Hamdani, Syed Usman, Zill-e-Huma, , Suleman, Nadia, Akhtar, Parveen, Nazir, Huma, Masood, Aqsa, Tariq, Mahjabeen, Koukab, Ahmareen, Salomone, Erica, Pacione, Laura et al (show 7 more authors)
(2021)
Effectiveness of a technology-assisted, family volunteers delivered, brief, multicomponent parents' skills training intervention for children with developmental disorders in rural Pakistan: a cluster randomized controlled trial.
INTERNATIONAL JOURNAL OF MENTAL HEALTH SYSTEMS, 15 (1).
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Effectiveness of a technology-assisted, family volunteers delivered, brief, multicomponent parents skills training intervent.pdf - Published version Download (1MB) | Preview |
Abstract
<h4>Background</h4>Globally, there is a large documented gap between needs of families and children with developmental disorders and available services. We adapted the World Health Organization's mental health Gap-Intervention Guidelines (mhGAP-IG) developmental disorders module into a tablet-based android application to train caregivers of children with developmental disorders. We aimed to evaluate the effectiveness of this technology-assisted, family volunteers delivered, parents' skills training intervention to improve functioning in children with developmental disorders in a rural community of Rawalpindi, Pakistan.<h4>Methods</h4>In a single-blinded, cluster randomized controlled trial, 30 clusters were randomised (1:1 ratio) to intervention (n = 15) or enhanced treatment as usual (ETAU) arm (n = 15). After screening, 540 children (18 participants per cluster) aged 2-12 years, with developmental disorders and their primary caregivers were recruited into the trial. Primary outcome was child's functioning, measured by Childhood Disability Assessment Schedule for Developmental Disorders (DD-CDAS) at 6-months post-intervention. Secondary outcomes were parents' health related quality of life, caregiver-child joint engagement, socio-emotional well-being of children, family empowerment and stigmatizing experiences. Intention-to-treat analyses were done using mixed-models adjusted for covariates and clusters.<h4>Results</h4>At 6-months post-intervention, no statistically significant mean difference was observed on DD-CDAS between intervention and ETAU (mean [SD], 47.65 [26.94] vs. 48.72 [28.37], Adjusted Mean Difference (AMD), - 2.63; 95% CI - 6.50 to 1.24). However, parents in the intervention arm, compared to ETAU reported improved health related quality of life (mean [SD] 65.56 [23.25] vs. 62.17 [22.63], AMD 5.28; 95% CI 0.44 to 10.11). The results were non-significant for other secondary outcomes.<h4>Conclusions</h4>In the relatively short intervention period of 6 months, no improvement in child functioning was observed; but, there were significant improvements in caregivers' health related quality of life. Further trials with a longer follow-up are recommended to evaluate the impact of intervention. Trial registration Clinicaltrials.gov, NCT02792894. Registered April 4, 2016, https://clinicaltrials.gov/ct2/show/NCT02792894.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Developmental disorders, WHO mhGAP-IG, Family Volunteers, Technology assisted task-shifting, Low income settings, Caregivers' skills training, Low resource settings |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 08 Jul 2021 08:09 |
| Last Modified: | 18 Jan 2023 21:36 |
| DOI: | 10.1186/s13033-021-00476-w |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3129172 |
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