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Preventing mental health problems in children : the families in mind population-based cluster randomised controlled trial.

journal contribution
posted on 08.06.2012, 00:00 authored by H Hiscock, J Bayer, Kate LycettKate Lycett, O Ukoumunne, D Shaw, Lisa GoldLisa Gold, B Gerner, Amy LoughmanAmy Loughman, M Wake
Background

Externalising and internalising problems affect one in seven school-aged children and are the single strongest predictor of mental health problems into early adolescence. As the burden of mental health problems persists globally, childhood prevention of mental health problems is paramount. Prevention can be offered to all children (universal) or to children at risk of developing mental health problems (targeted). The relative effectiveness and costs of a targeted only versus combined universal and targeted approach are unknown. This study aims to the effectiveness, costs and uptake of two approaches to early childhood prevention of mental health problems ie: a Combined universal-targeted approach, versus a Targeted only approach, in comparison to current primary care services (Usual care).
Design

Three armed, population-level cluster randomised trial (2010-2014) within the universal, well child Maternal Child Health system, attended by more than 80% of families in Victoria, Australia at infant age eight months. Participants: Families of eight month old children from nine participating local government areas. Randomised to one of three groups: Combined, Targeted or Usual care. Intervention: (a) the Combined universal and targeted program where all families are offered the universal Toddlers Without Tears group parenting program followed by the targeted Family Check-Up one-on-one program or (b) the Targeted Family Check-Up program. The Family Check-Up program is only offered to children at risk of behavioural problems. Analysis: Participants will be analysed according to the trial arm to which they were randomised, using logistic and linear regression models to compare primary and secondary outcomes. An economic evaluation (cost consequences analysis) will compare incremental costs to all incremental outcomes from a societal perspective.
Discussion

This trial will inform public health policy by making recommendations about the effectiveness and cost-effectiveness of these early prevention programs. If effective prevention programs can be implemented at the population level, the growing burden of mental health problems could be curbed.

History

Journal

BMC public health

Volume

12

Issue

420

Pagination

1 - 9

Publisher

BioMed Central

Location

London, England

ISSN

1471-2458

Language

eng

Notes

This is an open access article distributed under the terms of the attached BioMed Central License. See license for details.

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2012, Hiscock et al. ; licensee BioMed Central Ltd.