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 and Taylor, John A. and Valentine, Althea and Guo, Boliang and Sampson, Christopher James and Sellman, Edward and James, Marilyn and 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

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Abstract

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.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Sayal, K., Taylor, J. A., Valentine, A., Guo, B., Sampson, C. J., Sellman, E., James, M., Hollis, C., and Daley, D. (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: 521–533. doi: 10.1111/cch.12349, which has been published in final form at: http://onlinelibrary.wiley.com/doi/10.1111/cch.12349/abstract. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Keywords: ADHD; hyperactivity; inattention; parent programme; teacher intervention; RCT; cost-effectiveness
Schools/Departments: University of Nottingham UK Campus > Faculty of Social Sciences > School of Education
University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine
Identification Number: https://doi.org/10.1111/cch.12349
Depositing User: Eprints, Support
Date Deposited: 04 May 2016 08:36
Last Modified: 18 Sep 2016 20:55
URI: http://eprints.nottingham.ac.uk/id/eprint/33036

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