Family-Focused Adolescent &Amp; Lifelong Health Promotion Optimization Trial

NCT ID: NCT06562244

Last Updated: 2024-12-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

640 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-21

Study Completion Date

2025-06-30

Brief Summary

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The aim of this study is to conduct a multi-country, cluster-randomized factorial trial to optimize the Parenting for Lifelong Health (PLH) for Parents and Teens program in Moldova and North Macedonia. Specifically, this trial will evaluate the effectiveness and cost consequences of three additional intervention components: UNICEF's Helping Adolescents Thrive comics, adolescent peer support based on UNICEF's I Support My Friends intervention, and engagement boosters.

ALTERNATIVA will deliver the program in North Macedonia and Health for Youth Association in the Republic of Moldova.

This trial is implemented according to the Multiphase Optimization Strategy (MOST). MOST involves three phases. The preparation phase involves adapting and piloting the intervention (Phase 1). The optimization phase involves a factorial trial (Phase 2). Finally, the evaluation phase involves conducting a randomized controlled trial to assess the optimized intervention's effectiveness and cost-effectiveness (Phase 3). A Phase 2 factorial trial is the focus of this registration.

Detailed Description

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Adolescent mental health is a significant global concern, especially in low- and middle-income countries (LMICs) like North Macedonia and Moldova. Adolescents in LMICs face numerous challenges, including socio-economic stressors, adverse childhood experiences, and limited access to mental health services. Parenting interventions are one approach to reduce risk for poor adolescent mental health outcomes and family maltreatment. Systematic optimization of parenting programs is essential for enhancing scalability and sustainability in low-resource settings.

Building on prior research, the "Family-Focused Adolescent \& Lifelong Health Promotion" (FLOURISH) project aims to adapt, optimize, and evaluate a parenting intervention for adolescents aged 10-14 and their caregivers in North Macedonia and Moldova. The project focuses on improving adolescent mental health and well-being in both teens and caregivers, and it is implemented according to the Multiphase Optimization Strategy (MOST) framework. Phase 1 of the project assessed the feasibility of the adapted parenting intervention, which included three components to enhance participation, retention, and effectiveness. The three components were UNICEF's Helping Adolescents Thrive (HAT) comics, peer support, and engagement boosters.

This protocol describes the optimization (Phase 2) of the adapted FLOURISH intervention package which will assess the effectiveness and costs of HAT, adolescent peer support, and the engagement boosters, as well as their combinations. The factorial experiment will consist of eight conditions, stratified by country, with each condition reflecting a unique combination of the three components. The results of this study will be used to select the optimized intervention package which will be tested in a randomized trial in the next phase of the FLOURISH project (Phase 3).

Conditions

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Adolescent - Emotional Problem Parent-Child Relations Family Functioning Well-Being, Psychological

Keywords

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Multiphase Optimization Strategy (MOST) Family-based intervention Adolescents Mental health Randomized trial

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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HAT On, Peer Support On, High Engagement

HAT component: On - Two interactive sessions using UNICEF's Helping Adolescents Thrive comics, covering recognizing emotions, stress management, conflict resolution, and relationship building.

Peer Support: On - Half-day workshop from UNICEF's "I Support My Friends" program, teaching adolescents to identify distress in peers, develop listening skills, and seek additional support.

Engagement booster: High - Includes refreshments, certificates, and vouchers (10 EUR for adolescents, 5 EUR for caregivers).

Group Type EXPERIMENTAL

Parenting for Lifelong Health for Parents and Teens (PLH)

Intervention Type BEHAVIORAL

The PLH program is the core intervention and will be delivered over 6 sessions with adolescents and caregivers, focusing on building positive parent-child relationships, problem-solving skills, stress management, effective limit-setting, and emotional regulation. There will also be a pre-program visit with the facilitator and families prior to the group sessions. Sessions will include both separate and joint activities between adolescents and caregivers. Engagement boosters will be provided during the PLH sessions and are part of the PLH intervention.

