title: Remote population-based intervention for disruptive behavior at age four: study protocol for a randomized trial of Internet-assisted parent training (Strongest Families Finland-Canada).
abstract: BACKGROUND
  Oppositional Defiant Disorder (ODD) is characterized by angry and noncompliant behaviour. It is the most common disruptive behaviour disorder (DBD), with prevalence estimates of 6-9% for preschoolers and is closely linked to several long-term difficulties, including disorders of conduct, mood, anxiety, impulse-control, and substance abuse. ODD in children is related to parental depression, family dysfunction, and impairments in parental work performance. Children displaying early DBDs exhibit more symptoms of greater severity, more frequent offences, and commit more serious crimes later in life. The goal of the Strongest Families Finland Canada (SFFC) Smart Website intervention research program is to develop and evaluate an affordable, accessible, effective secondary prevention parent training program for disruptive behaviour in preschoolers to prevent the negative sequelae of ODD. Strongest Families is an 11-session program with two booster sessions that focuses on teaching skills to: strengthen parent-child relationships; reinforce positive behaviour; reduce conflict; manage daily transitions; plan for potentially problematic situations; promote emotional regulation and pro-social behaviour and decrease antisocial behaviour.
  
  
  METHODS
  This protocol paper describes an ongoing population-based randomized controlled trial (RCT) of high-risk 4 year-olds attending well-child clinics in Turku, Finland and environs to examine the effectiveness of the Strongest Families Smart Website intervention compared to an Education Control condition. Randomization consists of a 1:1 ratio for intervention versus the education group, stratified by the child's sex. The participants randomized to the intervention group receive access to the Strongest Families Smart Website and weekly telephone coaching sessions. The participants randomized to the Education Control condition receive access to a static website with parenting tips. Children are followed using parental and daycare teacher measures at 6 and 12 months after randomization.
  
  
  CONCLUSIONS
  The Strongest Families Smart Website intervention is hypothesized to improve parenting skills, reduce child disruptive behaviour, reduce parental distress and improve family functioning. These results will likely inform subsequent investigations, public policy, and early treatment of childhood disruptive behaviour problems.
  
  
  BACKGROUND
  ClinicalTrials.gov # NCT01750996.
authors.affiliation: Centre for Research in Family Health, IWK Health Centre, 5850/5980 University Avenue, P,O, Box 9700, Halifax, Nova Scotia B3K 6R8, Canada. patrick.mcgrath@iwk.nshealth.ca.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: McGrath
authors.forename: Andre
authors.initials: A
authors.lastname: Sourander
authors.forename: Patricia
authors.initials: P
authors.lastname: Lingley-Pottie
authors.forename: Terja
authors.initials: T
authors.lastname: Ristkari
authors.forename: Charles
authors.initials: C
authors.lastname: Cunningham
authors.forename: Jukka
authors.initials: J
authors.lastname: Huttunen
authors.forename: Katharine
authors.initials: K
authors.lastname: Filbert
authors.forename: Minna
authors.initials: M
authors.lastname: Aromaa
authors.forename: Penny
authors.initials: P
authors.lastname: Corkum
authors.forename: Susanna
authors.initials: S
authors.lastname: Hinkka-Yli-Salomäki
authors.forename: Malin
authors.initials: M
authors.lastname: Kinnunen
authors.forename: Katja
authors.initials: K
authors.lastname: Lampi
authors.forename: Anne
authors.initials: A
authors.lastname: Penttinen
authors.forename: Atte
authors.initials: A
authors.lastname: Sinokki
authors.forename: Anita
authors.initials: A
authors.lastname: Unruh
authors.forename: Jenni
authors.initials: J
authors.lastname: Vuorio
authors.forename: Carolyn
authors.initials: C
authors.lastname: Watters
mesh_terms: D000328:Adult; D000987:Antisocial Personality Disorder / Q000150:complications / Q000517:prevention & control*; D002170:Canada; D002652:Child Behavior; D002653:Child Behavior Disorders / Q000150:complications / Q000517:prevention & control*; D002675:Child, Preschool; D003415:Crime; D004644:Emotions; D005260:Female; D005387:Finland; D006801:Humans; D020407:Internet; D008297:Male; D001523:Mental Disorders / Q000209:etiology / Q000517:prevention & control; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology; D010290:Parents / Q000193:education* / Q000523:psychology; D012107:Research Design; D012919:Social Behavior