Randomized Controlled Trial of a Family-focused Intervention for Caregivers and Young Adolescents (Phase 3 of FLOURISH)

NCT ID: NCT07240571

Last Updated: 2025-11-21

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

1280 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-24

Study Completion Date

2026-06-30

Brief Summary

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The aim of this study is to conduct a multi-country randomized waitlist controlled trial to evaluate the effectiveness, cost-effectiveness, and scalability of the optimized Parenting for Lifelong Health (PLH) for Parents and Teens program in Moldova and North Macedonia. In Phase 2 of the FLOURISH project, a factorial trial tested multiple intervention components and identified the optimized intervention package. In Phase 3, this trial will assess the implementation, outcomes, and economic impact of the optimized PLH program delivered to adolescents aged 10-14 and their caregivers. ALTERNATIVA will deliver the program in North Macedonia and the Health for Youth Association in the Republic of Moldova.

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 evaluation 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 and cultural adaptation of the PLH for Parents and Teens program. In Phase 2, a multi-country factorial trial tested different combinations of three additional components (adolescent mental health tools from UNICEF's Helping Adolescents Thrive comics, adolescent peer support, and engagement boosters) and identified the optimized intervention package.

This protocol describes the evaluation (Phase 3) of the optimized FLOURISH intervention package. The randomized waitlist controlled trial will recruit adolescent-caregiver pairs (320 to 340 families per country, 640 to 660 total) to test the effectiveness, cost-effectiveness, and scalability of the optimized PLH program. Families assigned to the intervention group will receive the program over seven weeks (one pre-program visit and six weekly group sessions), while families in the waitlist control group will receive the intervention after the six-month follow-up assessment. The results of this study will inform the potential for scaling up the optimized intervention at the national level in both countries and contribute robust evidence on adolescent mental health promotion in LMICs.

Conditions

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

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Optimized Parenting for Lifelong Health (PLH) for Parents and Teens

Families assigned to this arm will receive the optimized Parenting for Lifelong Health (PLH) for Parents and Teens program. The intervention is delivered in groups of approximately 10 adolescent-caregiver pairs over a 7-week period. It includes one pre-program visit and six weekly group sessions (about two hours each), with a mix of joint and separate sessions for caregivers and adolescents. Sessions are facilitated by trained professionals under ongoing supervision to ensure fidelity. The program focuses on strengthening family relationships, improving communication, managing emotions, problem-solving, and promoting positive parenting.

Group Type EXPERIMENTAL

Optimized Parenting for Lifelong Health (PLH) for Parents and Teens

Intervention Type BEHAVIORAL

The optimized Parenting for Lifelong Health (PLH) for Parents and Teens program is a group-based parenting and adolescent skills training intervention. It will be delivered to adolescent-caregiver pairs (ages 10-14 and their primary caregivers) in groups of about 10 families. The program lasts 7 weeks and includes one pre-program visit and six weekly group sessions of approximately two hours each. Sessions include both joint and separate modules for caregivers and adolescents, focusing on building positive relationships, managing emotions, establishing routines, problem solving, and strengthening family communication. The program is facilitated by trained professionals who receive two days of training and ongoing weekly supervision.

Waitlist Control

Families assigned to this arm will not receive the intervention during the initial study period. They will complete all study assessments at baseline, post-intervention, and 6-month follow-up. After completion of the 6-month follow-up assessment, families in the waitlist control arm will be offered the optimized Parenting for Lifelong Health (PLH) for Parents and Teens program under the same delivery format as the intervention group.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Optimized Parenting for Lifelong Health (PLH) for Parents and Teens

The optimized Parenting for Lifelong Health (PLH) for Parents and Teens program is a group-based parenting and adolescent skills training intervention. It will be delivered to adolescent-caregiver pairs (ages 10-14 and their primary caregivers) in groups of about 10 families. The program lasts 7 weeks and includes one pre-program visit and six weekly group sessions of approximately two hours each. Sessions include both joint and separate modules for caregivers and adolescents, focusing on building positive relationships, managing emotions, establishing routines, problem solving, and strengthening family communication. The program is facilitated by trained professionals who receive two days of training and ongoing weekly supervision.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* For Caregivers:

Must be 18 years or older at 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 (e.g., Macedonian, Romanian, Russian, Ukrainian or Albanian)

Must agree to participate in the program and provide informed consent for both themselves and their adolescent

For Adolescents:

Must be aged 10-14 at the baseline assessment

Must provide assent to participate in the study

Must have caregiver consent to participate.
Minimum Eligible Age

10 Years

Maximum Eligible Age

14 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Health for Youth Association, Moldova

OTHER

Sponsor Role collaborator

Institute for Marriage, Family and Systemic Practice - ALTERNATIVA

OTHER

Sponsor Role collaborator

Cardiff University

OTHER

Sponsor Role collaborator

Medical University of Vienna

OTHER

Sponsor Role collaborator

Bielefeld University

OTHER

Sponsor Role collaborator

University Jaume I Castellon

UNKNOWN

Sponsor Role collaborator

Association of Systemic Therapists Education Centre

UNKNOWN

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

Role: PRINCIPAL_INVESTIGATOR

Institute for Marriage, Family and Systemic Practice - ALTERNATIVA

Galina Dr Lesco

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

Locations

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Health For Youth Association

Chisinau, , Moldova

Site Status RECRUITING

Institute for Marriage, Family and Systemic Practice - ALTERNATIVA

Skopje, , North Macedonia

Site Status RECRUITING

Countries

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Moldova North Macedonia

Central Contacts

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Heather M Foran, Prof

Role: CONTACT

+4346027001641

Antonio Piolanti, Dr

Role: CONTACT

Facility Contacts

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Galina Lesco, Dr.

Role: primary

Viorel Babii

Role: backup

Marija Raleva, Prof.

Role: primary

Slavica Gajdadzis-Knezhevikj, Dr.

Role: backup

Other Identifiers

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20230135

Identifier Type: -

Identifier Source: org_study_id

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