TY - JOUR
T1 - Telephone-based mental health interventions for child disruptive behavior or anxiety disorders
T2 - Randomized trials and overall analysis
AU - McGrath, Patrick J.
AU - Lingley-Pottie, Patricia
AU - Thurston, Catherine
AU - MacLean, Cathy
AU - Cunningham, Charles
AU - Waschbusch, Daniel A.
AU - Watters, Carolyn
AU - Stewart, Sherry
AU - Bagnell, Alexa
AU - Santor, Darcy
AU - Chaplin, William
N1 - Funding Information:
Disclosure: Dr. McGrath received funding from a Canada Research Chair. He may commercialize the Strongest Family Program. Dr. Chaplin was paid a stipend to conduct blinded analysis of the data. Dr. Cunningham has received honoraria for Community Parent Education Program (COPE) workshops and has received royalties for COPE materials. Drs. Lingley-Pottie, Waschbusch, McLean, Santor, Bagnell, Stewart, Watters, and Ms. Thurston report no biomedical financial interests or potential conflicts of interest.
Funding Information:
The main source of funding for these trials was received from the Canadian Institutes of Health Research, Community Alliances for Health Research Program. Funding for the development of the materials was obtained from the former Nova Scotia Northern Health District (now known as Nova Scotia District Health Authorities 4, 5 and 6) and the Hospital for Sick Children, Toronto, Ontario. Software development funding was provided by the Canadian Foundation of Innovation and Human Resources Development Canada, Amherst Division (now known as Human Resources and Social Development Canada).
Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2011/11
Y1 - 2011/11
N2 - Objective: Most children with mental health disorders do not receive timely care because of access barriers. These initial trials aimed to determine whether distance interventions provided by nonprofessionals could significantly decrease the proportion of children diagnosed with disruptive behavior or anxiety disorders compared with usual care. Method: In three practical randomized controlled trials, 243 children (80 with oppositional-defiant, 72 with attention-deficit/hyperactivity, and 91 with anxiety disorders) were stratified by DSM-IV diagnoses and randomized to receive the Strongest Families intervention (treatment) or usual care (control). Assessments were blindly conducted and evaluated at 120, 240, and 365 days after randomization. The intervention consisted of evidence-based participant materials (handbooks and videos) and weekly telephone coach sessions. The main outcome was mental health diagnosis change. Results: Intention-to-treat analysis showed that for each diagnosis significant treatment effects were found at 240 and 365 days after randomization. Moreover, in the overall analysis significantly more children were not diagnosed as having disruptive behavior or anxiety disorders in the treatment group than the control group (120 days: χ 1 2 = 13.05, p < .001, odds ratio 2.58, 95% confidence interval 1.54-4.33; 240 days: χ 1 2 = 20.46, p < .001, odds ratio 3.44, 95% confidence interval 1.99-5.92; 365 days: χ 1 2 = 13.94, p < .001, odds ratio 2.75, 95% confidence interval 1.61-4.71). Conclusions: Compared with usual care, telephone-based treatments resulted in significant diagnosis decreases among children with disruptive behavior or anxiety. These interventions hold promise to increase access to mental health services. Clinical trial registration information--Strongest Families: Pediatric Disruptive Behaviour Disorder, http://www.clinicaltrials.gov, NCT00267579; Strongest Families: Pediatric Attention-Deficit/Hyperactivity Disorder, http://www.clinicaltrials.gov, NCT00267605; and Strongest Families: Pediatric Anxiety, http://www.clinicaltrials.gov, NCT00267566.
AB - Objective: Most children with mental health disorders do not receive timely care because of access barriers. These initial trials aimed to determine whether distance interventions provided by nonprofessionals could significantly decrease the proportion of children diagnosed with disruptive behavior or anxiety disorders compared with usual care. Method: In three practical randomized controlled trials, 243 children (80 with oppositional-defiant, 72 with attention-deficit/hyperactivity, and 91 with anxiety disorders) were stratified by DSM-IV diagnoses and randomized to receive the Strongest Families intervention (treatment) or usual care (control). Assessments were blindly conducted and evaluated at 120, 240, and 365 days after randomization. The intervention consisted of evidence-based participant materials (handbooks and videos) and weekly telephone coach sessions. The main outcome was mental health diagnosis change. Results: Intention-to-treat analysis showed that for each diagnosis significant treatment effects were found at 240 and 365 days after randomization. Moreover, in the overall analysis significantly more children were not diagnosed as having disruptive behavior or anxiety disorders in the treatment group than the control group (120 days: χ 1 2 = 13.05, p < .001, odds ratio 2.58, 95% confidence interval 1.54-4.33; 240 days: χ 1 2 = 20.46, p < .001, odds ratio 3.44, 95% confidence interval 1.99-5.92; 365 days: χ 1 2 = 13.94, p < .001, odds ratio 2.75, 95% confidence interval 1.61-4.71). Conclusions: Compared with usual care, telephone-based treatments resulted in significant diagnosis decreases among children with disruptive behavior or anxiety. These interventions hold promise to increase access to mental health services. Clinical trial registration information--Strongest Families: Pediatric Disruptive Behaviour Disorder, http://www.clinicaltrials.gov, NCT00267579; Strongest Families: Pediatric Attention-Deficit/Hyperactivity Disorder, http://www.clinicaltrials.gov, NCT00267605; and Strongest Families: Pediatric Anxiety, http://www.clinicaltrials.gov, NCT00267566.
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U2 - 10.1016/j.jaac.2011.07.013
DO - 10.1016/j.jaac.2011.07.013
M3 - Article
C2 - 22024004
AN - SCOPUS:80054851832
SN - 0890-8567
VL - 50
SP - 1162
EP - 1172
JO - Journal of the American Academy of Child and Adolescent Psychiatry
JF - Journal of the American Academy of Child and Adolescent Psychiatry
IS - 11
ER -