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Trial registered on ANZCTR
Registration number
ACTRN12624000818538
Ethics application status
Approved
Date submitted
29/05/2024
Date registered
3/07/2024
Date last updated
3/07/2024
Date data sharing statement initially provided
3/07/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Implementation and effectiveness of the Connect for Relative/Kinship Carers program
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Scientific title
A randomised controlled trial to evaluate the effectiveness of an attachment- and trauma-informed parent program in relative/kinship care
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Secondary ID [1]
312245
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
This study protocol is based on the preliminary findings from a pilot randomised controlled trial of Connect for Relative/Kinship Carers (please see ACTRN12617000946314)
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Health condition
Health condition(s) or problem(s) studied:
Child mental health problems
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Complex trauma
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Trauma-informed caregiving
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Condition category
Condition code
Mental Health
330623
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0
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Other mental health disorders
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Public Health
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0
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Other public health
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This randomised controlled trial aims to evaluate the implementation and effectiveness of Connect for Relative/Kinship Carers (Connect-Rel/Kin Carers; Moretti, Ostling, & Pasalich, 2017; Pasalich et al., 2021), which is an adaptation of the Connect parent program (Moretti, Pasalich, & O’Donnell, 2018; Moretti, 2020).
Connect-Rel/Kin Carers has been tailored to the specific needs of relative/kinship caregivers and the children in their care. The program is trauma-informed and incorporates key principles from attachment theory which are applied to the context of relative/kinship care. These intervention features are significant for promoting the wellbeing and resilience of children in relative/kinship care who have histories of trauma and disrupted attachment relationships.
Connect-Rel/Kin Carers will be implemented by caseworkers and practitioners who will be trained in the manualised intervention and then provided with weekly supervision while delivering their first parent group. Caseworkers/practitioners will be trained in the program by members of the research team. Training will take place roughly 4 weeks before the first study cohort is recruited and will involve attendance at 6 half-day training sessions.
Two caseworkers/practitioners will co-facilitate each parent group of around 10 relative/kinship caregivers. Groups will meet weekly for 1.5 hours over 9 weeks. Each Connect-Rel/Kin Carer session introduces an attachment principle that relates to child development, trauma and sensitive caregiving, and captures a key aspect of the caregiver-child relationship and common parenting challenges (e.g., empathy, conflict, growth and change). Experiential activities, including role-plays and reflection exercises, are used to illustrate each principle and build caregiver sensitivity and skills to promote secure attachment and family connectedness.
Intervention fidelity will be assessed using an observational scale developed for the program (see Pasalich et al., 2021) and other indicators of program attendance (e.g., session attendance, program dropouts) will be measured using reports provided by program facilitators.
References:
Moretti, M. M. (2020). Connect: An Attachment Based and Trauma Informed Program for Parents and Caregivers, Third Edition,TM ©. Department of Psychology, Simon Fraser University.
Moretti, M. M., Ostling, O., & Pasalich, D. S. (2017). Connect for Kinship Parents. Department of Psychology, Simon Fraser University
Moretti, M. M., Pasalich, D. S., & O’Donnell, K. A. (2018). An attachment-based program for parents of teens. In H. Steele & M. Steele (Eds.), Handbook of attachment-based interventions. New York, NY: Guilford Press.
Pasalich, D. S., Moretti, M. M., Hassall, A., & Curcio, A. (2021). Pilot randomized controlled trial of an attachment-and trauma-focused intervention for kinship caregivers. Child Abuse & Neglect, 120, 105178.
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Intervention code [1]
328693
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Behaviour
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Intervention code [2]
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Treatment: Other
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Comparator / control treatment
Relative/kinship caregivers in the delayed intervention control group will receive care as usual (CAU). CAU includes appropriate support and intervention services provided by child protection or out-of-home care agencies and/or by mental health and other health specialists (based on referrals made by agency staff). Data will be collected regarding the type and frequency of CAU services received by families in both the experimental and control conditions. Relative/kinship caregivers in the control group will be invited to participate in Connect-Rel/Kin Carers six months after completing the baseline assessment.
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Control group
Active
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Outcomes
Primary outcome [1]
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Intervention Fidelity
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Assessment method [1]
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Observed fidelity: Adherence to manual content and competence in delivery as measured by observational ratings of practitioners’ fidelity to the program (e.g., Pasalich et al., 2021)
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Timepoint [1]
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Assessed at post-intervention (10 weeks after baseline).
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Primary outcome [2]
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Program Acceptability (composite outcome)
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Assessment method [2]
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Carers' attendance, completion, and self-reported satisfaction with the program via questionnaire caseworker/practitioners’ satisfaction with the training and program as assessed by a 14-item satisfaction survey (questionnaire specifically designed for this study).
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Timepoint [2]
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Carers’ outcomes assessed post-intervention (10 weeks after baseline); practitioners’ outcomes assessed post- training (immediately after the 3-day practitioner training).
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Primary outcome [3]
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Change in children's mental health (composite outcome)
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Assessment method [3]
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Strengths and Difficulties Questionnaire (SDQ) measuring mental health problems and prosocial behaviour; Affect Regulation Checklist; Inventory of Callous-Unemotional Traits (ICU).
