Centre for Community Child Health

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Families in Mind

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    Behaviour and emotional problems affect one in seven Australian children. These problems include aggression, hyperactivity, disobedience, anxiety, social withdrawal and depression. Up to 50% of preschool children's problems continue through the childhood years.

    In 2002-05, theToddlers without Tears (TWT) program aimed to stop children from developing behaviour and emotional problems using a brief group parenting program. Families in Mind combines this brief program with a targeted intervention to examine whether combining the two programs is more effective than one program alone. Families in Mind has been designed by child doctors, child psychologists and maternal and child health nurses. It is a three-arm randomised cluster controlled trial comparing the following arms:

    1. Combined arm: a brief group parenting program (modelled on TWT) plus a targeted one-on-one family support program
    2. Targeted arm: a one-on-one family support program
    3. Usual care arm: no extra programs but families can access help from usual services

    Families in Mind is suitable for all families with young children, and uses parenting handouts, group discussion, and video examples.

    Aims

    • Help parents learn how to encourage positive toddler behaviour, and reduce aggressive and anxious behaviours
    • Understand how child behaviour and emotional problems develop in the first six years of life (from infancy)
    • Prevent young children from developing behaviour and emotional problems as they grow
    • Measure the economic costs of delivering this parenting program, including the targeted one-on-one support in the community

    Recruitment began in August 2010 in nine local government areas in Melbourne: Bayside, Casey, Darebin, Hobsons Bay, Knox, Manningham, Mornington Peninsula, Port Phillip and Yarra Ranges.

    Stages

    • Stage 1 (2010): 1353 families who choose to take part (approximately 69% of eligible births) are randomly divided into three groups: Combined, Targeted and Usual care. Families in the Combined arm are invited to attend three parenting groups run in their local area by maternal and child health nurses when their children turn 15, 18 and 24 months old. These groups are based on the Toddlers without Tears study and focus on parenting practices to prevent behaviour problems.
    • Stage 2 (2012): all families are followed up as their children turn 2 years old. Families in the Combined and Targeted arms who may need extra support are offered the targeted one-on-one support program.
    • Stage 3 (2013): all families are followed up as their children turn 3 years of age.
    • Stage 4 (2014): all families are followed up as their children turn 4 years of age.
    • Stage 5 (2015): all families are followed up as their children turn 5 and many are starting school. 

    Update

    Recruitment finished in early 2011.

    From December 2010 to April 2011, all families were sent a questionnaire when their child was 12 months old and a newsletter update of the study's progress.

    During April 2011- April 2012, parents randomly allocated to the Combined group were invited to three group parenting sessions in their local government area. These sessions were co-facilitated by the maternal and child health nurses and parenting experts from the Parenting Research Centre (PRC). Groups focussed on forming positive parent-child relationships, encouraging good behaviour, managing child misbehaviour, child anxiety and distress. Families who were unable to attend were mailed the handouts and were offered a phone call with a clinician to discuss the session content.

    From December 2011 to April 2012, all families involved in the study were sent a 2 year old Questionnaire.  We received 88% of these back.

    From March 2012 until the end of 2012, some families in the Combined and Targeted arms are offered the 'the Family Check-up' one-on-one support program. This program is offered to parents who report in the 2 year old questionnaire that their toddler is having challenging behaviours. The program involves up to 6 individual sessions from a trained parent consultant. The content of each session is tailored to each family and offers a range of child and family interventions.  97 families chose to take up the program.

    Partners 

    Victorian Department of Education and Early Childhood Development, Victorian Department of Health, Deakin University, Municipal Association of Victoria

    Date:

    2010 - 2015

    Funding:

    NHMRC Partnership Grant #: 546525

    ISRCTN:

    61137690

    Contacts/Staff involved:

     Harriet Hiscock

    harriet.hiscock@rch.org.au

    Alisha Gulenc

    alisha.gulenc@mcri.edu.au

    Publications

    Hiscock H, Bayer JK, Lycett K, Ukoumunne OC, Shaw D, Gold L, Gerner B, Loughman A, Wake M.  Preventing mental health problems in children: The Families in Mind population-based cluster randomised controlled trial.  BMC Public Health 2012, 12:420 doi:10.1186/1471-2458-12-420.

    The electronic version of this article can be found online at: http://www.biomedcentral.com/1471-2458/12/420

 

Murdoch Childrens Research Institute

The Centre for Community Child Health is a department of The Royal Children’s Hospital and a research group of Murdoch Childrens Research Institute.