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Reducing and preventing internalizing and externalizing behavior problems in children with type 1 diabetes: a randomized controlled trial of the Triple P-Positive Parenting Program
journal contributionposted on 2015-11-01, 00:00 authored by Elizabeth WestruppElizabeth Westrupp, E Northam, K J Lee, S E Scratch, F Cameron
BACKGROUND: Children with type 1 diabetes are at increased risk of mental health problems, which in turn are associated with poor glycemic control, diabetes-related complications, and long-term psychiatric morbidity. We tested the efficacy of the Triple P-Positive Parenting Program in reducing or preventing mental health problems and improving glycemic control in children with type 1 diabetes in a randomized controlled trial. METHODS: Participants were recruited from the Diabetes Clinic, Royal Children's Hospital, Melbourne, Australia, and randomized to Triple P or standard diabetes care. The primary outcome was child internalizing and externalizing behavior problems 3 and 12 months postrandomization. Secondary outcomes were glycemic control, parent mental health, parenting skills, and family functioning at 3 and 12 months, and glycemic control at 24 months. RESULTS: A total of 76 participants were randomized (38 to intervention and 38 to control), 60 completed 3-month, and 57 completed 12-month assessments. Benefits of Triple P were evident at 3 months for parent mental health, parenting skills, and family functioning (p < 0.05), but not for child mental health or glycemic control, with little effect at 12 months. Prespecified subgroup analyses for children with pre-existing internalizing or externalizing behavior problems indicated greater improvements in child mental health, parent mental health, parenting skills, and diabetes family conflict (p < 0.05), but lower parenting self-efficacy at 3 months. Improvements in parent mental health and parenting competency associated with Triple P were sustained to 12 months for children with pre-existing mental health problems. CONCLUSIONS: This study provides some support for the efficacy of Triple P in improving parent and family outcomes, and reducing child internalizing and externalizing behavior problems primarily in children who have pre-existing mental health problems.
Pagination554 - 563
Publication classificationC Journal article; C1.1 Refereed article in a scholarly journal
Copyright notice2014, John Wiley & Sons A/S
child behaviorparent mental healthparentingtype 1 diabetesChildChild Behavior DisordersDiabetes Mellitus, Type 1Education, NonprofessionalFamily RelationsFemaleFollow-Up StudiesHealth Knowledge, Attitudes, PracticeHospitals, PediatricHumansHyperglycemiaHypoglycemiaMaleOutpatient Clinics, HospitalPatient DropoutsPsychiatric Status Rating ScalesPsychology, ChildSelf EfficacyVictoriaScience & TechnologyLife Sciences & BiomedicineEndocrinology & MetabolismPediatricsONSET CONDUCT PROBLEMSGLYCEMIC CONTROLMETAANALYSISMELLITUSADJUSTMENTDIAGNOSISCONFLICTEFFICACY