BEAM: Building Emotional Awareness and Mental Health in Parenting. An App-based Intervention to Improve Parental Mental Health and Support Children's Brain Development.
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- University of Calgary
- Enrollment
- 240
- Locations
- 2
- Primary Endpoint
- Changes in parental mental health
Study Overview
Brief Summary
Postpartum (child age 0-5 years) mental health problems are common, with prevalence rates ranging from 15-20% for depression, 3-43% for anxiety, and approximately 30% for anger. Depression, anxiety, and anger often occur comorbidly. If left untreated, these disorders can be long-lasting and lead to child behaviour problems, brain changes, and risk for later mental illness. We developed an app-based treatment for parental mental illness: Building Emotional Awareness and Mental Health in Parenting (BEAM). The BEAM program includes mental health and parenting videos, peer coaching, as well as a forum and drop-in Zoom sessions where parents can connect with each other to receive and provide social support. The program is supported by peer coaches (parents with lived experience of recovery from mental illness and who may have received emotion-focused parenting support) and supervised by clinically-trained staff. Peer coaches check-in with parents weekly to support their progress. Our study will see the BEAM app's effect on parent mental health, parenting stress, child behaviour, and child brain structure and function. 240 parents with high depression, anxiety, and/or anger symptoms will be recruited, with half forming the treatment-as-usual group.
Detailed Description
Although there are existing treatments for parental mental illness, there can be barriers to accessing care such as high cost and limited options in rural areas. This is troubling as untreated parental mental health symptoms can contribute to adverse consequences for both the parent and child. Thus, early intervention is critical to help prevent negative long-term effects. Digital resources can provide effective support, as they bypass many of the barriers associated with in-person interventions. The BEAM app was designed to combat these barriers and assist parents struggling with their mental health and the transition to parenthood. BEAM is a 12-week intervention with weekly videos about mental health and parenting for participants to watch. Exercises will be available so participants can practice new skills. Participants will also participate in weekly check-ins with peer coaches and have access to a secure forum where they can talk to other participants and receive social support. The BEAM Program also includes optional monthly drop-in sessions where parents can connect with each other in real time over Zoom.
Parent mental health (depression, anxiety, anger), parenting stress, and overreactive parenting will be assessed pre- and post-intervention, as well as 6 months post-intervention. Child behaviour and mental health will also be measured at all three timepoints (pre-, post-, and 6-months post-intervention). Child brain structure and function will be examined by MRI scans 6-months post-intervention. Participants will also receive brief wellness monitoring surveys in-app on a weekly basis.
There are three objectives for the present study:
- Examine the effects of the BEAM program on parent mental health (including symptoms of depression, anxiety, and anger).
- Examine the effects of the BEAM program on children's behaviour and mental health.
- Examine the effects of the BEAM program on children's brain structure and function.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Outcomes Assessor)
Masking Description
Research assistants who are conducting the MRI brain imaging will be blinded to the participants' condition (i.e., whether they are in the control or experimental group).
Eligibility Criteria
- Ages
- 18 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Parent is 18 years of age or older
- •Must have a child who is 3-4 years old
- •Must show clinically elevated symptoms of depression, anxiety, &/or anger
- •Living in the Vancouver or Calgary area
- •Parent is comfortable understanding, speaking, and reading English
Exclusion Criteria
- •Parent is under the age of 18
- •Does not show clinically elevated symptoms of depression, anxiety, and/or anger
- •History of attempted suicide or self-harm in the past 6 months
- •Does not live in the Vancouver or Calgary area
- •Child has serious genetic, neurological, or neurodevelopmental disorders that impact cognitive function or brain structure/function (e.g., Down Syndrome, epilepsy, etc.), or if they have contra-indications to MRI scanning (i.e., metal implants)
Arms & Interventions
BEAM Program
The BEAM Program is delivered via mobile application, weekly check-ins, and peer coaching. BEAM includes videos with emotion-regulation strategies that come from the Unified Protocol (evidence-based treatment for depression and anxiety disorders) and Dialectical Behavior Therapy (DBT) to help with mental health, as well they focus on developing self-compassion and effective communication. There are also supportive parenting videos which focus on providing parents with emotion-focused parenting strategies, based on Tuning in to Kids® and Parent Management Training - The Oregon Model (PMTO), which aim to help parents better understand and respond to their child. There will be approximately 15-20 minutes of videos to watch weekly.
Intervention: Building Emotion Awareness and Mental Health (BEAM) (Behavioral)
Treatment-As-Usual
This is the control arm of the study. It is designed to account for the potential effects of time on symptoms of depression, anxiety, and anger.
Outcomes
Primary Outcomes
Changes in parental mental health
Time Frame: To be assessed pre-intervention, immediately post-intervention, and 6-months post-intervention
Parent mental health will be a composite of symptoms of depression, anxiety, and anger. Depression symptoms will be measured via the 10-item Center for Epidemiologic Studies Depression Scale (CES-D; scores range from 0-30 with higher score indicating more severe symptoms). Clinically elevated depressive symptoms will be identified with a cut-off of \>10. Anxiety symptoms will be measured via the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety short form (raw scores range from 7-35 with higher scores indicating more severe symptoms). Parent anger will be measured via PROMIS Anger (raw scores range from 5-25 with higher scores indicating more anger). T-score cut-offs of \>60 will be used to identify those with clinically elevated anger and anxiety symptoms. An aggregate variable for parent mental health symptoms will be computed by converting scores on the CES-D, PROMIS Anxiety, and PROMIS Anger to standardized z-scores and then taking their average.
Secondary Outcomes
- Changes in parenting stress(To be assessed pre-intervention, immediately post-intervention, and 6-months post-intervention)
- Children's phonological processing(To be assessed 6 months post-intervention)
- Changes in children's behaviour(To be assessed pre-intervention, immediately post-intervention, and 6-months post-intervention)
- Changes in relationship satisfaction(To be assessed pre-intervention, immediately post-intervention, and 6-months post-intervention)
- Changes in household environment(To be assessed pre-intervention, immediately post-intervention, and 6-months post-intervention)
- Changes in parent self-efficacy(To be assessed pre-intervention, immediately post-intervention, and 6-months post-intervention)
- Changes in parental sleep(To be assessed pre-intervention, immediately post-intervention, and 6-months post-intervention)
- Adverse childhood experiences(To be assessed at pre-intervention)
- Changes in discipline practices(To be assessed pre-intervention, immediately post-intervention, and 6-months post-intervention)
- Children's speeded naming ability(To be assessed 6 months post-intervention)
- Changes in children's mental health and development(To be assessed pre-intervention, immediately post-intervention, and 6-months post-intervention)
- Children's structural brain connectivity(To be assessed 6 months post-intervention)
- Children's functional brain connectivity(To be assessed 6 months post-intervention)
Investigators
Lianne Tomfohr-Madsen
Associate Professor
University of British Columbia