A digital parent skills training programme for parents of children with intellectual disabilities

Background: A high proportion of children with intellectual disabilities (ID) have clinically concerning levels of behaviour problems, coupled with elevated parental psychosocial health difficulties. Digital technology provides an unparalleled opportunity to deliver support interventions for families caring for a child with ID.

Aim: The primary aim of this study is to design a trial to examine the effectiveness and cost effectiveness of the Stepping Stones Triple P (SSTP) online parenting programme. The research team and collaborating organisations will work together to address six specific objectives to inform the design of a randomised controlled trial to achieve this aim. The objectives are:

1 Intervention delivery: Explore views on delivering the SSTP online parent skills programme with or without additional guidance. If consensus is that additional guidance/support is indicated, we will explore questions including how much support, who might deliver such support, and what form this support might take. Revise the current SSTP Logic Model.

2 Optimising engagement: Determine the potential barriers for parents in engaging with and maintaining engagement in a digital self-directed parenting programme and how best to overcome these.

3 Recruitment pathways: Determine the optimal way to recruit parents with a child with ID to a future trial. Explore potential recruitment pathways with practitioners and social care organisations, schools and support and advocacy/community organisations. Build relationships with organisations to facilitate recruitment for a future trial and seek initial agreement for Local Authorities to be involved as sites in a future trial.

4 Outcome measures: Review, seek PPI input about, and determine a candidate set of outcome measures as guided by the revised logic model for SSTP online. Measures will address key outcomes such as child behaviour and emotional problems, parenting practices, parent mental health and wellbeing, and family functioning. Guided by the Logic Model, a primary outcome for a future trial will be selected. Explore data collection tools for a health economics evaluation.

5 Intervention costs: Explore options for funding the intervention costs involved in delivering the SSTP online in the context of a randomised controlled trial. 6 Design of a future trial: Design a future trial to evaluate the SSTP online parent skills training programme.

Methods: We will work together with our PPI partner co-applicant Allard and the Council for Disabled Children (CDC) and PPI co-applicant Griffin to recruit parents to join a co-production group to work in partnership with the study team to address the key questions in relation to Objectives 1-4.

We will recruit up to six practitioners/senior staff from organisations that deliver Triple P and/or Triple P online, local authorities, and community-based organisations delivering parenting/family support for families of children with ID. Practitioners/senior staff will be invited to a consultation group to work with the study team to address Objectives 1-4.

Outputs: Study outputs will include a plan for a randomised controlled trial to examine the effectiveness and cost effectiveness of the SSTP online parent skills training programme, a SSTP online Logic Model, and a grant application to NIHR HTA. Within the 12 month period, we will also produce a journal article about the PPI co-production process integrated with the consultative model with professionals.