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Maternal Outcomes of a Randomized Controlled Trial of a Community-Based Support Program for Families of Children With Chronic Illnesses
Henry T. Ireys, PhD;
Robin Chernoff, MD;
Katherine A. DeVet, PhD;
Young Kim, PhD
Arch Pediatr Adolesc Med. 2001;155:771-777.
Background Parents of children with chronic illnesses are at high risk for secondary
mental health problems, such as anxiety and depression.
Objective To evaluate maternal outcomes of a support intervention for families
of children with selected chronic illnesses.
Design A randomized controlled clinical trial design with repeated measures
1 year apart.
Setting A community-based family support intervention linked to subspecialty
and general pediatric clinics and practices in a metropolitan area.
Participants A population-based sample of 193 mothers of children aged 7 to 11 years;
the children were diagnosed as having diabetes, sickle cell anemia, cystic
fibrosis, or moderate to severe asthma. About 15% of the persons contacted
refused to participate in the research, and 14% of the families were lost
to follow-up.
Intervention The 15-month intervention, the Family-to-Family Network, was designed
to enhance mothers' mental health by linking mothers of school-aged children
with selected chronic illnesses with mothers of older children with the same
condition. The program included telephone contacts, face-to-face visits, and
special family events.
Main Outcome Measures Beck Depression Inventory score and the Psychiatric Symptom Index.
Results Maternal anxiety scores for participants in the experimental group decreased
during the intervention period for all diagnostic groups and for the total
group; scores for the control group increased (F = 5.07, P = .03). In multiple regression analyses, the intervention group was
a significant predictor of posttest anxiety scores (P
= .03). Effects were greater for mothers with high baseline anxiety (P<.001) and for those who were themselves in poor health
(P<.01).
Conclusions A family support intervention can have beneficial effects on the mental
health status of mothers of children with chronic illnesses. This type of
intervention can be implemented in diverse pediatric settings.
From the Department of Population and Family Health Sciences, School
of Hygiene and Public Health (Drs Ireys, DeVet, and Kim), and the Department
of Pediatrics, School of Medicine (Dr Chernoff), The Johns Hopkins University,
Baltimore, Md. Dr Ireys is now with Mathematica Policy Research, Inc, Washington,
DC.
Corresponding author and reprints: Henry T. Ireys, PhD, Mathematica
Policy Research, Inc, 600 Maryland Ave SW, Suite 550, Washington, DC 20024-2512
(e-mail: hlreys{at}mathematica-mpr.com).
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