Study protocol of a factorial trial ECHO: optimizing a group-based school intervention for children with emotional problems

Simon-Peter Neumer; Joshua Patras; Solveig Holen; Carina Lisøy; Anne Liv Askeland; Ida Mari Haug; Annette Jeneson; Tore Wentzel-Larsen; Frode Adolfsen; Lene-Mari Potulski Rasmussen; Jo Magne Ingul; Kristin Ytreland; Elisabeth Valmyr Bania; Anne Mari Sund; Kristin Martinsen

doi:10.1186/s40359-021-00581-y

journal article Open Access Jun 21, 2021

Study protocol of a factorial trial ECHO: optimizing a group-based school intervention for children with emotional problems

Joshua Patras Solveig Holen Carina Lisøy Anne Liv Askeland Ida Mari Haug Annette Jeneson Tore Wentzel-Larsen Frode Adolfsen Lene-Mari Potulski Rasmussen Jo Magne Ingul Kristin Ytreland Elisabeth Valmyr Bania Anne Mari Sund Kristin Martinsen

BMC Psychology Vol. 9 No. 1 · Springer Science and Business Media LLC

View at Publisher Save 10.1186/s40359-021-00581-y

Abstract

AbstractBackgroundYouth mental health problems are a major public health concern. Anxiety and depression are among the most common psychological difficulties. The aim of this study is to evaluate an optimized version of a promising indicated group intervention for emotional problems. The program (EMOTION Coping Kids Managing Anxiety and Depression) targets school children 8–12 years with anxious and depressive symptoms and examines three factors. Factor 1 compares the standard EMOTION intervention delivered in 16 group-based sessions (Group), versus a partially-digital EMOTION intervention (DIGGI) delivered as eight group sessions and eight digital sessions. Both versions use virtual reality technology (VR) to improve behavioral experiments. Factor 2 compares parent participation in a 5-session parent group (high involvement) versus sharing information with parents via a brochure (low involvement). Factor 3 compares the use of a measurement and feedback system (MFS) designed to help group leaders tailor the intervention using feedback from children with no MFS.MethodsUsing a cluster-randomized factorial design, 40 schools across Norway will be randomized to eight different experimental conditions based on three, two-level factors. To assess internalizing symptoms in children, children and their parents will be given self-report questionnaires pre-, post-, and one year after intervention. Parents also report on demographics, user satisfaction, personal symptoms and perception of family related factors. Teachers report on child symptoms and school functioning. Group leaders and the head of the municipal services report on implementation issues. The primary outcomes are changes in depressive and anxious symptoms. Some secondary outcomes are changes in self-esteem, quality of life, and user satisfaction. Questions regarding the consequences of the COVID-19 pandemic are included. Treatment fidelity is based on checklists from group leaders, and on user data from the participating children.DiscussionThis study is a collaboration between three regional centers for child and adolescent mental health in Norway. It will provide knowledge about: (1) the effect of school-based preventive interventions on anxiety and depression in children; (2) the effect of feedback informed health systems, (3) the effect and cost of digital health interventions for children, and (4) the effect of parental involvement.

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References

61

[1]

Merikangas KR, He J-P, Burstein M, Swanson SA, Avenevoli S, Cui L, et al. Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010;49(10):980–9. 10.1016/j.jaac.2010.05.017

[2]

Prevalence and Development of Psychiatric Disorders in Childhood and Adolescence

E. Jane Costello, Sarah Mustillo, Alaattin Erkanli et al.

Archives of General Psychiatry 2003 10.1001/archpsyc.60.8.837

[3]

Folkehelseinstituttet. Helsetilstanden i Norge. Folkehelserapporten – kortversjon. Oslo: Folkehelseinstituttet; 2018.

[4]

Balazs J, Miklosi M, Kereszteny A, Hoven CW, Carli V, Wasserman C, et al. Adolescent subthreshold-depression and anxiety: Psychopathology, functional impairment and increased suicide risk. J Child Psychol Psychiatry. 2013;54(6):670–7. 10.1111/jcpp.12016

[5]

Nygaard E, Kårikstad V. Prioriteringsveileder psykisk helsevern for barn og unge Oslo: Helsedirektoratet; 2015.

