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Inside the Clockwork of the ECHO Factorial Trial: A Conceptual Model With Proposed Mediators for Prevention of Emotional Problems in Children.

ABSTRACT: Having interventions that are not only evidence-based and effective but also cost-effective and efficient is important for the prevention and treatment of child and adolescent emotional problems. A randomized clinical trial (RCT) tests the total interventions effect but does not address specific components of the intervention. In this article the hypothesis and a conceptual model of the ECHO study are presented and discussed. The ECHO intervention consists of three different components each containing two levels of intervention. By using a cluster randomized factorial design, children aged 8-12 at 40 schools across Norway will be randomized to eight different experimental conditions investigating the optimal balance between effect, cost-effectiveness, and efficiency. The article presents the design and the different components being tested and discusses how optimalization can be reached through this innovative design. The article also discusses how interventions can be improved by investigating and understanding the mechanisms of change within psychological interventions. For each of the three components in the study we consider the mediators that could be active within the intervention and how the study investigates such mediation. The results will contribute to a better understanding of how psychological interventions work and how we intend to optimize the EMOTION intervention.

SUBMITTER: Ingul JM

PROVIDER: S-EPMC8255930 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Inside the Clockwork of the ECHO Factorial Trial: A Conceptual Model With Proposed Mediators for Prevention of Emotional Problems in Children.

Ingul Jo Magne JM Martinsen Kristin K Adolfsen Frode F Sund Anne Mari AM Ytreland Kristin K Bania Elisabeth Valmyr EV Lisøy Carina C Rasmussen Lene-Mari Potulski LP Haug Ida Mari IM Patras Joshua J Collins Linda M LM Kendall Philip C PC Neumer Simon Peter SP

Frontiers in psychology 20210621

Having interventions that are not only evidence-based and effective but also cost-effective and efficient is important for the prevention and treatment of child and adolescent emotional problems. A randomized clinical trial (RCT) tests the total interventions effect but does not address specific components of the intervention. In this article the hypothesis and a conceptual model of the ECHO study are presented and discussed. The ECHO intervention consists of three different components each cont ...[more]

PMID: 34234731

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Project description:BackgroundYouth mental health problems are a major public health concern. Anxiety and depression are among the most common psychological difficulties. The aim of this study is to evaluate an optimized version of a promising indicated group intervention for emotional problems. The program (EMOTION Coping Kids Managing Anxiety and Depression) targets school children 8-12 years with anxious and depressive symptoms and examines three factors. Factor 1 compares the standard EMOTION intervention delivered in 16 group-based sessions (Group), versus a partially-digital EMOTION intervention (DIGGI) delivered as eight group sessions and eight digital sessions. Both versions use virtual reality technology (VR) to improve behavioral experiments. Factor 2 compares parent participation in a 5-session parent group (high involvement) versus sharing information with parents via a brochure (low involvement). Factor 3 compares the use of a measurement and feedback system (MFS) designed to help group leaders tailor the intervention using feedback from children with no MFS.MethodsUsing a cluster-randomized factorial design, 40 schools across Norway will be randomized to eight different experimental conditions based on three, two-level factors. To assess internalizing symptoms in children, children and their parents will be given self-report questionnaires pre-, post-, and one year after intervention. Parents also report on demographics, user satisfaction, personal symptoms and perception of family related factors. Teachers report on child symptoms and school functioning. Group leaders and the head of the municipal services report on implementation issues. The primary outcomes are changes in depressive and anxious symptoms. Some secondary outcomes are changes in self-esteem, quality of life, and user satisfaction. Questions regarding the consequences of the COVID-19 pandemic are included. Treatment fidelity is based on checklists from group leaders, and on user data from the participating children.DiscussionThis study is a collaboration between three regional centers for child and adolescent mental health in Norway. It will provide knowledge about: (1) the effect of school-based preventive interventions on anxiety and depression in children; (2) the effect of feedback informed health systems, (3) the effect and cost of digital health interventions for children, and (4) the effect of parental involvement.

Project description:This study explores the impact of the extensive use of an oral device since infancy (pacifier) on the acquisition of concrete, abstract, and emotional concepts. While recent evidence showed a negative relation between pacifier use and children's emotional competence (Niedenthal et al., 2012), the possible interaction between use of pacifier and processing of emotional and abstract language has not been investigated. According to recent theories, while all concepts are grounded in sensorimotor experience, abstract concepts activate linguistic and social information more than concrete ones. Specifically, the Words As Social Tools (WAT) proposal predicts that the simulation of their meaning leads to an activation of the mouth (Borghi and Binkofski, 2014; Borghi and Zarcone, 2016). Since the pacifier affects facial mimicry forcing mouth muscles into a static position, we hypothesize its possible interference on acquisition/consolidation of abstract emotional and abstract not-emotional concepts, which are mainly conveyed during social and linguistic interactions, than of concrete concepts. Fifty-nine first grade children, with a history of different frequency of pacifier use, provided oral definitions of the meaning of abstract not-emotional, abstract emotional, and concrete words. Main effect of concept type emerged, with higher accuracy in defining concrete and abstract emotional concepts with respect to abstract not-emotional concepts, independently from pacifier use. Accuracy in definitions was not influenced by the use of pacifier, but correspondence and hierarchical clustering analyses suggest that the use of pacifier differently modulates the conceptual relations elicited by abstract emotional and abstract not-emotional. While the majority of the children produced a similar pattern of conceptual relations, analyses on the few (6) children who overused the pacifier (for more than 3 years) showed that they tend to distinguish less clearly between concrete and abstract emotional concepts and between concrete and abstract not-emotional concepts than children who did not use it (5) or used it for short (17). As to the conceptual relations they produced, children who overused the pacifier tended to refer less to their experience and to social and emotional situations, use more exemplifications and functional relations, and less free associations.

Dataset Information

Inside the Clockwork of the ECHO Factorial Trial: A Conceptual Model With Proposed Mediators for Prevention of Emotional Problems in Children.

Publications

Inside the Clockwork of the ECHO Factorial Trial: A Conceptual Model With Proposed Mediators for Prevention of Emotional Problems in Children.

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