Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 2;5(3):e25235.
doi: 10.2196/25235.

Feasibility and Acceptability of a Digital Intervention to Support Shared Decision-making in Children's and Young People's Mental Health: Mixed Methods Pilot Randomized Controlled Trial

Shaun Liverpool  1   2 , Julian Edbrooke-Childs  1
Affiliations

Feasibility and Acceptability of a Digital Intervention to Support Shared Decision-making in Children's and Young People's Mental Health: Mixed Methods Pilot Randomized Controlled Trial

Shaun Liverpool et al. JMIR Form Res. .

Abstract

Background: Interventions to involve parents in decisions regarding children's and young people's mental health are associated with positive outcomes. However, appropriately planning effectiveness studies is critical to ensure that meaningful evidence is collected. It is important to conduct pilot studies to evaluate the feasibility and acceptability of the intervention itself and the feasibility of the protocol to test effectiveness.

Objective: This paper reports the findings from a feasibility and acceptability study of Power Up for Parents, an intervention to promote shared decision-making (SDM) and support parents and caregivers making decisions regarding children's and young people's mental health.

Methods: A mixed method study design was adopted. In stage 1, health care professionals and parents provided feedback on acceptability, usefulness, and suggestions for further development. Stage 2 was a multicenter, 3-arm, individual, and cluster randomized controlled pilot feasibility trial with parents accessing services related to children's and young people's mental health. Outcome measures collected data on demographics, participation rates, SDM, satisfaction, and parents' anxiety. Qualitative data were analyzed using thematic analysis. Google Analytics estimates were used to report engagement with the prototype. Outcomes from both stages were tested against a published set of criteria for proceeding to a randomized controlled trial.

Results: Despite evidence suggesting the acceptability of Power Up for Parents, the findings suggest that recruitment modifications are needed to enhance the feasibility of collecting follow-up data before scaling up to a fully powered randomized controlled trial. On the basis of the Go or No-Go criteria, only 50% (6/12) of the sites successfully recruited participants, and only 38% (16/42) of parents completed follow-up measures. Nonetheless, health care practitioners and parents generally accessed and used the intervention. Themes describing appearance and functionality, perceived need and general helpfulness, accessibility and appropriateness, and a wish list for improvement emerged, providing valuable information to inform future development and refinement of the intervention.

Conclusions: Owing to the high attrition observed in the trial, proceeding directly to a full randomized controlled trial may not be feasible with this recruitment strategy. Nonetheless, with some minor adjustments and upgrades to the intervention, this pilot study provides a platform for future evaluations of Power Up for Parents.

Trial registration: International Standard Randomized Controlled Trial Number (ISRCTN) 39238984; http://www.isrctn.com/ISRCTN39238984.

International registered report identifier (irrid): RR2-10.2196/14571.

Keywords: adolescent; child; mental health; parents; pilot projects; shared decision making.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Consolidated Standards of Reporting Trials flowchart of participants in the quantitative study. IG1: intervention group 1; IG2: intervention group 2; NHS: National Health Service; PUfP: Power Up for Parents.
Figure 2
Figure 2
An overview of the themes emerging from qualitative data.
See this image and copyright information in PMC

References

    1. Elwyn G, Durand MA, Song J, Aarts J, Barr PJ, Berger Z, Cochran N, Frosch D, Galasiński D, Gulbrandsen P, Han PKJ, Härter M, Kinnersley P, Lloyd A, Mishra M, Perestelo-Perez L, Scholl I, Tomori K, Trevena L, Witteman HO, Van der Weijden T. A three-talk model for shared decision making: multistage consultation process. Br Med J. 2017 Nov 06;359:j4891. doi: 10.1136/bmj.j4891. http://www.bmj.com/lookup/pmidlookup?view=long&pmid=29109079 - DOI - PMC - PubMed
    1. Wyatt KD, List B, Brinkman WB, Prutsky Lopez G, Asi N, Erwin P, Wang Z, Domecq Garces JP, Montori VM, LeBlanc A. Shared decision making in pediatrics: a systematic review and meta-analysis. Acad Pediatr. 2015 Nov;15(6):573–83. doi: 10.1016/j.acap.2015.03.011. - DOI - PubMed
    1. Shay LA, Lafata JE. Where is the evidence? A systematic review of shared decision making and patient outcomes. Med Decis Making. 2014 Oct 28;35(1):114–31. doi: 10.1177/0272989x14551638. - DOI - PMC - PubMed
    1. Gondek D, Edbrooke-Childs J, Velikonja T, Chapman L, Saunders F, Hayes D, Wolpert M. Facilitators and barriers to person-centred care in child and young people mental health services: a systematic review. Clin Psychol Psychother. 2017 Jul;24(4):870–86. doi: 10.1002/cpp.2052. - DOI - PubMed
    1. Weiss EM, Clark JD, Heike CL, Rosenberg AR, Shah SK, Wilfond BS, Opel DJ. Gaps in the implementation of shared decision-making: illustrative cases. Pediatrics. 2019 Mar 05;143(3):e20183055. doi: 10.1542/peds.2018-3055. http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=3082... - DOI - PubMed

LinkOut - more resources