[6]

Martinsen K, Stark KD, Rodriguez K, Kendall PC, Arora P. Mestrende barn: foreldremanual. Oslo: Gyldendal akademisk; 2014.

[7]

Patras J, Martinsen KD, Holen S, Sund AM, Adolfsen F, Rasmussen LP, et al. Study protocol of an RCT of EMOTION: An indicated intervention for children with symptoms of anxiety and depression. BMC Psychol. 2016;4(1):48. 10.1186/s40359-016-0155-y

[8]

Loevaas MES, Lydersen S, Sund AM, Neumer SP, Martinsen KD, Holen S, et al. A 12-month follow-up of a transdiagnostic indicated prevention of internalizing symptoms in school-aged children: the results from the EMOTION study. Child Adolesc Psychiatry Ment Health. 2020;14(1):15. 10.1186/s13034-020-00322-w

[9]

Martinsen K, Rasmussen LMP, Wentzel-Larsen T, Holen S, Sund AM, Lovaas MES, et al. Prevention of anxiety and depression in school children: Effectiveness of the transdiagnostic EMOTION program. J Consult Clin Psychol. 2018. 10.1037/ccp0000360

[10]

Rasmussen L-MP, Patras J, Neumer S-P, Adolfsen F, Martinsen KD, Holen S, et al. Facilitators and barriers to the implementation of EMOTION: an indicated intervention for young schoolchildren. Scand J Educ Res. 2020;64(5):728–43. 10.1080/00313831.2019.1596976

[11]

Mychailyszyn MP, Brodman DM, Read KL, Kendall PC. Cognitive-behavioral school-based interventions for anxious and depressed youth: a meta-analysis of outcomes. Clin Psychol. 2012;19(2):129–53.

[12]

Tollefsen TK, Darrow SM, Lohne V, Berg-Nielsen TS. Experiences with using an idiographic assessment procedure in primary mental health care services for adolescents. Int J Qual Stud Health Well-being. 2020;15(1):1763741. 10.1080/17482631.2020.1763741

[13]

Bergman H, Kornør H, Nikolakopoulou A, Hanssen‐Bauer K, Soares‐Weiser K, Tollefsen TK, et al. Client feedback in psychological therapy for children and adolescents with mental health problems. Cochrane Database Syst Rev. 2018(8). 10.1002/14651858.cd011729.pub2

[14]

Lyon AR, Lewis CC, Boyd MR, Hendrix E, Liu F. Capabilities and characteristics of digital measurement feedback systems: results from a comprehensive review. Adm Policy Ment Health. 2016;43(3):441–66. 10.1007/s10488-016-0719-4

[15]

Annual Research Review: Digital health interventions for children and young people with mental health problems – a systematic and meta‐review

Chris Hollis, Caroline J. Falconer, Jennifer L. Martin et al.

Journal of Child Psychology and Psychiatry 2017 10.1111/jcpp.12663

[16]

Brendel KE, Maynard BR. Child–parent interventions for childhood anxiety disorders: a systematic review and meta-analysis. Res Soc Work Pract. 2014;24(3):287–95. 10.1177/1049731513503713

[17]

Silverman WK, Pina AA, Viswesvaran C. Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents. J Clin Child Adolesc Psychol. 2008;37(1):105–30. 10.1080/15374410701817907

[18]

Collins LM, Dziak JJ, Kugler KC, Trail JB. Factorial experiments: efficient tools for evaluation of intervention components. Am J Prev Med. 2014;47(4):498–504. 10.1016/j.amepre.2014.06.021

[19]

Freeman D, Reeve S, Robinson A, Ehlers A, Clark D, Spanlang B, et al. Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychol Med. 2017;47(14):2393–400. 10.1017/s003329171700040x

[20]

Campbell MK, Elbourne DR, Altman DG. CONSORT statement: extension to cluster randomised trials. BMJ. 2004;328(7441):702–8. 10.1136/bmj.328.7441.702

[21]

Angold A, Costello EJ, Messer SC, Pickles A. Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. Int J Methods Psychiatr Res. 1995;5(4):237–49.