Helping Adolescents Thrive comics

Intervention Type BEHAVIORAL

UNICEF's Helping Adolescents Thrive (HAT) comics will be used to guide adolescents through content on improving relationships, handling conflict, understanding emotions, and problem solving. These sessions will be group-based and cover the content in the HAT manual with the adolescents in an interactive format.

I Support My Friends

Intervention Type BEHAVIORAL

An adapted version of UNICEF's "I Support My Friends" program will be provided to adolescents by a facilitator in a group-based workshop format over the course of 1 day.

HAT On, Peer Support Off, High Engagement

HAT component: On - Two interactive sessions using UNICEF's Helping Adolescents Thrive comics, covering recognizing emotions, stress management, conflict resolution, and relationship building.

Peer Support: Off

Engagement booster: High - Includes refreshments, certificates, and vouchers (10 EUR for adolescents, 5 EUR for caregivers).

Group Type EXPERIMENTAL

Parenting for Lifelong Health for Parents and Teens (PLH)

Intervention Type BEHAVIORAL

The PLH program is the core intervention and will be delivered over 6 sessions with adolescents and caregivers, focusing on building positive parent-child relationships, problem-solving skills, stress management, effective limit-setting, and emotional regulation. There will also be a pre-program visit with the facilitator and families prior to the group sessions. Sessions will include both separate and joint activities between adolescents and caregivers. Engagement boosters will be provided during the PLH sessions and are part of the PLH intervention.

Helping Adolescents Thrive comics

Intervention Type BEHAVIORAL

UNICEF's Helping Adolescents Thrive (HAT) comics will be used to guide adolescents through content on improving relationships, handling conflict, understanding emotions, and problem solving. These sessions will be group-based and cover the content in the HAT manual with the adolescents in an interactive format.

HAT On, Peer Support On, Low Engagement

HAT component: On - Two interactive sessions using UNICEF's Helping Adolescents Thrive comics, covering recognizing emotions, stress management, conflict resolution, and relationship building.

Peer Support: On - Half-day workshop from UNICEF's "I Support My Friends" program, teaching adolescents to identify distress in peers, develop listening skills, and seek additional support.

Engagement booster: Low - Refreshments and certificates.

Group Type EXPERIMENTAL

Parenting for Lifelong Health for Parents and Teens (PLH)

Intervention Type BEHAVIORAL

The PLH program is the core intervention and will be delivered over 6 sessions with adolescents and caregivers, focusing on building positive parent-child relationships, problem-solving skills, stress management, effective limit-setting, and emotional regulation. There will also be a pre-program visit with the facilitator and families prior to the group sessions. Sessions will include both separate and joint activities between adolescents and caregivers. Engagement boosters will be provided during the PLH sessions and are part of the PLH intervention.

Helping Adolescents Thrive comics

Intervention Type BEHAVIORAL

UNICEF's Helping Adolescents Thrive (HAT) comics will be used to guide adolescents through content on improving relationships, handling conflict, understanding emotions, and problem solving. These sessions will be group-based and cover the content in the HAT manual with the adolescents in an interactive format.

I Support My Friends

Intervention Type BEHAVIORAL

An adapted version of UNICEF's "I Support My Friends" program will be provided to adolescents by a facilitator in a group-based workshop format over the course of 1 day.

HAT On, Peer Support Off, Low Engagement

HAT component: On - Two interactive sessions using UNICEF's Helping Adolescents Thrive comics, covering recognizing emotions, stress management, conflict resolution, and relationship building.

Peer Support: Off

Engagement booster: Low - Refreshments and certificates.

Group Type EXPERIMENTAL

Parenting for Lifelong Health for Parents and Teens (PLH)

Intervention Type BEHAVIORAL

The PLH program is the core intervention and will be delivered over 6 sessions with adolescents and caregivers, focusing on building positive parent-child relationships, problem-solving skills, stress management, effective limit-setting, and emotional regulation. There will also be a pre-program visit with the facilitator and families prior to the group sessions. Sessions will include both separate and joint activities between adolescents and caregivers. Engagement boosters will be provided during the PLH sessions and are part of the PLH intervention.

