Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial
Background NICE guidelines recommend a stepped care approach for the identification and management of children with, or at risk of, Attention-Deficit / Hyperactivity Disorder (ADHD). We investigated the effectiveness, cost-effectiveness and acceptability of a group parenting intervention programme...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
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Wiley
2016
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| Online Access: | https://eprints.nottingham.ac.uk/33036/ |
| _version_ | 1848794543947776000 |
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| author | Sayal, Kapil Taylor, John A. Valentine, Althea Guo, Boliang Sampson, Christopher James Sellman, Edward James, Marilyn Hollis, Chris Daley, David |
| author_facet | Sayal, Kapil Taylor, John A. Valentine, Althea Guo, Boliang Sampson, Christopher James Sellman, Edward James, Marilyn Hollis, Chris Daley, David |
| author_sort | Sayal, Kapil |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background
NICE guidelines recommend a stepped care approach for the identification and management of children with, or at risk of, Attention-Deficit / Hyperactivity Disorder (ADHD). We investigated the effectiveness, cost-effectiveness and acceptability of a group parenting intervention programme (+/- a teacher session) for children at risk of ADHD.
Methods
In a three-arm cluster RCT, 12 primary schools were randomly assigned to control, parent-only, and combined (parent + teacher) intervention arms. Eligible children had high levels of parent-rated hyperactivity/inattention (n=199). At six month follow-up, the primary outcome measure was the parent-completed Conners’ Rating Scale – Revised (ADHD Index). Secondary outcomes included the Conners’ sub-scales (hyperactivity, cognitive problems/inattention, oppositional behaviour), the teacher-completed Conners’ Rating Scale – Revised, child health-related quality of life, parental burden and parental mental health. The cost-effectiveness analyses reflected a health and personal social services perspective. Trial Registration:ISRCTN87634685.
Results
Follow-up data were obtained from 76 parents and 169 teachers. There was no effect of the parentonly (mean difference = -1.1, 95% CI -5.1,2.9; p=0.57) or combined interventions (mean difference = -2.1, 95% CI -6.4,2.1; p=0.31) on the ADHD Index. The combined intervention was associated with reduced parent-reported hyperactivity symptoms (mean difference = -5.3; 95% CI -10.5,-0.01; p=0.05) and the parent-only intervention with improved parental mental health (mean difference = - 1.9; 95% CI -3.2,-0.5; p=0.009). The incremental costs of the parent-only and the combined interventions were £73 and £123 respectively. Above a willingness to pay of £31 per 1-point improvement in the ADHD index, the parent-only programme had the highest probability of cost effectiveness. Participants found the interventions acceptable.
Conclusions
For children at risk of ADHD, this school-based parenting programme was not associated with improvement in core ADHD symptoms. Secondary analyses suggested a possible reduction in parent-reported hyperactivity and parental mental health problems. Future research should compare targeted interventions against watchful waiting and specialist referral. |
| first_indexed | 2025-11-14T19:17:52Z |
| format | Article |
| id | nottingham-33036 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:17:52Z |
| publishDate | 2016 |
| publisher | Wiley |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-330362020-05-04T17:54:07Z https://eprints.nottingham.ac.uk/33036/ Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial Sayal, Kapil Taylor, John A. Valentine, Althea Guo, Boliang Sampson, Christopher James Sellman, Edward James, Marilyn Hollis, Chris Daley, David Background NICE guidelines recommend a stepped care approach for the identification and management of children with, or at risk of, Attention-Deficit / Hyperactivity Disorder (ADHD). We investigated the effectiveness, cost-effectiveness and acceptability of a group parenting intervention programme (+/- a teacher session) for children at risk of ADHD. Methods In a three-arm cluster RCT, 12 primary schools were randomly assigned to control, parent-only, and combined (parent + teacher) intervention arms. Eligible children had high levels of parent-rated hyperactivity/inattention (n=199). At six month follow-up, the primary outcome measure was the parent-completed Conners’ Rating Scale – Revised (ADHD Index). Secondary outcomes included the Conners’ sub-scales (hyperactivity, cognitive problems/inattention, oppositional behaviour), the teacher-completed Conners’ Rating Scale – Revised, child health-related quality of life, parental burden and parental mental health. The cost-effectiveness analyses reflected a health and personal social services perspective. Trial Registration:ISRCTN87634685. Results Follow-up data were obtained from 76 parents and 169 teachers. There was no effect of the parentonly (mean difference = -1.1, 95% CI -5.1,2.9; p=0.57) or combined interventions (mean difference = -2.1, 95% CI -6.4,2.1; p=0.31) on the ADHD Index. The combined intervention was associated with reduced parent-reported hyperactivity symptoms (mean difference = -5.3; 95% CI -10.5,-0.01; p=0.05) and the parent-only intervention with improved parental mental health (mean difference = - 1.9; 95% CI -3.2,-0.5; p=0.009). The incremental costs of the parent-only and the combined interventions were £73 and £123 respectively. Above a willingness to pay of £31 per 1-point improvement in the ADHD index, the parent-only programme had the highest probability of cost effectiveness. Participants found the interventions acceptable. Conclusions For children at risk of ADHD, this school-based parenting programme was not associated with improvement in core ADHD symptoms. Secondary analyses suggested a possible reduction in parent-reported hyperactivity and parental mental health problems. Future research should compare targeted interventions against watchful waiting and specialist referral. Wiley 2016-07-01 Article PeerReviewed Sayal, Kapil, Taylor, John A., Valentine, Althea, Guo, Boliang, Sampson, Christopher James, Sellman, Edward, James, Marilyn, Hollis, Chris and Daley, David (2016) Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial. Child: Care, Health and Development, 42 (4). pp. 521-533. ISSN 1365-2214 ADHD; hyperactivity; inattention; parent programme; teacher intervention; RCT; cost-effectiveness http://onlinelibrary.wiley.com/doi/10.1111/cch.12349/full doi:10.1111/cch.12349 doi:10.1111/cch.12349 |
| spellingShingle | ADHD; hyperactivity; inattention; parent programme; teacher intervention; RCT; cost-effectiveness Sayal, Kapil Taylor, John A. Valentine, Althea Guo, Boliang Sampson, Christopher James Sellman, Edward James, Marilyn Hollis, Chris Daley, David Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial |
| title | Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial |
| title_full | Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial |
| title_fullStr | Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial |
| title_full_unstemmed | Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial |
| title_short | Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial |
| title_sort | effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of adhd: a cluster randomised controlled trial |
| topic | ADHD; hyperactivity; inattention; parent programme; teacher intervention; RCT; cost-effectiveness |
| url | https://eprints.nottingham.ac.uk/33036/ https://eprints.nottingham.ac.uk/33036/ https://eprints.nottingham.ac.uk/33036/ |