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WHO Parents Skills Training (PST) programme for children with developmental disorders and delays delivered by Family Volunteers in rural Pakistan: study protocol for effectiveness implementation hybrid cluster randomized controlled trial

  • S. U. Hamdani (a1), P. Akhtar (a1), Zill-e-Huma (a1), H. Nazir (a1), F. A. Minhas (a2), S. Sikander (a1), D. Wang (a3), C. Servilli (a4) and A. Rahman (a5)...

Abstract

Background.

Development disorders and delays are recognised as a public health priority and included in the WHO mental health gap action programme (mhGAP). Parents Skills Training (PST) is recommended as a key intervention for such conditions under the WHO mhGAP intervention guide. However, sustainable and scalable delivery of such evidence based interventions remains a challenge. This study aims to evaluate the effectiveness and scaled-up implementation of locally adapted WHO PST programme delivered by family volunteers in rural Pakistan.

Methods.

The study is a two arm single-blind effectiveness implementation-hybrid cluster randomised controlled trial. WHO PST programme will be delivered by ‘family volunteers’ to the caregivers of children with developmental disorders and delays in community-based settings. The intervention consists of the WHO PST along with the WHO mhGAP intervention for developmental disorders adapted for delivery using the android application on a tablet device. A total of 540 parent-child dyads will be recruited from 30 clusters. The primary outcome is child's functioning, measured by WHO Disability Assessment Schedule – child version (WHODAS-Child) at 6 months post intervention. Secondary outcomes include children's social communication and joint engagement with their caregiver, social emotional well-being, parental health related quality of life, family empowerment and stigmatizing experiences. Mixed method will be used to collect data on implementation outcomes. Trial has been retrospectively registered at ClinicalTrials.gov (NCT02792894).

Discussion.

This study addresses implementation challenges in the real world by incorporating evidence-based intervention strategies with social, technological and business innovations. If proven effective, the study will contribute to scaled-up implementation of evidence-based packages for public mental health in low resource settings.

Trial registration.

Registered with ClinicalTrials.gov as Family Networks (FaNs) for Children with Developmental Disorders and Delays. Identifier: NCT02792894 Registered on 6 July 2016.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

*Address for correspondence: S. U. Hamdani, Human Development Research Foundation, Implementation Research Unit, House No# 6, Street 55, F-7/4 Islamabad, 44000 Pakistan. (Email: usman.hamdani@hdrfoundation.org)