Helping Adolescents Thrive comics

Intervention Type BEHAVIORAL

UNICEF's Helping Adolescents Thrive (HAT) comics will be used to guide adolescents through content on improving relationships, handling conflict, understanding emotions, and problem solving. These sessions will be group-based and cover the content in the HAT manual with the adolescents in an interactive format.

HAT Off, Peer Support On, High Engagement

HAT component: Off

Peer Support: On - Half-day workshop from UNICEF's "I Support My Friends" program, teaching adolescents to identify distress in peers, develop listening skills, and seek additional support.

Engagement booster: High - Includes refreshments, certificates, and vouchers (10 EUR for adolescents, 5 EUR for caregivers).

Group Type EXPERIMENTAL

Parenting for Lifelong Health for Parents and Teens (PLH)

Intervention Type BEHAVIORAL

The PLH program is the core intervention and will be delivered over 6 sessions with adolescents and caregivers, focusing on building positive parent-child relationships, problem-solving skills, stress management, effective limit-setting, and emotional regulation. There will also be a pre-program visit with the facilitator and families prior to the group sessions. Sessions will include both separate and joint activities between adolescents and caregivers. Engagement boosters will be provided during the PLH sessions and are part of the PLH intervention.

I Support My Friends

Intervention Type BEHAVIORAL

An adapted version of UNICEF's "I Support My Friends" program will be provided to adolescents by a facilitator in a group-based workshop format over the course of 1 day.

HAT Off, Peer Support Off, High Engagement

HAT component: Off

Peer Support: Off

Engagement booster: High - Includes refreshments, certificates, and vouchers (10 EUR for adolescents, 5 EUR for caregivers).

Group Type EXPERIMENTAL

Parenting for Lifelong Health for Parents and Teens (PLH)

Intervention Type BEHAVIORAL

The PLH program is the core intervention and will be delivered over 6 sessions with adolescents and caregivers, focusing on building positive parent-child relationships, problem-solving skills, stress management, effective limit-setting, and emotional regulation. There will also be a pre-program visit with the facilitator and families prior to the group sessions. Sessions will include both separate and joint activities between adolescents and caregivers. Engagement boosters will be provided during the PLH sessions and are part of the PLH intervention.

HAT Off, Peer Support On, Low Engagement

HAT component: Off

Peer Support: On - Half-day workshop from UNICEF's "I Support My Friends" program, teaching adolescents to identify distress in peers, develop listening skills, and seek additional support.

Engagement booster: Low - Refreshments and certificates.

Group Type EXPERIMENTAL

Parenting for Lifelong Health for Parents and Teens (PLH)

Intervention Type BEHAVIORAL

The PLH program is the core intervention and will be delivered over 6 sessions with adolescents and caregivers, focusing on building positive parent-child relationships, problem-solving skills, stress management, effective limit-setting, and emotional regulation. There will also be a pre-program visit with the facilitator and families prior to the group sessions. Sessions will include both separate and joint activities between adolescents and caregivers. Engagement boosters will be provided during the PLH sessions and are part of the PLH intervention.

I Support My Friends

Intervention Type BEHAVIORAL

An adapted version of UNICEF's "I Support My Friends" program will be provided to adolescents by a facilitator in a group-based workshop format over the course of 1 day.

HAT Off, Peer Support Off, Low Engagement

HAT component: Off

Peer Support: Off

Engagement booster: Low - Refreshments and certificates

Group Type EXPERIMENTAL

Parenting for Lifelong Health for Parents and Teens (PLH)

Intervention Type BEHAVIORAL

The PLH program is the core intervention and will be delivered over 6 sessions with adolescents and caregivers, focusing on building positive parent-child relationships, problem-solving skills, stress management, effective limit-setting, and emotional regulation. There will also be a pre-program visit with the facilitator and families prior to the group sessions. Sessions will include both separate and joint activities between adolescents and caregivers. Engagement boosters will be provided during the PLH sessions and are part of the PLH intervention.

Interventions

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Parenting for Lifelong Health for Parents and Teens (PLH)

The PLH program is the core intervention and will be delivered over 6 sessions with adolescents and caregivers, focusing on building positive parent-child relationships, problem-solving skills, stress management, effective limit-setting, and emotional regulation. There will also be a pre-program visit with the facilitator and families prior to the group sessions. Sessions will include both separate and joint activities between adolescents and caregivers. Engagement boosters will be provided during the PLH sessions and are part of the PLH intervention.