[22]

Rhew IC, Simpson K, Tracy M, Lymp J, McCauley E, Tsuang D, et al. Criterion validity of the Short Mood and Feelings Questionnaire and one- and two-item depression screens in young adolescents. Child Adolesc Psychiatry Ment Health. 2010;4:8. 10.1186/1753-2000-4-8

[23]

March JS, Parker JDA, Sullivan K, Stallings P, Conners CK. The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. J Am Acad Child Adolesc Psychiatry. 1997;36(4):554–65. 10.1097/00004583-199704000-00019

[24]

Olason DT, Sighvatsson MB, Smami J. Psychometric properties of the Multidimensional Anxiety Scale for Children (MASC) among Icelandic schoolchildren. Scand J Psychol. 2004;45(5):429–36. 10.1111/j.1467-9450.2004.00424.x

[25]

Villabø M, Gere M, Torgersen S, March JS, Kendall PC. Diagnostic efficiency of the child and parent versions of the Multidimensional Anxiety Scale for Children. J Clin Child Adolesc Psychol Off J Soc Clin Child Adolesc Psychol Am Psychol Assoc Div. 2012;41(1):75–85.

[26]

Angold A, Erkanli A, Silberg J, Eaves L, Costello E. Depression scale scores in 8–17-year-olds: effects of age and gender. J Child Psychol Psychiatry. 2002;43(8):1052–63. 10.1111/1469-7610.00232

[27]

Weisz JR, Vaughn-Coaxum RA, Evans SC, Thomassin K, Hersh J, Lee EH, et al. Efficient monitoring of treatment response during youth psychotherapy: the behavior and feelings survey. J Clin Child Adolesc Psychol Off J Soc Clin Child Adolesc Psychol Am Psychol Assoc Div. 2019;53:1–15.

[28]

Martinsen K, Kendall PC, Stark K, Rodriguez K, Arora P. Mestrende barn : gruppeledermanual barn. 2nd ed. Oslo: Gyldendal akademisk; 2017.

[29]

Martinsen K, Stark K, Rodriguez K, Kendall PC, Arora P. Mestrende barn : gruppeledermanual foreldre. 2nd ed. Oslo: Gyldendal akademisk; 2017.

[30]

ECHO. Hvordan støtte barnet ditt? En veileder til foreldre med triste og engstelige barn. [Brochure]. Trondheim: RKBU, NTNU; 2019.

[31]

Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale

Bruce F Chorpita, Letitia Yim, Catherine Moffitt et al.

Behaviour Research and Therapy 2000 10.1016/s0005-7967(99)00130-8

[32]

Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses

Franz Faul, Edgar Erdfelder, Axel Buchner et al.

Behavior Research Methods 2009 10.3758/brm.41.4.1149

[33]

Ukoumunne OC, Gulliford MC, Chinn S, Sterne JA, Burney PG. Methods for evaluating area-wide and organisation-based interventions in health and health care: a systematic review. Health Technol Assess. 1999;3(5). 10.3310/hta3050

[34]

Holen S, Waaktaar T, Lervag A, Ystgaard M. The effectiveness of a universal school-based programme on coping and mental health: a randomised, controlled study of Zippy’s Friends. Educ Psychol. 2012;32(5):657–77. 10.1080/01443410.2012.686152

[35]

Altman DG. Practical statistics for medical research. London: Chapman and Hall; 1991.

[36]

Beck AT, Brown GK, Steer RA. BDI-II, Beck depression inventory: manual. San Antonio, Tex.: Psychological Corp.; 1996. VI, 38 s. p. 10.1037/t00742-000

[37]

Runyon MK, Steer RA, Deblinger E. Psychometric characteristics of the beck self-concept inventory for youth with adolescents who have experienced sexual abuse. J Psychopathol Behav Assess. 2009;31(2):129–36. 10.1007/s10862-008-9100-6

[38]

Schwarzer R, Jerusalem M. The general self-efficacy scale (GSE). Anxiety Stress Coping. 2010;12:329–45.

