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Brief parenting intervention (Triple P) for families of children with eczema: a randomized controlled trial
Amy E Mitchell1,2,3, Alina Morawska2,4, Emily Casey5
1School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, Australia.
Insights
A brief parenting intervention improved parental self-efficacy and reduced ineffective parenting for children with eczema. The intervention did not significantly impact eczema severity, adherence, or quality of life.
Area of Science:
- Pediatric Dermatology
- Behavioral Science
- Health Services Research
Background:
- Eczema management in children presents challenges for parents, impacting family well-being.
- Parenting interventions can address behavioral aspects of chronic condition management.
Purpose of the Study:
- To assess the effectiveness and cost of a brief, group-delivered parenting program for families with children diagnosed with eczema.
- To evaluate the intervention's impact on parenting practices, self-efficacy, and child behavior related to eczema management.
Main Methods:
- A randomized controlled trial involved 59 families with children aged 2-10 years diagnosed with eczema.
- Participants were randomized to either the Healthy Living Triple P intervention or standard care.
- Outcomes included clinician-rated eczema severity, parent-reported symptoms, treatment adherence, parenting behavior, self-efficacy, and quality of life, assessed at baseline, 4 weeks, and 6 months.
Main Results:
- The intervention significantly improved parenting practices (d=.60), parental self-efficacy (d=.74), and task performance (d=.81).
- Improvements were also noted in confidence managing child behavior (d=.63).
- No significant effects were observed on eczema severity, topical corticosteroid adherence, or quality of life. The mean cost per family with improved parenting was $159.
Conclusions:
- The Healthy Living Triple P program effectively reduces ineffective parenting and enhances parental self-efficacy and task performance in managing childhood eczema.
- The intervention shows promise for improving behavioral aspects of eczema management but does not directly affect disease severity or adherence.
Objective:
To evaluate the efficacy and costs of a brief, group-delivered parenting intervention for families of children with eczema.
Methods:
A randomized controlled trial design was used. Families attending the Queensland Children's Hospital and from the community (n = 257) were assessed for eligibility (child 2-10 years, diagnosed with eczema, prescribed topical corticosteroids). Families who consented to participate (N = 59) were assessed at baseline for clinician-rated eczema severity, parent-reported eczema symptom severity, and electronically-monitored topical corticosteroid adherence (primary outcomes); and parenting behavior, parents' self-efficacy and task performance when managing eczema, eczema-related child behavior problems, and child and parent quality of life (secondary outcomes). Families were randomized (1:1, unblinded) to intervention (n = 31) or care-as-usual (n = 28). The intervention comprised two, 2-hr Healthy Living Triple P group sessions (face-to-face/online) and 28 intervention families attended one/both sessions. All families were offered standardized eczema education. Families were reassessed at 4-weeks post-intervention and 6-month follow-up, with clinician-raters blinded to condition. Costs of intervention delivery were estimated.
Results:
Multilevel modeling across assessment timepoints showed significant intervention effects for ineffective parenting (d = .60), self-efficacy (d = .74), task performance (d = .81), and confidence with managing eczema-related child behavior (d = .63), but not disease/symptom severity, treatment adherence or quality of life. Mean cost per participating family with parenting behavior (clinically) improved was $159.
Conclusions:
Healthy Living Triple P is effective in reducing ineffective parenting practices and improving parents' self-efficacy and task performance when managing children's eczema and eczema-related behavior difficulties. There was no effect on disease/symptom severity, treatment adherence, or quality of life.
Clinical Trial Registration:
ACTRN12618001332213.
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