title: The Child Illness and Resilience Program (CHiRP): a study protocol of a stepped care intervention to improve the resilience and wellbeing of families living with childhood chronic illness.
abstract: BACKGROUND
  Families of children living with chronic illness are more vulnerable to mental health problems, however this can be ameliorated by a family's resilience. The Child Illness and Resilience Program (CHiRP) will develop and evaluate a parent-focussed family intervention designed to increase the resilience and wellbeing of families living with childhood chronic illness.
  
  
  METHODS
  The study will be conducted in an Australian regional paediatric hospital and will use a stepped care intervention that increases in intensity according to parental distress. All parents of children discharged from the hospital will receive a family resilience and wellbeing factsheet (Step 1). Parents of children attending selected outpatient clinics will receive a family resilience and wellbeing activity booklet (Step 2). Parents who receive the booklet and report psychological distress at three-month follow-up will be randomised to participate in a family resilience information support group or waitlist control (Step 3). The Step 3 control group will provide data to compare the relative effectiveness of the booklet intervention alone versus the booklet combined with the group intervention for distressed parents. These participants will then receive the information support group intervention. All parents in Step 2 and 3 will complete baseline, post-intervention and six month follow up assessments. The primary outcomes of the study will be changes in scores between baseline and follow-up assessments on measures of constructs of family resilience, including parental wellbeing, family functioning, family beliefs and perceived social support. Qualitative feedback regarding the utility and acceptability of the different intervention components will also be collected.
  
  
  CONCLUSIONS
  It is hypothesised that participation in the CHiRP intervention will be associated with positive changes in the key outcome measures. If effective, CHiRP will provide an opportunity for the health sector to deliver a standardised stepped care mental health promotion intervention to families living with childhood chronic illness.
  
  
  BACKGROUND
  Australian clinical Trials Registry ACTRN 12613000844741 Universal Trial Number (UTN): 1111-1142-8829.
authors.affiliation: Hunter Institute of Mental Health, Hunter New England Local Health District, Newcastle, Australia ; School of Medicine and Public Health, University of Newcastle, PO Box 833, Newcastle, NSW 2300 Australia.
authors.forename: Katrina M
authors.initials: KM
authors.lastname: Hamall
authors.affiliation: School of Medicine and Public Health, University of Newcastle, PO Box 833, Newcastle, NSW 2300 Australia ; Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.
authors.forename: Todd R
authors.initials: TR
authors.lastname: Heard
authors.affiliation: NHMRC Centre for Research Excellence in Mental Health and Substance Use, Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle, Australia.
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Inder
authors.affiliation: Hunter Institute of Mental Health, Hunter New England Local Health District, Newcastle, Australia.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: McGill
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia ; Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle, Australia.
authors.forename: Frances
authors.initials: F
authors.lastname: Kay-Lambkin
keywords: Childhood chronic illness; Evaluation; Family functioning; Family intervention; Family resilience; Parental wellbeing; Social support