[39]

Romppel M, Herrmann-Lingen C, Wachter R, Edelmann F, Düngen HD, Pieske B, et al. A short form of the General Self-Efficacy Scale (GSE-6): development, psychometric properties and validity in an intercultural non-clinical sample and a sample of patients at risk for heart failure. Psycho-Soc Med. 2013;10 10.1037/t69316-000

[40]

Ravens-Sieberer U, Gortler E, Bullinger M. Subjective health and health behavior of children and adolescents–a survey of Hamburg students within the scope of school medical examination. Gesundheitswesen. 2000;62(3):148–55. 10.1055/s-2000-10487

[41]

Haraldstad K, Richter J. Måleegenskaper ved den norske versjonen av KIDSCREEN. PsykTestBarn. 2014. 10.21337/0032

[42]

Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical sample

Bruce F. Chorpita, Catherine E. Moffitt, Jennifer Gray

Behaviour Research and Therapy 2005 10.1016/j.brat.2004.02.004

[43]

Rapee RM, Wignall A, Sheffield J, Kowalenko N, Davis A, McLoone J, et al. Adolescents’ reactions to universal and indicated prevention programs for depression: perceived stigma and consumer satisfaction. Prev Sci. 2006;7(2):167–77. 10.1007/s11121-006-0035-4

[44]

Tollefsen TK, Neumer S-P, Berg-Nielsen TS. “What matters to you?”: a randomized controlled effectiveness trial, Using Systematic Idiographic Assessment as an intervention to Increase Adolescents’ perceived control of their mental health. J Adolesc. 2020;78:53–61. 10.1016/j.adolescence.2019.11.006

[45]

Achenbach TM, Rescorla L. Manual for the ASEBA school-age forms & profiles: child behavior checklist for ages 6–18, teacher's report form, youth self-report: an integrated system of multi-informant assessment. Burlington, Vt.: ASEBA; 2001. XII, 238 s. p. 10.1037/t47452-000

[46]

Backer-Grøndahl A, Martinussen M. Måleegenskaper ved den norske versjonen av Brief Problem Monitor (BPM). PsykTestBARN [Internet]. 2018; 8(1). Available from: https://psyktestbarn.r-bup.no/no/artikler/bpm-brief-problem-monitor. 10.21337/0057

[47]

Martinussen M, Adolfsen F, Lauritzen C, Richardsen AM. Improving interprofessional collaboration in a community setting: relationships with burnout, engagement and service quality. J Interprof Care. 2012;26(3):219–25. 10.3109/13561820.2011.647125

[48]

Mårdberg B, Lundberg U, Frankenhaeuser M. The total workload of parents employed in white-collar jobs: construction of a questionnaire and scoring system. Stockholm: Department of Psychology, University of Stockholm; 1990.

[49]

Ehrhart MG, Aarons GA, Farahnak LR. Assessing the organizational context for EBP implementation: the development and validity testing of the Implementation Climate Scale (ICS). Implement Sci. 2014;9(1):1–11. 10.1186/s13012-014-0157-1

[50]

Egeland KM, Skar A-MS, Endsjø M, Laukvik EH, Bækkelund H, Babaii A, et al. Testing the leadership and organizational change for implementation (LOCI) intervention in Norwegian mental health clinics: a stepped-wedge cluster randomized design study protocol. Implement Sci. 2019;14(1):28. 10.1186/s13012-019-0873-7

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Details

Published: Jun 21, 2021
Vol/Issue: 9(1)
License: View

Authors

UiT The Arctic University of Norway, Tromsø, Norway

Lene-Mari Potulski Rasmussen

Elisabeth Valmyr Bania

Funding

Kavli Trust Award: 31/18

Cite This Article

Simon-Peter Neumer, Joshua Patras, Solveig Holen, et al. (2021). Study protocol of a factorial trial ECHO: optimizing a group-based school intervention for children with emotional problems. BMC Psychology, 9(1). https://doi.org/10.1186/s40359-021-00581-y

Study protocol of a factorial trial ECHO: optimizing a group-based school intervention for children with emotional problems

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