A web-based group course intervention for 15-25-year-olds whose parents have substance use problems or mental illness: study protocol for a randomized controlled trial.
BACKGROUND
Depending on the definitions used, between 5 and 20 % of all Swedish children grow up with at least one parent suffering from alcohol problems, while 6 % have at least one parent who has received inpatient psychiatric care, conditions that may affect the children negatively. Nine out of ten Swedish municipalities therefore provide support resources, but less than 2 % of these children are reached by such support. Delivering intervention programs via the Internet is a promising strategy. However, web-based programs targeting this at-risk group of children are scarce. We have previously developed a 1.5-h-long web-based self-help program, Alcohol & Coping, which appears to be effective with regards to adolescents' own alcohol consumption. However, there is a need for a more intense program, and therefore we adapted Kopstoring, a comprehensive Dutch web-based psycho-educative prevention program, to fit the Swedish context. The purpose of the program, which in Swedish has been called Grubbel, is to strengthen protective factors, such as coping skills and psychological well-being, prevent the development of psychological disorders, and reduce alcohol consumption.


METHODS
The aim of the current study is to evaluate the effectiveness of Grubbel, which targets 15-25-year-olds whose parents have substance use problems and/or mental illness. Specific research questions relate to the participants' own coping strategies, mental health status and substance use. The study was initiated in the spring of 2016 and uses a two-armed RCT design. Participants will be recruited via social media and also through existing agencies that provide support to this target group. The assessment will consist of a baseline measurement (t0) and three follow-ups after six (t1), 12 (t2), and 24 months (t3). Measures include YSR, CES-DC, Ladder of Life, Brief COPE, AUDIT-C, and WHOQOL-BREF.


CONCLUSIONS
Studies have revealed that the majority of children whose parents have substance use or mental health problems are not reached by the existing support. Thus, there is an urgent need to develop, implement, and evaluate novel intervention programs and disseminate successful programs to a broader audience. This study, investigating the effects of a web-based intervention, therefore makes an important contribution to this field of research.


BACKGROUND
ISRCTN10099247 . Retrospectively registered on August 31, 2016.
STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden. tobias.elgan@ki.se.
Tobias H
TH
Elgán
STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
Nicklas
N
Kartengren
STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
Anna K
AK
Strandberg
STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
Maria
M
Ingemarson
School of Social Work, Faculty of Social Sciences, Lund University, Lund, Sweden.
Helena
H
Hansson
Clinical Health Promotion Centre, Department of Health Sciences, Lund University and Skåne University Hospital MAS, Lund, Sweden.
Ulla
U
Zetterlind
STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
Johanna
J
Gripenberg
Chat; Child of impaired parents; Children of alcoholics; Digital intervention; Group; Internet; Mental illness; RCT; Social media; Web-based intervention
BMC Med Res Methodol. 2004 Nov 09;4:26
15535880
Am J Epidemiol. 1982 Nov;116(5):791-800
7148805
Am J Epidemiol. 1990 Mar;131(3):538-51
2301363
BMC Health Serv Res. 2014 Jul 18;14:313
25037951
Addiction. 2012 Jun;107(6):1082-9
22229839
Eur Addict Res. 2013;19(3):121-7
23183686
Pediatrics. 1999 May;103(5 Pt 2):1112-21
10224198
Arch Intern Med. 1998 Sep 14;158(16):1789-95
9738608
Child Adolesc Psychiatr Clin N Am. 2011 Jan;20(1):135-53
21092918
Pediatrics. 2008 Aug;122(2):e298-304
18676515
Addiction. 1995 Feb;90(2):255-67
7703819
Soc Psychiatry Psychiatr Epidemiol. 2008 Nov;43(11):927-35
18575792
Annu Rev Clin Psychol. 2007;3:53-76
17716048
Psychol Bull. 1992 Jul;112(1):155-9
19565683
J Abnorm Psychol. 1991 Nov;100(4):449-63
1757658
Int J Behav Med. 1997;4(1):92-100
16250744
Scand J Public Health. 2016 Feb;44(1):14-7
26287020
Qual Life Res. 2004 Mar;13(2):299-310
15085902
J Anxiety Disord. 2015 Jan;29:83-92
25527900
Addict Behav. 1993 May-Jun;18(3):337-45
8342446
Am J Public Health. 2000 Jan;90(1):112-5
10630147
J Stud Alcohol. 1999 Jan;60(1):18-26
10096305
Behav Res Ther. 2015 Apr;67:1-18
25727678
Child Dev. 1999 Mar-Apr;70(2):443-58
10218265
BMC Public Health. 2012 Jan 16;12:35
22248564
BMC Psychiatry. 2014 Sep 18;14:263
25269863
J Med Internet Res. 2015 Dec 02;17(12):e274
26633244
Curr Opin Pediatr. 2000 Aug;12(4):336-40
10943813
Eur Child Adolesc Psychiatry. 1997 Jun;6(2):81-7
9257089
Pediatrics. 1999 May;103(5 Pt 2):1085-99
10224196
Psychiatr Serv. 2002 Aug;53(8):1001-9
12161676
J Abnorm Child Psychol. 2004 Oct;32(5):519-33
15500031
Clin Child Fam Psychol Rev. 2010 Sep;13(3):275-90
20532980
Psychol Rep. 2002 Feb;90(1):341-8
11899007
Annu Rev Public Health. 2009;30:273-92
19296777
Int J Ment Health Nurs. 2003 Sep;12(3):223-8
17393649
BMC Public Health. 2010 Aug 10;10:470
20698962
Cyberpsychol Behav Soc Netw. 2014 Aug;17(8):519-27
24810933
BMC Public Health. 2009 Oct 08;9:377
19814787
Behav Res Ther. 2009 Mar;47(3):175-80
19230862
Health Policy. 2011 Jun;101(1):29-36
21055839
Am J Orthopsychiatry. 2007 Jul;77(3):362-9
17696664
Alcohol Health Res World. 1997;21(3):185-91
15706767
Behav Res Methods. 2007 May;39(2):175-91
17695343
Alcohol Health Res World. 1997;21(3):247-54
15706777