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The Effects of a Web-Based Tool for Parents of Children With Juvenile Idiopathic Arthritis: Randomized Controlled
Kathleen Mulligan1,2, Shashivadan P Hirani1, Sally Harris3
1Centre for Health Services Research, School of Health Sciences, City, University of London, London, United Kingdom.
Insights
A web-based tool called WebParC effectively reduced parenting stress for parents of children with juvenile idiopathic arthritis (JIA). This intervention helps parents manage their child's illness and improves their confidence.
Area of Science:
- Pediatric Rheumatology
- Digital Health Interventions
- Parental Support
Background:
- Juvenile idiopathic arthritis (JIA) presents significant challenges for parents, often leading to increased stress, anxiety, and feelings of powerlessness.
- Parenting stress in chronic childhood illness is linked to poorer psychological outcomes for both parents and children.
- Effective interventions are crucial to support parents managing a child's JIA diagnosis.
Purpose of the Study:
- To evaluate the benefits of a novel web-based tool, WebParC, designed for parents of children recently diagnosed with JIA.
- To assess the tool's impact on reducing illness-related parenting stress and improving parental well-being.
Main Methods:
- A multicentered randomized controlled trial involving parents of children (≤12 years) with recent JIA diagnoses.
- Parents were randomized to receive either the WebParC intervention plus standard care or standard care alone.
- Outcomes measured included parenting stress (Pediatric Inventory for Parents), parental mood, self-efficacy, and child's quality of life.
Main Results:
- The WebParC intervention group reported significantly less frequency and difficulty with illness-related stressful events compared to the control group.
- Specific subscales of the Pediatric Inventory for Parents showed statistically significant reductions in stress for the intervention group.
- Follow-up at 4 and 12 months demonstrated sustained effects of the intervention.
Conclusions:
- The WebParC web-based tool is a feasible and effective intervention for reducing illness-related parenting stress in parents of children with JIA.
- This digital health approach offers a promising preventive strategy for parental support in chronic childhood conditions.
- The intervention's adaptability for parents of children with other chronic illnesses warrants further investigation.
Background:
Juvenile idiopathic arthritis (JIA) is a group of autoinflammatory diseases that cause pain and disability if not controlled by treatment. Parenting a child with JIA is stressful for parents, who express concerns about their child's treatment and may experience anxiety and powerlessness concerning their child's illness. Parenting stress is greater in parents of children with chronic illness than in those with healthy children and is related to poorer psychological adjustment in both parents and children. It is therefore important to develop interventions to support parents. This paper reports the evaluation of a web-based tool that provides information and practical skills to help increase parents' confidence in managing their child's illness and reduce parenting stress.
Objective:
The aim of this study is to evaluate the benefits of a web-based tool (WebParC) for parents of children with recently diagnosed JIA.
Methods:
A multicentered randomized controlled trial was conducted at pediatric rheumatology centers in England. We recruited parents of children aged ≤12 years who had been diagnosed with JIA within the previous 6 months. They were randomized to the intervention (WebParC access plus standard care) or the control (standard care alone) and followed up 4 months and 12 months after randomization. Where both parents participated, they were randomized by household to the same trial arm. The WebParC intervention consists of information about JIA and its treatment plus a toolkit, based on cognitive behavioral therapy, to help parents develop skills to manage JIA-related issues. The primary outcome was the self-report Pediatric Inventory for Parents measure of illness-related parenting stress. The secondary outcomes were parental mood, self-efficacy, coping, effectiveness of participation in their child's health care, satisfaction with health care, and child's health-related quality of life.
Results:
A total of 203 households comprising 220 parents were randomized to the intervention (100/203, 49.3%) or control (103/203, 50.7%) arm. Follow-up assessments were completed by 65.5% (133/203) of the households at 4 months (intervention 60/100, 60%, and control 73/103, 70.9%) and 61.1% (124/203) of the households at 12 months (intervention 58/100, 58%, and control 66/103, 64.1%). A main effect of the trial arm was found on the Pediatric Inventory for Parents: the intervention participants reported less frequency (subscales communication F1,120627=5.37; P=.02, and role function F1,27203=5.40; P=.02) and difficulty (subscales communication F1,2237=7.43; P=.006, medical care F1,2907=4.04; P=.04, and role function F1,821=4.37, P=.04) regarding illness-related stressful events than the control participants.
Conclusions:
The WebParC website for parents of children with JIA reduced illness-related parenting stress. This web-based intervention offers a feasible preventive approach for parents of children with JIA and potentially could be adapted and evaluated for parents of children with other chronic illnesses.
Trial Registration:
International Standard Randomized Controlled Trial Number (ISRCTN) 13159730; http://www.isrctn.com/ISRCTN13159730.
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