Effectiveness of an online parenting program for childhood anxiety in North Macedonia
Published 2023-12-30
Keywords
- parenting,
- anxiety,
- children,
- internet,
- online
How to Cite
Copyright (c) 2023 Ivo Kunovski, Marija Raleva
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
Anxiety is considered a basic and adaptive emotion. However, anxiety problems are one of the most prevalent mental health problems, with multiple negative effects and a tendency to worsen with age. The high prevalence rates and their negative consequences accent the importance of developing timely and effective prevention strategies. The aim of the study was to evaluate the effectiveness of an online parenting program in reducing anxiety symptoms in young children in the Republic of North Macedonia. Materials and methods: A controlled randomized controlled study was conducted including parents of children aged 2-9 years old in North Macedonia. Eligible parents were assessed at baseline and post-intervention, using self-report questionnaires on sociodemographic characteristics and childhood anxiety (CBCL anxiety scale, CBCL-A; CBCL anxiety/depression scale, CBCL-AD). Parents were assigned to five group sessions of a parenting program, as the intervention group, or a structured group presentation, as a control group. Results: A total of 288 parents were included in the study. The findings showed significant reductions in childhood anxiety symptoms reported by parents in both the parenting program and the active control condition. However, between-group comparisons showed no significant differences between the two conditions. Conclusions:The study is the first to evaluate the effectiveness of an online group parenting program in reducing anxiety symptoms in young children in North Macedonia. The findings demonstrate that it is possible to achieve a significant change in child anxiety problems, using technology-assisted methods of intervention delivery in the country.
Downloads
References
- Beesdo-Baum K, Knappe S. Developmental epidemiology of anxiety disorders. Child Adolesc Psychiatr Clin N Am. 2012;21(3):457-78.https://doi.org/10.1016/j.chc.2012.05.001 DOI: https://doi.org/10.1016/j.chc.2012.05.001
- Merikangas KR, He JP, Brody D, Fisher PW, Bourdon K, Koretz DS. Prevalence and treatment of mental disorders among US children in the 2001–2004 NHANES. Pediatrics. 2010;125(1):75-81. https://doi.org/10.1542/peds.2008-2598 DOI: https://doi.org/10.1542/peds.2008-2598
- Baxter AJ, Scott KM, Vos T, Whiteford HA. Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychol Med. 2013;43(5):897-910.https://doi.org/10.1017/S003329171200147X DOI: https://doi.org/10.1017/S003329171200147X
- Pahl KM, Barrett PM. Preventing anxiety and promoting social and emotional strength in preschool children: A universal evaluation of the Fun FRIENDS program. Adv Sch Ment Health Promot. 2010;3(3):14-25.https://doi.org/10.1080/1754730X.2010.9715683 DOI: https://doi.org/10.1080/1754730X.2010.9715683
- Kessler, R. C., Ruscio, A. M., Shear, K., &Wittchen, H.-U. (2009). Epidemiology of anxiety disorders. In M. M. Antony & M. B. Stein (Eds.), Oxford handbook of anxiety and related disorders (pp. 19–33). Oxford University Press. DOI: https://doi.org/10.1093/oxfordhb/9780195307030.013.0002
- Sandler IN, Schoenfelder EN, Wolchik SA, MacKinnon DP. Long-term impact of prevention programs to promote effective parenting: Lasting effects but uncertain processes. Annu Rev Psychol. 2011;62:299-329.https://doi.org/10.1146/annurev.psych.121208.131619 DOI: https://doi.org/10.1146/annurev.psych.121208.131619
- Pedersen GA, Smallegange E, Coetzee A, Hartog K, Turner J, Jordans MJ, Brown FL. A systematic review of the evidence for family and parenting interventions in low-and middle-income countries: child and youth mental health outcomes. J Child Fam Stud. 2019;28:2036-55.https://doi.org/10.1007/s10826-019-01399-4 DOI: https://doi.org/10.1007/s10826-019-01399-4
- Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, et al. Child and adolescent mental health worldwide: evidence for action. The Lancet. 2011;378(9801):1515-25.https://doi.org/10.1016/S0140-6736(11)60827-1 DOI: https://doi.org/10.1016/S0140-6736(11)60827-1
- Suveg C, Morelen D, Brewer GA, Thomassin K. The emotion dysregulation model of anxiety: A preliminary path analytic examination. J Anxiety Disord. 2010;24(8):924-30.https://doi.org/10.1016/j.janxdis.2010.06.018 DOI: https://doi.org/10.1016/j.janxdis.2010.06.018
- Yap MB, Jorm AF. Parental factors associated with childhood anxiety, depression, and internalizing problems: A systematic review and meta-analysis. J Affect Disord. 2015;175:424-40.https://doi.org/10.1016/j.jad.2015.01.050 DOI: https://doi.org/10.1016/j.jad.2015.01.050
- Yap MB, Morgan AJ, Cairns K, Jorm AF, Hetrick SE, Merry S. Parents in prevention: a meta-analysis of randomized controlled trials of parenting interventions to prevent internalizing problems in children from birth to age 18. Clin Psychol Rev. 2016;50:138-58.https://doi.org/10.1016/j.cpr.2016.10.003 DOI: https://doi.org/10.1016/j.cpr.2016.10.003
- Brendel KE, Maynard BR. Child–parent interventions for childhood anxiety disorders: a systematic review and meta-analysis. Res Soc Work Pract. 2014;24(3):287-95.https://doi.org/10.1177/1049731513503713 DOI: https://doi.org/10.1177/1049731513503713
- Baumann AA, Mejia A, Lachman JM, Parra-Cardona R, López-Zerón G, Amador Buenabad NG, et al. Parenting programs for underserved populations in low-and middle-income countries: issues of scientific integrity and social justice. Glob Soc. 2019;6:199-207.https://doi.org/10.1007/s40609-018-0121-0 DOI: https://doi.org/10.1007/s40609-018-0121-0
- Sanders MR, Kirby JN. Consumer engagement and the development, evaluation, and dissemination of evidence-based parenting programs. Behav Ther. 2012;43(2):236-50.https://doi.org/10.1016/j.beth.2011.01.005 DOI: https://doi.org/10.1016/j.beth.2011.01.005
- Achenbach TM, Rescorla LA. Manual for the ASEBA preschool forms and profiles. Burlington, VT: University of Vermont, Research center for children, youth, & families; 2000.