References

Hide All
Baggett, KM, Carta, JJ, Horn, EM (2009). Indicator of Parent-Child Interaction (IPCI) User's Manual. Department of Special Education, University of Kansas, University of Kansas, USA.
Chen, R, Hao, Y, Feng, L, Zhang, Y, Huang, Z (2011). The Chinese version of the Pediatric Quality of Life Inventory™(PedsQL™) family impact module: cross-cultural adaptation and psychometric evaluation. Health and Quality of Life Outcomes 9, 16.
Chisholm, D, Knapp, MR, Knudsen, HC, Amaddeo, F, Gaite, L, Van Wijngaarden, B (2000). Client socio-demographic and service receipt inventory-European version: development of an instrument for international research EPSILON Study 5. British Journal of Psychiatry 177, s28s33.
Dua, T, Barbui, C, Clark, N, Fleischmann, A, Poznyak, V, Van Ommeren, M, Yasamy, MT, Ayuso-Mateos, JL, Birbeck, GL, Drummond, C (2011). Evidence-based guidelines for mental, neurological, and substance use disorders in low-and middle-income countries: summary of WHO recommendations. PLoS Medicine 8, e1001122.
Durkin, MS, Wang, W, Shrout, PE, Zaman, SS, Hasan, Z, Desai, P, Davidson, L (1995). Evaluating a ten questions screen for childhood disability: reliability and internal structure in different cultures. Journal of Clinical Epidemiology 48, 657666.
Eaton, J, Mccay, L, Semrau, M, Chatterjee, S, Baingana, F, Araya, R, Ntulo, C, Thornicroft, G, Saxena, S (2011). Scale up of services for mental health in low-income and middle-income countries. Lancet 378, 15921603.
Goodman, R (1997). The strengths and difficulties questionnaire: a research note. Journal of Child Psychology and Psychiatry 38, 581586.
Hamdani, SU, Atif, N, Tariq, M, Minhas, FA, Iqbal, Z, Rahman, A (2014). Family networks to improve outcomes in children with intellectual and developmental disorders: a qualitative study. International Journal of Mental Health Systems 8, 7.
Hamdani, SU, Minhas, FA, Iqbal, Z, Rahman, A (2015). Model for service delivery for developmental disorders in low-income countries. Pediatrics 136, 11661172.
Husain, N, Creed, F, Tomenson, B (2000). Depression and social stress in Pakistan. Psychological Medicine 30, 395402.
Kohrt, BA, Jordans, MJ, Rai, S, Shrestha, P, Luitel, NP, Ramaiya, MK, Singla, DR, Patel, V (2015). Therapist competence in global mental health: development of the ENhancing Assessment of Common Therapeutic factors (ENACT) rating scale. Behaviour Research and Therapy 69, 1121.
Koren, Pe, Dechillo, N, Friesen, BJ (1992). Measuring empowerment in families whose children have emotional disabilities: a brief questionnaire. Rehabilitation Psychology 37, 305321.
Mcconachie, H, Parr, JR, Glod, M, Hanratty, J, Livingstone, N, Oono, IP, Robalino, S, Baird, G, Beresford, B, Charman, T (2015). Systematic review of tools to measure outcomes for young children with autism spectrum disorder. Health Technology Assessment 19(41).
Murray, LK, Dorsey, S, Bolton, P, Jordans, MJ, Rahman, A, Bass, J, Verdeli, H (2011). Building capacity in mental health interventions in low resource countries: an apprenticeship model for training local providers. International Journal of Mental Health Systems 5, 1.
Proctor, E, Silmere, H, Raghavan, R, Hovmand, P, Aarons, G, Bunger, A, Griffey, R, Hensley, M (2011). Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research 38, 6576.
Rahman, A, Divan, G, Hamdani, SU, Vajaratkar, V, Taylor, C, Leadbitter, K, Aldred, C, Minhas, A, Cardozo, P, Emsley, R (2016 a). Effectiveness of the parent-mediated intervention for children with autism spectrum disorder in south Asia in India and Pakistan (PASS): a randomised controlled trial. Lancet Psychiatry 3, 128136.
Rahman, A, Hamdani, SU, Awan, NR, Bryant, RA, Dawson, KS, Khan, MF, Azeemi, MM-U-H, Akhtar, P, Nazir, H, Chiumento, A (2016 b). Effect of a multicomponent behavioral intervention in adults impaired by psychological distress in a conflict-affected area of Pakistan: a randomized clinical trial. JAMA Journal of the American Medical Association 316 (24).
Rahman, A, Malik, A, Sikander, S, Roberts, C, Creed, F (2008). Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomised controlled trial. Lancet 372, 902909.
Reichow, B, Servili, C, Yasamy, MT, Barbui, C, Saxena, S (2013). Non-specialist psychosocial interventions for children and adolescents with intellectual disability or lower-functioning autism spectrum disorders: a systematic review. PLoS Medicine 10, e1001572.
Samad, L, Hollis, C, Prince, M, Goodman, R (2005). Child and adolescent psychopathology in a developing country: testing the validity of the strengths and difficulties questionnaire (Urdu version). International Journal of Methods in Psychiatric Research 14, 158166.
Scarpelli, AC, Paiva, SM, Pordeus, IA, Varni, JW, Viegas, CM, Allison, PJ (2008). The Pediatric Quality of Life Inventory™(PedsQL™) family impact module: reliability and validity of the Brazilian version. Health and Quality of Life Outcomes 6, 35.
Schulz, KF, Altman, DG, Moher, D (2010). CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMC Medicine 8, 1.
Stuart, H, Milev, R, Koller, M (2005). The inventory of stigmatizing experiences: its development and reliability. World Psychiatry 4, 3539.
Syed, EU, Hussein, SA, Mahmud, S (2007). Screening for emotional and behavioural problems amongst 5–11-year-old school children in Karachi, Pakistan. Social Psychiatry and Psychiatric Epidemiology 42, 421427.
Varni, JW, Seid, M, Rode, CA (1999). The PedsQL™: measurement model for the pediatric quality of life inventory. Medical Care 37, 126139.
World Health Organization (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. World Health Organization: Geneva.

Keywords

WHO Parents Skills Training (PST) programme for children with developmental disorders and delays delivered by Family Volunteers in rural Pakistan: study protocol for effectiveness implementation hybrid cluster randomized controlled trial

  • S. U. Hamdani (a1), P. Akhtar (a1), Zill-e-Huma (a1), H. Nazir (a1), F. A. Minhas (a2), S. Sikander (a1), D. Wang (a3), C. Servilli (a4) and A. Rahman (a5)...

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