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The Impact of Parent Training on the Child's Health Services

Sponsor
Children's Hospital Los Angeles (Other)
Overall Status
Enrolling by invitation
CT.gov ID
NCT03704974
Collaborator
AltaMed Health Services (Other)
45
Enrollment
1
Location
38.5
Anticipated Duration (Months)
1.2
Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The purpose of the study is to determine whether parent training with the Incredible Years Parent Program delivered in pediatric primary care decreases usage of healthcare services for the next year when compared to annual healthcare service use during the two years prior to the parents participating in program.

Condition or Disease Intervention/Treatment Phase
  • Behavioral: Video-Based Parent Training Program

Detailed Description

Pediatric health services utilization (pHSU) by children with mental health conditions demonstrated dramatic increases between 2006 and 2011. These national trends reflecting large increases in pHSU for mental health conditions were seen across multiple developmental levels. Health services costs for children with mental health conditions are estimated to be twice those for the average child. The Incredible Years® Parent Program (IY) has a strong evidence-base supporting its effectiveness in reducing early onset conduct problems. The overall objective of this stage 3 (T3) translational research proposal is to conduct a pilot study of 45 pediatrician-referred parents who participate in IY and examine the impact of IY on pHSU of their children. Pediatric HSU outcome measures include: all-cause ED visits; in-patient hospitalizations and length of stay; authorizations for specialist referrals; primary and acute care visits; and ED visits for mental health conditions. The investigator's central hypothesis is that children ages 3 to 6 years with behavior concerns whose parents are referred by their pediatricians for participation in IY will have decreased mean annual all-cause pHSU and decreased ED visits for mental health conditions in the 12 months following IY, compared to the 24 months prior to IY participation. This is important to demonstrate because significant financial barriers exist to integrating effective family focused prevention services like IY into pediatric primary care settings. Demonstration of reduced pHSU is one way to address these translational barriers. Results of this pilot study are expected to provide preliminary data on pre- and post-intervention effect sizes; these data will be used to demonstrate the feasibility of collecting data using existing sources of pHSU to design a more fully powered multi-site trial with a robust comparator group.

Study Design

Study Type:
Observational
Anticipated Enrollment :
45 participants
Observational Model:
Cohort
Time Perspective:
Retrospective
Official Title:
The Impact of Evidence-Based Parent Training on Pediatric Health Services Utilization
Actual Study Start Date :
Aug 16, 2018
Anticipated Primary Completion Date :
Oct 31, 2021
Anticipated Study Completion Date :
Oct 31, 2021

Arms and Interventions

Arm Intervention/Treatment
Children of Parents Receiving IY

Children ages 3 to 6 years at start of group with behavior concerns whose parents are referred by their pediatricians for participation in a video-based parent training program from 2014 through 2018.

Behavioral: Video-Based Parent Training Program
An18-20 week evidence-based social cognitive theory-based parenting program where parents see brief video vignettes of effective and less effective parenting and develop concepts to modify their child's behavior.
Other Names:
  • Incredible Years® Preschool BASIC Parenting Program
  • Incredible Years® Early Childhood BASIC Parenting Program

    		•

    Outcome Measures

    Primary Outcome Measures

    1. Change in Annual Pediatric Health Services Utilization from 24 months prior to IY Parent Group Participation to 12 months following IY Parent Group Participation [Utilization for 24 months prior to intervention and 12 months following intervention]

      (1) all-cause Emergency Department (ED) visits (yes/no) and number; (2) ED visits for mental health conditions (yes/no) and number; (3) in-patient hospitalizations (yes/no) and number, and length of stay in days; (4) authorizations for specialist referrals from AltaMed (yes/no) and number; (5) number of AltaMed primary care visits; (6) AltaMed acute care visits (yes/no) and number; (7) AltaMed mental health visits (yes/no) and number; (8) Children's Hospital Los Angeles (CHLA) specialty mental health visits (yes/no) and number.

    Secondary Outcome Measures

    1. Eyberg Child Behavior Inventory [During week before or after starting group; and during week before or after ending group, up to 20 weeks]

      Raw and T-scores for Intensity [measures frequency of problem behaviors; range 36 to 252; higher worse] and Problem [measures number of behaviors that are a problem for the parent; range 0 to 36; higher worse] Subscales

    2. Youth Outcome Questionnaire (Parent Report) [During week before or after starting group; and during week before or after ending group, up to 20 weeks]

      Total raw score [measures change in frequency of child symptoms and prosocial behaviors; range -16 to 240; higher worse].

    3. Pediatric Symptom Checklist [During week before or after starting group; and during week before or after ending group, up to 20 weeks]

      Total raw score [measures frequency of pediatric psychosocial problems; range 0 to 70; higher worse].

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    36 Months to 83 Months
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:

    • Children receiving primary care at CHLA AltaMed with parent-reported behavioral concerns whose parents are referred by their pediatricians for participation in the Incredible Years Parenting Program.

    • Continuous enrollment in AltaMed Medicaid funded health services during the 24 months prior to participation in IY and 12 months following participation in IY with lapses in coverage of no more than 90 days in length.

    • Parents are English or Spanish-speaking or willing to use interpretation if they speak another language.

    Exclusion Criteria:
    • Private (commercial non-Medicaid) insurance coverage for greater than 90 days during the 24 months prior to participation in IY and 12 months following participation in IY.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Children's Hospital Los Angeles Los Angeles California United States 90027

    Sponsors and Collaborators

    • Children's Hospital Los Angeles
    • AltaMed Health Services

    Investigators

    • Principal Investigator: DEAN M COFFEY, PsyD, University of Southern California; Children's Hospital Los Angeles

    Study Documents (Full-Text)

    None provided.

    More Information

    Additional Information:

    Publications

    Responsible Party:
    Children's Hospital Los Angeles
    ClinicalTrials.gov Identifier:
    NCT03704974
    Other Study ID Numbers:
    • CHLA-17-00001
    • UL1TR001855
    First Posted:
    Oct 15, 2018
    Last Update Posted:
    Sep 16, 2021
    Last Verified:
    Sep 1, 2021
    Individual Participant Data (IPD) Sharing Statement:
    Undecided
    Plan to Share IPD:
    Undecided
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    No
    Keywords provided by Children's Hospital Los Angeles
    Child Health Services
    Pediatric Health Service Utilization
    Incredible Years
    Additional relevant MeSH terms:
    Problem Behavior

    Study Results

    No Results Posted as of Sep 16, 2021