Effectiveness of an Online Intervention to Prevent Anxiety in the Children of Anxious Parents: A Study Protocol for a Randomised Controlled Trial. (Preprint)

BACKGROUND Anxiety is the most common childhood mental health condition and is associated with impaired child outcomes, including increased risk of mental health difficulties in adulthood. Anxiety runs in families: when a parent has anxiety, their child has a 50 per cent higher chance of developing it themselves. Environmental factors are predominant in the intergenerational transmission of anxiety and, of these, parenting processes play a major role. Interventions that target parents to support them to limit the impact of any anxiogenic parenting behaviours are associated with reduced anxiety in their children. A brief UK-based group-based intervention delivered to parents within the UK National Health Service led to a 16 per cent reduction in children meeting criteria for an anxiety disorder. However, this intervention is not widely accessible. To widen access, a nine-module online version of this intervention has been developed. This course comprises psychoeducation and home practice delivered through text, video, animations, and practice tasks. OBJECTIVE To evaluate the feasibility of delivering a brief online intervention for parents and assess its effectiveness in reducing child anxiety symptoms. METHODS A randomised controlled trial (RCT) of a community sample of 1,754 parents with self-identified high levels of anxiety with a child aged 2-11. Parents in the intervention arm to receive access to the online course, which they undertake at a self-determined rate. The control arm receives no intervention. Follow-up data collection at 6 and 9-21 months. Intention to treat analysis will be conducted on outcomes including child anxiety, child mental health symptoms and wellbeing; parental anxiety, wellbeing; and parenting behaviours. RESULTS Funded in April 2020, recruitment started in February 2021 and projected to end October 2022. CONCLUSIONS The results of the RCT will provide evidence on the utility of an online course in preventing intergenerational transmission of anxiety and increase understanding of familial anxiety. CLINICALTRIAL Prospectively registered on ClinicalTrials.Gov NCT04755933 on Feb 16th 2021.