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A randomized preference trial to inform personalization of a parent training program implemented in community mental health clinics

  • Original Research
  • Published:
Translational Behavioral Medicine

Abstract

Incorporating participant preferences into intervention decision-making may optimize health outcomes by improving participant engagement. We describe the rationale for a preference-based approach to the personalization of community-based interventions. Compensating for the limitations of traditional randomized controlled trials (RCTs) and partially randomized preference trials (PRPTs), we employed a doubly randomized preference trial in the present study. Families (N = 129) presenting to community mental health clinics for child conduct problems were randomized to choice or no-choice conditions. Within each condition, parents were again randomized, or offered choices between home- and clinic-based, individual and group versions of a parent training program or services-as-usual. Participants were assessed at baseline, and treatment retention data were gathered. Families assigned to the choice condition were significantly less likely to drop out of treatment than those in the no-choice condition. In the choice condition, in-home treatment was the preferred modality, and across conditions, families were less likely to be retained in group and clinic modalities. Research on preferences may boost participant engagement and inform shared decision-making.

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Notes

  1. The missing data (23 %) were due to missing values in demographics (family income, parent age, and ethnicity) from families who did not complete the demographics form. Therefore, methods to impute missing values were not used in the study.

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Acknowledgments

The research reported here was funded by grant no. P20 MH 079906 from the National Institute of Mental Health to Gerald August (PI of the center) and Abigail Gewirtz (PI of this pilot research study).

Author information

Authors and Affiliations

  1. Department of Family Social Science, University of Minnesota Twin Cities, St. Paul, MN, USA

    Yaliu He M.Ed

  2. Department of Family Social Science and Institute of Translational Research in Children’s Mental Health, University of Minnesota Twin Cities, 290 McNeal Hall, 1985 Buford Avenue, St. Paul, MN, 55108, USA

    Abigail Gewirtz Ph.D & Gerald August Ph.D

  3. Psychiatry Department, University of Minnesota Twin Cities, Minneapolis, MN, USA

    Susanne Lee Ph.D & Nicole Morrell M.Ed

Authors
  1. Yaliu He M.Ed
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  2. Abigail Gewirtz Ph.D
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  3. Susanne Lee Ph.D
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  4. Nicole Morrell M.Ed
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  5. Gerald August Ph.D
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Corresponding author

Correspondence to Abigail Gewirtz Ph.D.

Ethics declarations

Conflict of interest

Abigail Gewirtz is a consultant to Implementation Sciences International, which provides training in the PMTO model.

Adherence to ethical principles

This study was approved by the University of Minnesota IRB and the Human Subjects Research Protection Board of the State of Michigan’s Department of Community Health. Informed consent was obtained from all participants for being included in the study.

Additional information

Implications

Implication for researchers: Personalization studies aimed at tailoring treatment options to family preferences with the help of decision aids to promote informed choice are needed.

Implications for practitioners: Accommodating to parents’ treatment preferences may be a good strategy for increasing engagement in children’s mental health service particularly when viable equipoise options exist.

Implications for policymakers: Parents’ participation in the delivery and design of children’s mental health services (e.g., maximizing parents’ choice) probably should be recommended as a matter of public policy.

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He, Y., Gewirtz, A., Lee, S. et al. A randomized preference trial to inform personalization of a parent training program implemented in community mental health clinics. Behav. Med. Pract. Policy Res. 6, 73–80 (2016). https://doi.org/10.1007/s13142-015-0366-4

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  • DOI: https://doi.org/10.1007/s13142-015-0366-4

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