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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
BACKGROUND: 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...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8165981/ https://www.ncbi.nlm.nih.gov/pubmed/34059074 http://dx.doi.org/10.1186/s13033-021-00476-w |
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author | Hamdani, Syed Usman Huma, Zill-e- Suleman, Nadia Akhtar, Parveen Nazir, Huma Masood, Aqsa Tariq, Mahjabeen Koukab, Ahmareen Salomone, Erica Pacione, Laura Brown, Felicity Shire, Stephanie Sikander, Siham Servili, Chiara Wang, Duolao Minhas, Fareed Aslam Rahman, Atif |
author_facet | Hamdani, Syed Usman Huma, Zill-e- Suleman, Nadia Akhtar, Parveen Nazir, Huma Masood, Aqsa Tariq, Mahjabeen Koukab, Ahmareen Salomone, Erica Pacione, Laura Brown, Felicity Shire, Stephanie Sikander, Siham Servili, Chiara Wang, Duolao Minhas, Fareed Aslam Rahman, Atif |
author_sort | Hamdani, Syed Usman |
collection | PubMed |
description | BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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 |
format | Online Article Text |
id | pubmed-8165981 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-81659812021-06-02 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 Hamdani, Syed Usman Huma, Zill-e- Suleman, Nadia Akhtar, Parveen Nazir, Huma Masood, Aqsa Tariq, Mahjabeen Koukab, Ahmareen Salomone, Erica Pacione, Laura Brown, Felicity Shire, Stephanie Sikander, Siham Servili, Chiara Wang, Duolao Minhas, Fareed Aslam Rahman, Atif Int J Ment Health Syst Research BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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 BioMed Central 2021-05-31 /pmc/articles/PMC8165981/ /pubmed/34059074 http://dx.doi.org/10.1186/s13033-021-00476-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Hamdani, Syed Usman Huma, Zill-e- Suleman, Nadia Akhtar, Parveen Nazir, Huma Masood, Aqsa Tariq, Mahjabeen Koukab, Ahmareen Salomone, Erica Pacione, Laura Brown, Felicity Shire, Stephanie Sikander, Siham Servili, Chiara Wang, Duolao Minhas, Fareed Aslam Rahman, Atif 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 |
title | 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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8165981/ https://www.ncbi.nlm.nih.gov/pubmed/34059074 http://dx.doi.org/10.1186/s13033-021-00476-w |
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