Examining the Feasibility, Acceptability, and Fidelity of Utilizing Parent Training Graduates as Peer Supports

Using Peer Coaches to Extend Behavioral Parent Training Programs in Underserved Communities

Disruptive behavioral disorders are common in early childhood, affecting up to 15% of preschool-aged children. Behavioral parent training programs are a first-line evidence-based treatment for child disruptive behaviors. There is evidence showing that (a) these programs are effective in reducing disruptive behavior and improving long-term outcomes, and (b) there is an excellent return on investment for early intervention. Nevertheless, there is limited availability of behavioral parent training programs, particularly in rural settings, due to shortages of trained clinicians. Thus, there is a pressing need for expanding the mental healthcare workforce in rural/underserved areas. The study will involve an established parent-based behavioral intervention (First Approach Skills Training for Behavior; or FAST-B) with added pilot component incorporating parents who have previously been through parent behavioral management training programs as Peer Supports.

Study Overview

• Status: Recruiting
• Conditions: Child Behavior Problems; Child Disruptive Behavior Disorders; Peer Support; Challenging Behavior; Parent Child Relationship; Positive Parenting; Parent Management Training
• Intervention / Treatment: Behavioral: FAST-B PEERS; Behavioral: FAST-B (First Approach Skills Training - Behavior)

Detailed Description

Up to 30 (15 per group, with 2 total groups) participant families will be recruited for FAST-B Peers intervention. These participants will receive the FAST-B standard of care in the context of the research study through trained clinician on the research team. As is the current standard of clinical care, FAST-B will be delivered in 1-hour weekly sessions in group-based format via Zoom, using the standard FAST-B curriculum and caregiver workbooks (https://www.seattlechildrens.org/health-safety/classes-events/behavior-basics-class/).

In addition to standard of care, half the FAST-B participants will be randomized 1:1 to additionally receive an added pilot Peer Support component. Upon enrollment completion of FAST-B group, randomization will be performed via random number generator. This FAST-B Peers pilot intervention involves trained Peer Supports who will each work with 2-3 families over the course of the 5-week intervention.

Peer Supports will conduct weekly calls with families going through FAST-B intervention to review the material presented, discuss application for the family, problem-solve barriers, and reinforce the family's efforts. Peer supports will additionally receive weekly consultation (1-2 hours/week) with the clinician delivering FAST-B. After the intervention is completed, both peer supports and participant families will be asked to participate in follow-up focus groups to discuss their experience in the intervention, specifically as it relates to the work of the peer supports.

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Julia T Mattson, MD, PhD; Phone Number: 206-993-1535; Email: julia.mattson@seattlechildrens.org
• Study Contact Backup: Name: Alissa D Hemke, MD; Phone Number: 206-993-1655; Email: alissa.hemke@seattlechildrens.org

Study Locations

• United States
  • Washington
    • Seattle, Washington, United States, 98115
      • Recruiting
      • Seattle Children's
      • Contact: Doug Mason; Phone Number: 206-987-7000; Email: doug.mason@seattlechildrens.org
      • Principal Investigator: Alissa D Hemke, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Parent of child ages 3-6
• Parent has access to video-enabled device
• Parent is fluent in English or Spanish
• Child of parent has a score of at least 3 on conduct subscale of Strengths and Difficulties Questionnaire or at least 6 on hyperactivity subscale of Strengths and Difficulties Questionnaire
• Parent is comfortable being randomized to either standard intervention (FAST-B) or FAST-B with added FAST-B PEERS component.

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: FAST-B PEERS; Parents in FAST-B PEERS group will receive standard 5-week FAST-B program as well as weekly check-in support from trained 'Peer Support' parents who have previously been through parent behavioral management training programs.	Behavioral: FAST-B PEERS; FAST-B PEERS consists of trained Peer Support providing weekly check-in calls with families going through FAST-B behavioral parent training program. Peer Support are parents who have previously participated in a behavioral parent training program who have undergone 6-8 hours of additional dedicated training.; Behavioral: FAST-B (First Approach Skills Training - Behavior); 5-week parent behavioral management training program
Active Comparator: FAST-B; Parents in FAST-B group will receive standard FAST-B program with 5 weekly group sessions with clinician.	Behavioral: FAST-B (First Approach Skills Training - Behavior); 5-week parent behavioral management training program

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Acceptability of FAST-B PEERS	Participant rating of experience working with Peer Support, from 1 (poor) to 5 (excellent)	Up to 6 weeks
Acceptability of FAST-B	Participant rating of FAST-B program, from 1 (poor) to 5 (excellent)	Up to 6 weeks
FAST-B PEERS support calls attended	Percent of peer support calls attended	Up to 6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Weekly Assessment of Child Behavior - P	Standardized parent-report measure of positive child behaviors (minimum = 0; maximum = 63), with higher scores indicating higher level of positive behaviors	Up to 6 weeks
Coping with Child Negative Emotions Scale	Standardized parent-report measure of parents typically respond to their child's negative emotions. Three subscales focus on positive responses: expressive encouragement, emotion-focused reactions, problem-focused reactions (minimum = 1 (worst), maximum = 7 (best)). Three subscales focus on negative responses: distress reactions, punitive reactions, minimization reactions (minimum = 1 (best), maximum = 7 (worst)).	Up to 6 weeks
Strengths and Difficulties Questionnaire	Standardized measurement of child strengths and difficulties across behavioral domains, yielding Total Difficulties Score (minimum = 0 (best); maximum = 40 (worst).	Up to 6 weeks

Collaborators and Investigators

• Sponsor: Seattle Children's Hospital
• Investigators: Principal Investigator: Julia T Mattson, MD, PhD, Seattle Children's/University of Washington; Principal Investigator: Alissa D Hemke, MD, Seattle Children's/University of Washington

Study record dates

Study Major Dates

• Study Start (Estimated): April 10, 2024
• Primary Completion (Estimated): June 19, 2024
• Study Completion (Estimated): June 19, 2024

Study Registration Dates

• First Submitted: April 4, 2024
• First Submitted That Met QC Criteria: April 10, 2024
• First Posted (Actual): April 16, 2024

Study Record Updates

• Last Update Posted (Actual): April 16, 2024
• Last Update Submitted That Met QC Criteria: April 10, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Neurodevelopmental Disorders; Problem Behavior; Mental Disorders; Attention Deficit and Disruptive Behavior Disorders
• Other Study ID Numbers: STUDY00003416

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Recordings of behavioral intervention sessions, peer support calls, and post-intervention focus groups will not be shared with anybody outside of approved research team members involved in coding process. Data from the pilot intervention will be shared in conference abstracts and peer-reviewed journal publications.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No