Brief parenting intervention (Triple P) for families of children with eczema: a randomized controlled trial

Abstract

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.

Keywords: adherence/self-management; chronic illness; health behavior; parenting; parents; randomized controlled trial.

Figure 1.

CONSORT diagram of flow of participants. ^aClinically ineligible families screened out by clinic staff (no eczema diagnosis, n = 100; not prescribed topical corticosteroids, n = 8); another 80 families excluded by the research assistant (insufficient English, n = 30; lived too far away, n = 27; child intellectual/developmental disability, n = 14; parents seeing psychologist, n = 4; previously completed Triple P, n = 2; child in foster care, n = 3). ^bDeclined to be contacted (uninterested, n = 44; no time, n = 38; no concerns, n = 19; eczema “too mild”, n = 16; travel difficulties, n = 18; caregiving responsibilities, n = 9; unable to attend sessions, n = 3; no reason, n = 3).