A Tailored Web-Based Intervention to Improve Parenting Risk and Protective Factors for Adolescent Depression and Anxiety Problems: Postintervention Findings From a Randomized Controlled Trial

Abstract

BackgroundDepression and anxiety disorders in young people are a global health concern. Parents have an important role in reducing the risk of these disorders, but cost-effective, evidence-based interventions for parents that can be widely disseminated are lacking.ObjectiveThis study aimed to examine the postintervention effects of the Partners in Parenting (PiP) program on parenting risk and protective factors for adolescent depression and anxiety, and on adolescent depression and anxiety symptoms.MethodsA two-arm randomized controlled trial was conducted with 359 parent-adolescent dyads, recruited primarily through schools across Australia. Parents and adolescents were assessed at baseline and 3 months later (postintervention). Parents in the intervention condition received PiP, a tailored Web-based parenting intervention designed following Persuasive Systems Design (PSD) principles to target parenting factors associated with adolescents’ risk for depression and anxiety problems. PiP comprises a tailored feedback report highlighting each parent’s strengths and areas for improvement, followed by a set of interactive modules (up to nine) that is specifically recommended for the parent based on individually identified areas for improvement. Parents in the active-control condition received a standardized package of five Web-based factsheets about adolescent development and well-being. Parents in both conditions received a 5-min weekly call to encourage progress through their allocated program to completion. Both programs were delivered weekly via the trial website. The primary outcome measure at postintervention was parent-reported changes in parenting risk and protective factors, which were measured using the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS). Secondary outcome measures were the adolescent-report PRADAS, the parent- and child-report Short Mood and Feelings Questionnaire (depressive symptoms), and parent- and child-report Spence Children’s Anxiety Scale (anxiety symptoms).ResultsParents in the intervention condition completed a mean of 73.7% of their intended personalized PiP program. A total of 318 parents (88.6%, 318/359) and 308 adolescents (92.8%, 308/332) completed the postintervention assessment. Attrition was handled using mixed model of repeated measures analysis of variance. As hypothesized, we found a significant condition-by-time interaction on the PRADAS, with a medium effect size, Cohen d=0.57, 95% CI 0.34-0.79. No significant differences between conditions were found at postintervention on any of the secondary outcome measures, with adolescent depressive (parent-report only) and anxiety (both parent- and adolescent-report) symptoms decreasing significantly from baseline to postintervention in both conditions.ConclusionsThe fully automated PiP intervention showed promising short-term effects on parenting behaviors that are associated with adolescents’ risk for depression and anxiety. Long-term follow-up is required to ascertain whether these effects translate into red...

A systematic review of technology‐assisted parenting programs for mental health problems in youth aged 0–18 years: Applicability to underserved Australian communities

“…Male youth were well represented across many studies, constituting more than 50% of the young people in 14 studies (Baker et al, ; Cardamone‐Breen et al, ; DuPaul et al, ; Enebrink et al, ; Hinton et al, ; Irvine et al, ; Jones et al, ; Morawska et al, ; Sanders et al, ; Sanders et al, ; Sourander et al, ; Van Zeijl et al, ; Yap et al, ), on average making up 44.6% of youth participants. In contrast, male caregivers were severely underrepresented (on average 5.0%), with only three studies including more than 10% male caregivers (Khanna et al, ; MacKenzie & Hilgedick, ; Yap et al, ). No male caregivers were primary recipients of the intervention in eight studies (Breitensteinet al, 2016; Fang et al, 2010; Hemdi & Daley, ; Sanders et al, ; Schinke et al, ; Schinke et al, ; Schwinn et al, ; Van Zeijl et al, ).…”

“…No male caregivers were primary recipients of the intervention in eight studies (Breitensteinet al, 2016; Fang et al, 2010; Hemdi & Daley, ; Sanders et al, ; Schinke et al, ; Schinke et al, ; Schwinn et al, ; Van Zeijl et al, ). In most studies, the majority (>50%) of the sample were educated with post‐secondary qualifications ( n = 14, Baker et al, ; Cardamone‐Breen et al, ; Day & Sanders, ; DuPaul et al, ; Fang et al, ; Hemdi & Daley, ; Jones et al, ; Khanna et al, ; Morgan et al, ; Sanders et al, ; Sanders et al, ; Schinke et al, ; Schinke et al, ; Schwinn et al, ; Yap et al, ). While most studies did not adequately report the employment status of their participants ( n = 14, DuPaul et al, ; Enebrink et al, 2012; Fang et al, ; Khanna et al, ; Kuravackel et al, ; MacKenzie & Hilgedick, ; Morawska et al, ; Morgan et al, ; Nixon et al, ; Sanders et al, ; Schinke et al, ; Schinke et al, ; Schinke et al, 2009b; Sourander et al, ; Van Zeijl et al, 2006), of those that did, most reported over 50% of their sample engaged in employed work of some description ( n = 8, Baker et al, ; Cardamone‐Breen et al, ; Day & Sanders, ; Hinton et al, ; Irvine et al, ; Sanders et al, ; Schwinn et al, ; Yap et al, ).…”

“…Nineteen studies reported strategies to enhance engagement (Baker et al, ; Breitenstein et al, 2016; Cardamone‐Breen et al, ; Day & Sanders, ; DuPaul et al, ; Fang et al, ; Hemdi & Daley, ; Hinton et al, ; Irvine et al, ; Jones et al, ; Kuravackel et al, ; MacKenzie & Hilgedick, ; Morawska et al, ; Morgan et al, ; Sanders et al, ; Sanders et al, ; Schwinn et al, ; Sourander et al, ; Yap et al, ), outlined either in the primary article describing the randomised controlled trial evaluation of the intervention, or the program development article. Of these, 12 described utilising a strategy intended to enhance engagement with underserved parent populations (Baker et al, ; Breitenstein et al, 2016; Day & Sanders, ; Fang et al, ; Hemdi & Daley, ; Irvine et al, ; Jones et al, ; Kuravackel et al, ; Morawska et al, ; Morgan et al, ; Sanders et al, ; Schwinn et al, ).…”

Parental Self‐Efficacy for Reducing the Risk of Adolescent Depression and Anxiety: Scale Development and Validation

“…Further information about the intervention and findings from the follow‐up assessment is available in Yap et al. ().…”

“…We used baseline data from both parent and adolescent participants to validate the PSES. Further information about the intervention and findings from the follow-up assessment is available in Yap et al (2018).…”