivering opportunistic behaviour change interventions. Across diverse professional groups, working in different medical professions, participants saw the value of delivering opportunistic behaviour change interventions. Targeting key theoretical domains that are shared across professional groups may be useful for increasing the delivery of opportunistic behaviour change...

The studies aimed to evaluate the effectiveness of the Triple P-based "Driving Mum and Dad Mad" television series in improving positive parenting behaviours and child wellbeing over a six month period. A secondary aim was to compare the effectiveness of the intervention with (enhanced condition) and without (standard condition) extra support and resources. The influence of demographic details and parenting background were recorded to check for effects on outcomes and compliance. HypothesesParticipants were recruited across two waves, GPE1 (N = 450) and GPE2 (N = 270). Data from these two waves were combined. Both assessment groups used a repeated measures design and were randomly allocated to the two intervention conditions (standard or enhanced). Participants in the enhanced condition received downloadable tip sheets, a workbook and media resources in addition to the standard reminders to watch the series. All parents were administered a set of questionnaires measuring family background (Family Background Questionnaire); parental anger (Parental Anger Inventory); parenting style (Parenting Scale); parenting confidence for dealing with misbehaviour (Parenting Task Checklist); inter-parental conflict (Parent Problem Checklist); child disruptive behaviour (Eyberg Child Behavior Inventory); parental relationship satisfaction (Relationship Quality Index); and mood (Depression Anxiety Stress Scale). These were administered pre-intervention, as well as 12 weeks and 6 months after watching the series. Parents were also assessed on the number of episodes they watched, child-problem severity and demographic details. Hypotheses were as follows: 1. Parental factors, such as level of dysfunctional parenting style and anger, may influence the success of the interventions and persistence with watching the television series. 2. Demographic variables may influence intervention outcomes and viewing compliance. For example, based on prior research, parents from lower socio-economic status (SES) backgrounds were predicted to show less positive changes to parenting and child outcomes than parents from higher socio-economic backgrounds. 3. Severity of child problems may influence compliance and satisfaction outcomes. Parents of children with problems of greater severity were predicted to be less likely to complete watching the series, due to increased feelings of pressure and responsibility. ResultsResults were found to support the effectiveness of the media-based interventions over 12 week and 6-months for all measured variables apart from parental relationship quality. Information was found for the other hypotheses:-1. Parents with lower DASS and PS scores were more likely to have poorer reported child and parent outcomes. 2. Partner SES was significantly correlated with poorer reported child and parent outcomes. Additionally, parents from higher socio-economic backgrounds were more likely to watch the entire series and use the strategies at six-month follow-up. 3. Parents who reported greater severity of child problems were more ...

Objectives. The Capabilities, Opportunities, Motivations, Behaviour (COM-B) model is being used extensively to inform intervention design, but there is no standard measure with which to test the predictive validity of COM or to assess the impact of interventions on COM. We describe the development, reliability, validity, and acceptability of a generic 6-item self-evaluation COM questionnaire.Design and methods. The questionnaire was formulated by behaviour change experts. Acceptability was tested in two independent samples of health care professionals (N = 13 and N = 85, respectively) and a sample of people with low socio-economic status (N = 214). Acceptability (missing data analyses and user feedback), reliability (testretest reliability and Bland-Altman plots) and validity (floor and ceiling effects, Pearson's correlation coefficient [r], exploratory factor analysis [EFA], and confirmatory factor analysis [CFA]) were tested using a national survey of 1,387 health care professionals.Results. The questionnaire demonstrated acceptability (missing data for individual items: 5.9-7.7% at baseline and 18.1-32.5% at follow-up), reliability (ICCs .554-.833), and validity (floor effects 0.6-5.5% and ceiling effects 4.1-22.9%; pairwise correlations rs significantly <1.0). The regression models accounted for between 21 and 47% of the variance in behaviour. CFA (three-factor model) demonstrated a good model fit, (v 2 [6] = 7.34, p = .29, RMSEA = .02, CFI = .99, TLI = .99, BIC = 13,510.420, AIC = 13,428.067).Conclusions. The novel six-item questionnaire shows evidence of acceptability, validity, and reliability for self-evaluating capabilities, opportunities, and motivations. Future research should aim to use this tool in different populations to obtain further support for its reliability and validity.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Background“Making Every Contact Count” (MECC), a public health policy in the UK, compels healthcare professionals to deliver opportunistic health behaviour change interventions to patients during routine medical consultations. Professionals’ awareness of, and engagement with, the policy is unclear. This study examined (1) awareness of the MECC policy, and (2) the prevalence of MECC-related practice in relation to (a) perceived patient benefit, (b) how often healthcare professionals deliver interventions during routine consultations, and (c) the time spent on this activity.MethodsCross-sectional national survey was administered in 2017 of 1387 healthcare professionals working in the UK’s National Health Service (NHS). Descriptive statistics were used to assess awareness and practice consistent with the MECC policy. Chi-square was used to gauge the potential representativeness of our sample compared to NHS employment data.Results31.4% of healthcare professionals reported having heard of the policy; nevertheless, healthcare professionals perceived a need to provide patients with opportunistic behaviour change interventions in 55.9% (32,946/58,906) of consultations. However, healthcare professionals did not deliver interventions on 50.0% of occasions in which they perceived a need. Where behaviour change interventions were delivered to patients, this constituted 35.3% of the appointment time.ConclusionsPolicy makers must address the gap between the proportion of patients that healthcare professionals perceive would benefit from opportunistic behaviour change interventions and those receiving them (an estimated 50.0%; 16,473 additional patients could have benefited). Future research should consider how healthcare professionals identify patients who might benefit from opportunistic behaviour change interventions and developing training for efficient delivery of interventions.