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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 
ORCID: https://orcid.org/0000-0003-2788-2464, Minhas, Fareed Aslam and Rahman, Atif
(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, Vol 15, Issue 1, p. 53.
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Efectiveness of a technology-assisted - DWang.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview |
Abstract
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.
| Item Type: | Article |
|---|---|
| Subjects: | WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WM Psychiatry > WM 20 Research (General) WS Pediatrics > Diseases of Children and Adolescents > General Diseases > WS 200 General works |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1186/s13033-021-00476-w |
| Depositing User: | Julie Franco |
| Date Deposited: | 11 Jun 2021 11:40 |
| Last Modified: | 11 Jun 2021 11:40 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/18064 |
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