Intervention Type BEHAVIORAL

Helping Adolescents Thrive comics

UNICEF's Helping Adolescents Thrive (HAT) comics will be used to guide adolescents through content on improving relationships, handling conflict, understanding emotions, and problem solving. These sessions will be group-based and cover the content in the HAT manual with the adolescents in an interactive format.

Intervention Type BEHAVIORAL

I Support My Friends

An adapted version of UNICEF's "I Support My Friends" program will be provided to adolescents by a facilitator in a group-based workshop format over the course of 1 day.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

For Caregivers:

Must be 18 years or older at the baseline assessment. Must be the primary caregiver of an adolescent aged 10-14 who has resided in the same household for at least four nights a week in the past month.

Must be able to speak at least one of the local languages in which the program will be offered (Romanian, Macedonian).

Must agree to participate in the program. Must provide consent for both themselves and their child to participate in the study.

For Adolescents:

Must be aged 10-14 at the baseline assessment. Must assent to participate in the study. Must have caregiver consent to participate in the study.
Minimum Eligible Age

10 Years

Maximum Eligible Age

14 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Institute for Marriage, Family and Systemic Practice - ALTERNATIVA

OTHER

Sponsor Role collaborator

Cardiff University

OTHER

Sponsor Role collaborator

Association for Systematic Therapy Education Center

UNKNOWN

Sponsor Role collaborator

Medical University of Vienna

OTHER

Sponsor Role collaborator

University Jaume I Castellon

UNKNOWN

Sponsor Role collaborator

Bielefeld University

OTHER

Sponsor Role collaborator

Health for Youth Association, Moldova

OTHER

Sponsor Role collaborator

University of Klagenfurt

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Heather M Foran, Prof

Role: PRINCIPAL_INVESTIGATOR

University of Klagenfurt

Yulia Shenderovich, Dr

Role: PRINCIPAL_INVESTIGATOR

Cardiff University

Marija Raleva, Prof

Role: PRINCIPAL_INVESTIGATOR

Institute for Marriage, Family and Systemic Practice - ALTERNATIVA

Galina Lesco, Dr.

Role: PRINCIPAL_INVESTIGATOR

Health for Youth Association, Moldova

Graham Moore, Prof

Role: PRINCIPAL_INVESTIGATOR

Cardiff University

Rhiannon Evans, Prof

Role: PRINCIPAL_INVESTIGATOR

Cardiff University

Judit Simon, Prof

Role: PRINCIPAL_INVESTIGATOR

Medical University of Vienna

Nina Heinrichs, Prof

Role: PRINCIPAL_INVESTIGATOR

Bielefeld University

Nevena Calovska, Prof

Role: PRINCIPAL_INVESTIGATOR

Association of Systemic Therapists Education Centre

Bojan Shimbov, Prof

Role: PRINCIPAL_INVESTIGATOR

University Jaume I Castellon, Spain

Locations

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Institute Alternativa

Skopje, , North Macedonia

Site Status RECRUITING

Countries

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North Macedonia

Central Contacts

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Heather M Foran, Prof

Role: CONTACT

Phone: +4346327001641

Email: [email protected]

Antonio Piolanti, Dr

Role: CONTACT

Email: [email protected]

Facility Contacts

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Marija Raleva, M.D.

Role: primary

References

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Piolanti A, Mueller J, Waller F, Heinrichs N, Simon J, Shenderovich Y, Sampathkumar S, Wienand D, Raleva M, Kunovski I, Babii V, Zhao X, Moore G, Foran HM. Family-focused intervention programme to foster adolescent mental health and well-being: protocol for a multicountry cluster randomised factorial trial (FLOURISH Phase 2). BMJ Open. 2025 Feb 7;15(2):e094085. doi: 10.1136/bmjopen-2024-094085.

Reference Type DERIVED
PMID: 39920046 (View on PubMed)

Other Identifiers

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1010955282

Identifier Type: -

Identifier Source: org_study_id