Emily Widnall, Steven Dodd, Abigail Emma Russell, Esther Curtin, Ruth Simmonds, Mark Limmer, Judi Kidger
Mechanisms of school-based peer education interventions to improve young people's health literacy or health behaviours: A realist-informed systematic review
PloS one
stepping stones triple p adapted intervention parents young children developmental disabilities display behaviours challenge aiming teaching positive parenting techniques promoting positive parentchild relationship evaluate clinical costeffectiveness level 4 stepping stones triple p reducing behaviours challenge children moderate severe intellectual disabilities parallel twoarm pragmatic multisite singleblind randomised controlled trial recruited total 261 dyads parent child children aged 3059 months moderate severe intellectual disabilities participants randomised using 3 2 allocation ratio intervention arm stepping stones triple p n 155 treatment usual arm n 106 participants recruited four study sites blackpool north south london newcastle level 4 stepping stones triple p consists six group sessions three individual phone facetoface contacts 9 weeks changed remote sessions 16 march 2020 due coronavirus disease 2019 pandemic primary outcome measure parentreported child behaviour checklist assesses severity behaviours challenge found small nonsignificant difference mean child behaviour checklist scores 423 95 ci 998 152 p 0146 intervention arm compared treatment usual 12 months per protocol complier average causal effect sensitivity analyses took consideration number sessions attended showed child behaviour checklist mean score difference 12 months lower intervention arm 1077 95 ci 1912 242 p 0014 1153 95 ci 2697 391 p 0143 respectively child behaviour checklist mean score difference participants recruited coronavirus disease 2019 pandemic estimated 712 95 ci 1344 081 761 95 ci 543 2064 respectively p 0046 suggesting effect prepandemic may reversed pandemic differences secondary measures stepping stones triple p probably value money deliver 105788 95 ci 32186 4667 decisions roll alternative existing parenting interventions treatment usual may dependent policymaker willingness invest early interventions reduce behaviours challenge parents reported intervention boosted confidence skills group format enabled learn others benefit peer support 20 serious adverse events reported study none associated intervention low attendance rates stepping stones triple p arm well coronavirus disease 2019related challenges recruitment delivery intervention level 4 stepping stones triple p reduce early onset behaviours challenge young children moderate severe intellectual disabilities however effect child behaviours received sufficient dose intervention high probability stepping stones triple p least cost neutral therefore worth considering early therapeutic option given longterm consequences behaviours challenge people social networks research investigate implementation parenting groups behaviours challenge population well optimal mode delivery maximise engagement subsequent outcomes study registered nct03086876 httpswwwclinicaltrialsgovct2shownct03086876termhassiotisangeladraw1rank1 award funded national institute health care research nihr health technology assessment programme nihr award ref hta 1516202 published full health technology assessment vol 28 6 see nihr funding awards website award information