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Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial.

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Title: Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial.
Authors: Sayal, K., Taylor, J. A., Valentine, A., Guo, B., Sampson, C. J., Sellman, E., James, M., Hollis, C., Daley, D.
Source: Child: Care, Health & Development. Jul2016, Vol. 42 Issue 4, p521-533. 13p.
Subjects: Education of parents, Risk factors of attention-deficit hyperactivity disorder, Attention-deficit hyperactivity disorder, Confidence intervals, Cost effectiveness, Evaluation of medical care, Parenting, Questionnaires, Research funding, Statistical sampling, School health services, Randomized controlled trials, Data analysis software, Descriptive statistics, One-way analysis of variance
Geographic Terms: United Kingdom
Abstract: Background National Institute for Health and Care Excellence guidelines recommend a stepped care approach for the identification and management of children with, or at risk of, attention-deficit/hyperactivity disorder (ADHD). We investigated the effectiveness, cost-effectiveness and acceptability of a group parenting intervention programme (+/− a teacher session) for children at risk of ADHD. Methods In a three-arm cluster randomised controlled trial, 12 primary schools were randomly assigned to control, parent-only and combined (parent + teacher) intervention arms. Eligible children had high levels of parent-rated hyperactivity/inattention ( n = 199). At 6 month follow-up, the primary outcome measure was the parent-completed Conners' Rating Scale - Revised (ADHD index). Secondary outcomes included the Conners' sub-scales (hyperactivity, cognitive problems/inattention and oppositional behaviour), the teacher-completed Conners' Rating Scale - Revised, child health-related quality of life, parental burden and parental mental health. The cost-effectiveness analyses reflected a health and personal social services perspective. Trial Registration: ISRCTN87634685. Results Follow-up data were obtained from 76 parents and 169 teachers. There was no effect of the parent-only (mean difference = −1.1, 95% CI −5.1,2.9; p = 0.57) or combined interventions (mean difference = −2.1, 95% CI −6.4,2.1; p = 0.31) on the ADHD index. The combined intervention was associated with reduced parent-reported hyperactivity symptoms (mean difference = −5.3; 95% CI −10.5,−0.01; p = 0.05) and the parent-only intervention with improved parental mental health (mean difference = −1.9; 95% CI −3.2,−0.5; p = 0.009). The incremental costs of the parent-only and the combined interventions were £73 and £123, respectively. Above a willingness-to-pay of £31 per one-point improvement in the ADHD index, the parent-only programme had the highest probability of cost-effectiveness. Participants found the interventions acceptable. Conclusions For children at risk of ADHD, this school-based parenting programme was not associated with improvement in core ADHD symptoms. Secondary analyses suggested a possible reduction in parent-reported hyperactivity and parental mental health problems. Future research should compare targeted interventions against watchful waiting and specialist referral. [ABSTRACT FROM AUTHOR]
Copyright of Child: Care, Health & Development is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial.
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  Data: Background National Institute for Health and Care Excellence guidelines recommend a stepped care approach for the identification and management of children with, or at risk of, attention-deficit/hyperactivity disorder (ADHD). We investigated the effectiveness, cost-effectiveness and acceptability of a group parenting intervention programme (+/− a teacher session) for children at risk of ADHD. Methods In a three-arm cluster randomised controlled trial, 12 primary schools were randomly assigned to control, parent-only and combined (parent + teacher) intervention arms. Eligible children had high levels of parent-rated hyperactivity/inattention ( n = 199). At 6 month follow-up, the primary outcome measure was the parent-completed Conners' Rating Scale - Revised (ADHD index). Secondary outcomes included the Conners' sub-scales (hyperactivity, cognitive problems/inattention and oppositional behaviour), the teacher-completed Conners' Rating Scale - Revised, child health-related quality of life, parental burden and parental mental health. The cost-effectiveness analyses reflected a health and personal social services perspective. Trial Registration: ISRCTN87634685. Results Follow-up data were obtained from 76 parents and 169 teachers. There was no effect of the parent-only (mean difference = −1.1, 95% CI −5.1,2.9; p = 0.57) or combined interventions (mean difference = −2.1, 95% CI −6.4,2.1; p = 0.31) on the ADHD index. The combined intervention was associated with reduced parent-reported hyperactivity symptoms (mean difference = −5.3; 95% CI −10.5,−0.01; p = 0.05) and the parent-only intervention with improved parental mental health (mean difference = −1.9; 95% CI −3.2,−0.5; p = 0.009). The incremental costs of the parent-only and the combined interventions were £73 and £123, respectively. Above a willingness-to-pay of £31 per one-point improvement in the ADHD index, the parent-only programme had the highest probability of cost-effectiveness. Participants found the interventions acceptable. Conclusions For children at risk of ADHD, this school-based parenting programme was not associated with improvement in core ADHD symptoms. Secondary analyses suggested a possible reduction in parent-reported hyperactivity and parental mental health problems. Future research should compare targeted interventions against watchful waiting and specialist referral. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Child: Care, Health & Development is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=115929287
RecordInfo BibRecord:
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    Identifiers:
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        Value: 10.1111/cch.12349
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        Text: English
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      – SubjectFull: Risk factors of attention-deficit hyperactivity disorder
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      – SubjectFull: Attention-deficit hyperactivity disorder
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      – SubjectFull: Confidence intervals
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      – SubjectFull: Cost effectiveness
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      – SubjectFull: Parenting
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      – SubjectFull: Questionnaires
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      – SubjectFull: Research funding
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      – SubjectFull: Statistical sampling
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      – SubjectFull: School health services
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      – SubjectFull: Randomized controlled trials
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      – SubjectFull: One-way analysis of variance
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      – SubjectFull: United Kingdom
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