Process Evaluation of a Mindfulness-based Intervention for Children with Epilepsy
Abstract number :
3.408
Submission category :
16. Epidemiology
Year :
2022
Submission ID :
2204745
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:26 AM
Authors :
Karina Tassiopoulos, HBSc – Western University; Children’s Health Research Institute; Lawson Health Research Institute; Kathy Speechley, PhD (Epidemiology and Biostatistics), MA, BA – Professor, Department of Epidemiology and Biostatistics; Department of Paediatrics, Western University; Children’s Health Research Institute; Lawson Health Research Institute; Karen Bax, PhD, C Psych – Clinical Psychologist; Director, Adjunct Professor, Department of Psychology, Western University; Children’s Health Research Institute; Lawson Health Research Institute; Klajdi Puka, PhD (Epidemiology and Biostatistics), HBSc – Project Scientist; Adjunct Professor, Department of Epidemiology and Biostatistics, Western University; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health; Evelyn Vingilis, PhD (Psychology), MA, BSc – Psychologist; Director, Population and Community Health Unit; Professor, Department of Epidemiology and Biostatistics, Department of Family Medicine, Western University; Children’s Health Research Institute; Lawson Health Research Institute
Rationale: Epilepsy can significantly reduce health-related quality of life (HRQOL) in children. Children with epilepsy (CWE) are also at risk for other mental health comorbidities; these often go unrecognized and untreated which can worsen HRQOL. Poor HRQOL among CWE is also associated with poorer mental health and HRQOL in their caregivers. Previous research has shown family environment to be among the most meaningful determinants of HRQOL among CWE, suggesting it as a potentially important target for interventions aimed at improving CWE’s and parents’ HRQOL. The Making Mindfulness Matter© in Children with Epilepsy (M3-E) study aims to assess the feasibility of a mindfulness-based program proposed to improve HRQOL in CWE and parents. Several program- and system-level factors may influence M3-E outcomes. A process evaluation, essential to interpreting outcomes observed, was conducted to determine whether the intervention was delivered as proposed.
Methods: The M3-E study is a parallel, 1:1 randomized controlled trial comparing the 8-week Making Mindfulness Matter (M3©) intervention to waitlist control. Participants are recruited from a population of children ages 4 to 10 receiving epilepsy treatment in Southwestern Ontario, Canada. M3© is being delivered online on a rolling basis to 100 parent-child dyads in separate groups of three to eight by non-clinician staff of a local epilepsy agency. The intervention is a mindfulness program incorporating social-emotional learning and positive psychology. Data are collected via self-administered questionnaires. Mixed methods assessed key indicators of implementation: reach (participation rate), recruitment (session attendance, attrition, missing data), fidelity (quality of sessions), dose delivered (proportion of M3© curriculum units delivered), and dose received (participant adherence and satisfaction). For the process evaluation, results from study arms were combined.
Results: Of 273 parent-child dyads assessed for eligibility to date, 70 have been randomized: 32 to the intervention and 38 to waitlist control. Session attendance was higher among children than parents (43% vs. 24% attending all 8 sessions). Session quality was high; 87% to 100% of curriculum units were delivered fully by facilitators. Most participants (range, 58%-93%) were engaged in sessions and most (range, 51%-72%) reported practicing M3© skills the previous week. Over 95% were satisfied with M3©, but satisfaction data were missing for 24%.
Conclusions: Preliminary results indicate M3© is being delivered as proposed with high satisfaction. Areas for improvement include expanding recruitment and improving attrition and adherence. This research fills an important gap in implementing programming for CWE and their families by identifying problems and solutions, as well as circumstances under which M3© implementation is likely to succeed. Results will be used to guide a multi-centered trial to evaluate whether M3© improves HRQOL in CWE and parents.
Funding : Project grant from the Canadian Institutes of Health Research (PJT 159504)
Epidemiology