Background:

Adolescent depression can place a young person at high risk of recurrence and a range of psychosocial and vocational impairments in adult life, highlighting the importance of early recognition and prevention. Parents/carers are well placed to notice changes in their child’s emotional wellbeing which may indicate risk, and there is increasing evidence that modifiable factors exist within the family system that may help reduce the risk of depression and anxiety in an adolescent. A randomised controlled trial (RCT) of the online personalised ‘Partners in Parenting’ programme, developed in Australia, focused on improving parenting skills, knowledge and awareness, showed that it helped reduce depressive symptoms in adolescents who had elevated symptom levels at baseline. We have adapted this programme and will conduct an RCT in a UK setting.

Sponsor:

The University of Warwick

Funding:

National Institute of Health Research – Public Health Research NIHR (17/04/34)

Primary objective:

To evaluate the effect of the personalised programme on parent-reported severity of depressive symptoms in young people at high-risk of developing affective disorders.

Secondary objectives

To evaluate the effect of the personalised programme on parenting, parental self-efficacy, parental wellbeing, quality of life and attachment in parents of young people at high-risk of developing affective disorders.

To evaluate the effect of the personalised programme on self-reported severity of depressive symptoms, emotion regulation skills, anxiety symptoms, attachment, emotional and behavioural difficulties, quality of life and incidence of depression in young people at high-risk of developing affective disorders.

To evaluate the cost and cost-effectiveness of the personalised programme for prevention of affective disorders in young people at high-risk.

Methods:

433 family dyads (parents/carers and children aged 11-15) will be recruited through schools in the West Midlands. Following completion of screening measures of adolescent’s depressive symptoms, parents/carers of those with elevated scores will be randomised to receive the online personalised parenting programme or a series of online factsheets about adolescent development and wellbeing. Follow-up assessments will be undertaken at six and 15-months and a process evaluation will examine context, implementation and impact of the intervention. An economic evaluation will also be incorporated with cost-effectiveness of the parenting intervention expressed in terms of incremental cost per quality-adjusted life year gained.

Main Results:

Trial is currently in progress.

Conclusions:

Half of mental health problems emerge before mid-adolescence and approximately three-quarters by mid 20s, highlighting the need for effective preventative strategies. However, few early interventions are family focused and delivered online. We aim to conduct an RCT of the online personalised ‘Partners in Parenting’ programme, proven effective in Australia, targeting adolescents at risk of depression to evaluate its effectiveness, cost-effectiveness and usability in a UK setting

Implications for Implementation:

In conjunction with the Australian trials the results of the PIPA trial will provide a robust evidence base with regard to the efficacy of this online parenting programme, its potential for reducing depressive symptoms in UK adolescents, its acceptability and usability. It will also enable a cost/benefit comparison with typical face-to-face group based parenting programmes, informing policy and thus enhancing the design, and future delivery of more pragmatic resources for supporting families with adolescents at risk of depression and anxiety.

Protocol:

Not yet published.

Publication:

TBC