- Achenbach TM, Rescorla LA. Manual for the ASEBA school-age forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families; 2001.
- Achenbach TM, Dumenci L, Rescorla LA. DSM-oriented and empirically based approaches to constructing scales from the same item pools. J Clin Child Adolesc Psychol. 2003;32(3):328-40.https://doi.org/10.1207/S15374424JCCP3203_02 DOI: https://doi.org/10.1207/S15374424JCCP3203_02
- Kendall PC, Puliafico AC, Barmish AJ, Choudhury MS, Henin A, Treadwell KS. Assessing anxiety with the child behavior checklist and the teacher report form. J Anxiety Disord. 2007;21(8):1004-15.https://doi.org/10.1016/j.janxdis.2006.10.012 DOI: https://doi.org/10.1016/j.janxdis.2006.10.012
- Aschenbrand SG, Angelosante AG, Kendall PC. Discriminant validity and clinical utility of the CBCL with anxiety-disordered youth. J Clin Child Adolesc Psychol. 2005;34(4):735-46.https://doi.org/10.1207/s15374424jccp3404_15 DOI: https://doi.org/10.1207/s15374424jccp3404_15
- Read KL, Settipani CA, Peterman J, Kendall PC, Compton S, Piacentini J, et al. Predicting anxiety diagnoses and severity with the CBCL-A: improvement relative to other CBCL scales? J Psychopathol Behav Assess. 2015;37(1):100-11. https://doi.org/10.1007/s10862-014-9439-9 DOI: https://doi.org/10.1007/s10862-014-9439-9
- Knepley MJ, Kendall PC, Carper MM. An analysis of the child behavior checklist anxiety problems scale’s predictive capabilities. J Psychopathol Behav Assess. 2019;41(2):249-56.https://doi.org/10.1007/s10862-019-09722-5 DOI: https://doi.org/10.1007/s10862-019-09722-5
- Hutchings JM, Ward CL, Mikton C, Cluver L, Cooper P, Gardner F, et al. Parenting for lifelong health: from South Africa to other low-and middle-income countries. Early Child Matters. 2014:49-53.
- Flujas-Contreras JM, García-Palacios A, Gómez I. Technology-based parenting interventions for children's physical and psychological health: a systematic review and meta-analysis. Psychol Med. 2019;49(11):1787-98.https://doi.org/10.1017/S0033291719000692 DOI: https://doi.org/10.1017/S0033291719000692
- Morgan AJ, Rapee RM, Salim A, Goharpey N, Tamir E, McLellan LF, Bayer JK. Internet-delivered parenting program for prevention and early intervention of anxiety problems in young children: randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2017;56(5):417-25.https://doi.org/10.1016/j.jaac.2017.02.010 DOI: https://doi.org/10.1016/j.jaac.2017.02.010
- Sanders MR, Baker S, Turner KM. A randomized controlled trial evaluating the efficacy of Triple P Online with parents of children with early-onset conduct problems. Behav Res Ther. 2012;50(11):675-84.https://doi.org/10.1016/j.brat.2012.07.004 DOI: https://doi.org/10.1016/j.brat.2012.07.004
- Jewell C, Wittkowski A, Pratt D. The impact of parent-only interventions on child anxiety: A systematic review and meta-analysis. J Affect Disord. 2022; 309: 324-49.https://doi.org/10.1016/j.jad.2022.04.082 DOI: https://doi.org/10.1016/j.jad.2022.04.082
- Ward CL, Wessels IM, Lachman JM, Hutchings J, Cluver LD, Kassanjee R, et al. Parenting for lifelong health for young children: a randomized controlled trial of a parenting program in South Africa to prevent harsh parenting and child conduct problems. J Child Psychol Psychiatry. 2020;61(4):503-12. https://doi.org/10.1111/jcpp.13129 DOI: https://doi.org/10.1111/jcpp.13129