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Timepoint [3]
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Assessed at baseline, post-intervention (10 weeks after baseline) and 6-month follow-up.
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Secondary outcome [1]
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Change in the quality of the caregiver-child relationship (composite primary outcome)
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Assessment method [1]
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Measured by the Child-Parent Attachment Inventory, Revised Conflict Tactics Scale and the Five-Minute Speech Sample (interview/observational assessment of caregiving and relationship quality).
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Timepoint [1]
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Assessed at baseline, post-intervention (10 weeks after baseline) and 6-month follow-up.
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Secondary outcome [2]
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Change in caregivers’ relational regulatory capacity (composite outcome)
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Assessment method [2]
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Measured by the Caregiver Strain Questionnaire - Short Form, the Parenting Sense of Competence Scale, and the Interpersonal Mindfulness in Parenting Scale.
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Timepoint [2]
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Assessed at baseline, post-intervention (10 weeks after baseline) and 6-month follow-up.
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Secondary outcome [3]
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Change in the quality of caregiving, specifically caregivers’ parental reflective functioning, parenting joy, and commitment (composite outcome)
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Assessment method [3]
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Measured by the Parental Reflective Functioning Questionnaire, the Parent-Child Joy Scale, and the Caregiver Commitment Questionnaire.
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Timepoint [3]
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Assessed at baseline, post-intervention (10 weeks after baseline) and 6-month follow-up.
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Secondary outcome [4]
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Placement Stability
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Assessment method [4]
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Measured using carer reports and administrative data from child protection regarding unplanned placement changes (eg, new placement in out-of-home care).
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Timepoint [4]
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Assessed at 6-month follow-up.
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Eligibility
Key inclusion criteria
Relative/kinship caregivers will be eligible to participate in the study if they are currently caring for at least one child aged 4-17 years and the child has resided in their current kinship care placement for at least four weeks.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Exclusion criteria will include relative/kinship caregivers of children with psychosis, acute suicidality, and/or severe developmental or intellectual disability.
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participant recruitment and allocation will occur in cohorts at several different times across the duration of the study. Relative/kinship caregivers will be identified and then individually screened for eligibility. After obtaining participant consent, caregivers will complete the baseline assessment and will then be randomly allocated to either the intervention or control condition. To ensure concealment of the allocation sequence, a researcher who is not directly involved in the study will (only) be given the study IDs of the enrolled participants and will use a computer-generated randomisation list to randomly assign participants to a condition.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
To ensure that the conditions are balanced with respect to child demographics, randomisation will be stratified by child age (4-10 years, 11-17 years) and gender. Randomisation will be based on a computer-generated randomisation list.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Implementation outcomes will be chiefly examined using descriptive statistics. To evaluate effectiveness outcomes, “Intent to treat” ANCOVA models will be used to examine group differences (Connect-Rel/Kin Carer vs. control) on child and caregiver outcomes at post-intervention and follow-up time points, controlling for scores at baseline. Fisher's exact test will examine the association between group (Connect-Rel/Kin Carer vs. control) and unplanned placement changes at 6-month follow-up.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
22/07/2024
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Actual
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Date of last participant enrolment
Anticipated
22/07/2026
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Actual
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Date of last data collection
Anticipated
1/05/2027
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Actual
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Sample size
Target
120
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
ACT,NSW
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Australian Research Council
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Address [1]
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
A/Prof Dave Pasalich
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Address
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Country
Australia
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Secondary sponsor category [1]
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Government body
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Name [1]
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ACT Community Services Directorate
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Address [1]
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Country [1]
318808
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Australia
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Secondary sponsor category [2]
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Government body
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Name [2]
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NSW Department of Communities and Justice
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Address [2]
318809
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Country [2]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Australian National University Human Research Ethics Committee
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Ethics committee address [1]
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https://services.anu.edu.au/research-support/ethics-integrity
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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31/03/2023
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Approval date [1]
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03/04/2023
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Ethics approval number [1]
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2017/462
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Summary
Brief summary
The goals of this research project are to evaluate the implementation and effectiveness of an attachment-based and trauma-informed intervention for relative/kinship caregivers. The program is delivered in group format across 9 weekly 1.5 hr sessions and introduces caregivers to a set of attachment-informed principles relating to sensitive caregiving, child and youth development and family wellbeing. Overall, the program aims to reduce caregiver strain and promote caregivers' understanding of and sensitive responding to their child's attachment needs, and, in turn, strengthen the quality of the caregiver-child relationship and promote children's behavioural and socio-emotional wellbeing.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Dave Pasalich
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Address
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School of Medicine and Psychology, ANU College of Health and Medicine, Building 39 Science Rd, Canberra ACT 2601
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Country
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Australia
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Phone
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+61 02 6125 2067
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dave Pasalich
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Address
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School of Medicine and Psychology, ANU College of Health and Medicine, Building 39 Science Rd, Canberra ACT 2601
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Country
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Australia
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Phone
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+61 02 6125 2067
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dave Pasalich
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Address
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School of Medicine and Psychology, ANU College of Health and Medicine, Building 39 Science Rd, Canberra ACT 2601
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Country
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Australia
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Phone
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+61 02 6125 2067
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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