1. 27/11/2018
Increasing early childhood resilience – a feasibility study in general practice
Philip Wilson and Anette Graungaard
Section and Research Unit for General Practice

2. Aims of the feasibility study
Funded by TrygFonden
We aim to establish the feasibility of a randomised trial of an online resource (the Robusthed Programme, RP) to enhance the ‘mentalisation skills’ of parents of young children and thus improve parenting skills and child development

3. Design of the proposed full-scale cluster randomised trial
27/11/2018
Design of the proposed full-scale cluster randomised trial
The randomised trial will involve around 100 GPs and 1000 families
Recruitment during GP pregnancy check-ups
GPs will deliver structured pregnancy and child development checks which include:
Parental mental health
Parent-child interaction
Child brain (neurological) development
3 assessments in pregnancy then at 5 weeks, 5 months and 1 and 2 years.
~50 GPs in the intervention arm will recommend use of RP to all pregnant women and partner plus when they think it will be useful to families
~50 GPs in the control arm will not be trained in RP
Outcomes will be focussed on child development, particularly language, behaviour and cognitive functioning.

4. Components of the feasibility study 1
Develop and refine the RP intervention to meet the needs of families through pregnancy and early child-rearing
With a group of 10 GPs:
Develop structured pregnancy and child development assessments
Refine a tool (CARO) to assess parent-child interaction
Evaluate the quality of assessments using video recording
Offer training in the best use of the RP
Assess the extent to which the needs of families are matched to recommendations about using RP
Get feedback about the study design

5. Components of the feasibility study 2
With 100 families:
Establish patterns of use of the RP intervention
Establish the acceptability of the study process and outcome measures to mothers
Establish the acceptability to partners
Get feedback about the study design

6. Potential add-on projects at feasibility stage
Validation of the CARO tool for assessing parent-child interaction: assess the accuracy of GPs’ judgements about parent-child interaction
GP readiness for new approach to child assessment – NPT framework
Video recordings of consultations – how do GPs address issues about mental health and wellbeing in pregnancy consultations and child development assessments?
Assessment of consultation patterns and their relationship with parent stress and parent-infant interaction
Evaluating which RP tools work best for which families etc etc.

7. The RP trial feasibility study team
Anette Graungaard, Kirsten Lykke, Gritt Overbeck, Ruth Ertmann, Jakob Kragstrup, Phil Wilson
Mette Væver, Karsten Vrangbæk, Mette Gørtz, Volkert Siersma
Lucy Thompson, Christine Puckering, Christopher Gillberg
Thank you!