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Trial registered on ANZCTR


Registration number
ACTRN12625000972426
Ethics application status
Approved
Date submitted
10/08/2025
Date registered
3/09/2025
Date last updated
3/09/2025
Date data sharing statement initially provided
3/09/2025
Type of registration
Prospectively registered

Titles & IDs
Public title
Evaluating the effect of 'Partners in Parenting-Peer-to-Parent' (PiP-P2P) program for parents of adolescents with anxiety and depression on parenting skills and adolescent anxiety and depression symptoms
Scientific title
Prospective, parallel-group intention-to-treat randomised-controlled trial (RCT) to examine the effect of a peer-coach supported, online parenting program (‘Partners in Parenting-Peer-to-Parent; PiP-P2P’) for parents of adolescents with anxiety and depression, on parenting skills and adolescent anxiety and depression symptoms
Secondary ID [1] 314692 0
Nil known
Universal Trial Number (UTN)
U1111-1321-1351
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Parenting risk and protective factors for adolescent depression and anxiety disorders 337868 0
Parental self-efficacy 337869 0
Adolescent depression 337870 0
Adolescent anxiety 337871 0
Carer burden 337872 0
Condition category
Condition code
Public Health 334197 334197 0 0
Health promotion/education
Public Health 334198 334198 0 0
Health service research
Mental Health 334199 334199 0 0
Anxiety
Mental Health 334200 334200 0 0
Depression

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
The intervention, ‘Partners in Parenting-Peer-to-Parent (PiP-P2P)’, is a newly adapted version of a therapist-coach assisted online parenting program, Partners in Parenting Plus (PiP+; formerly known as the Therapist-assisted Online Parenting Strategies [TOPS] program; refer to ACTRN12618000290291). The original PiP+ program is an online parenting program designed to equip parents (refers to any adult in a regular caregiving role) with evidence-based parenting strategies to respond to anxiety or depression in their 12-18-year-old adolescent. Adaptations of PiP+ have since been developed to address specific areas of concern, including school refusal (Partners in Parenting Plus-Education [PiP-Ed+], refer to ACTRN12622000977774) and suicide prevention (Partners in Parenting Plus-Suicide Prevention [PiP-SP+], refer to ACTRN12623000266662).


In PiP-P2P, the coaching support that is provided by trained clinicians in PiP+ is instead provided by family/carer peer coaches, who are family/carer peer support workers with lived experience (FCWLE) of caring for an adolescent with mental health difficulties.


This intervention has two components:
1) a web-based program drawn from the Partners in Parenting intervention (refer to ACTRN12615000328572 and ACTRN12619001781134) which includes a parenting self-assessment with tailored feedback about the parent's current parenting practices and up to 10 web-based modules); and,
2) a coaching component (refer to ACTRN12618000290291) delivered via videoconference, henceforth referred to as ‘PiP-P2P coaching sessions’.


The web-based program includes 10 self-directed online modules covering topics related to parenting an adolescent with anxiety and/or depression: 1) understanding anxiety and depression, 2) parent-teen relationships, 3) minimising conflict in the home, 4) parental involvement and autonomy granting, 5) problem-solving, 6) breaking the anxiety cycle, 7) establishing family rules, 8) encouraging good habits, 9) encouraging supportive relationships, and 10) relapse prevention.


The coaching component involves parents attending a maximum of 10 PiP-P2P coaching sessions with a PiP-P2P coach via online videoconference. Prior to their first session, parents will receive a phone call from a member of the coaching team. The purpose of the phone call will be to introduce the coach and the program to the parent, and confirm the first coaching session.


Parents will be encouraged to complete their PiP-P2P coaching sessions weekly, and will have a maximum of 14 weeks to complete up to 10 coaching sessions. The PiP-P2P coaching sessions will expand on the content of the modules, and peer coaches will draw on their own lived experience to support the parent to apply the content to their own circumstances. Discussions around goal setting and enabling goal attainment are also a focus of these sessions. PiP-P2P coaching sessions are manualised to ensure standardised delivery of the intervention. Each session takes approximately 50-minutes.


PiP-P2P coaches will all be family/carer peer workers with lived experience (FCWLE), who have experience working as a family peer worker at a headspace centre or equivalent setting in Australia. headspace is Australia’s National Youth Mental Health Foundation, providing early intervention mental health services to 12-25 year olds and their families. Coaches will receive standardised training and regular supervision to deliver the manualised PiP-P2P coaching sessions.


Note: Adolescents will not participate in PiP-P2P coaching sessions. It will be recommended that the adolescent receives standard psychological care externally to the intervention as required. Non-participant co-parents of the participating parent will be permitted to join PiP-P2P coaching sessions if requested.


Parents will receive the following as part of the PiP-P2P intervention:


1) Parents first complete an online self-assessment of their parenting practices associated with risk of adolescent depression and anxiety disorders (the Parenting to Reduce Adolescent Depression and Anxiety Scale [PRADAS]). The PRADAS assesses parenting practices in relation to the recommendations in the evidence-base parenting guidelines "How to Prevent Depression and Clinical Anxiety in your Teenager: Strategies for Parents" (Parenting Strategies Program, 2013; henceforth the Guidelines), which form the basis of the program content.


2) Based on their responses to the PRADAS, parents receive an individually-tailored feedback report. The feedback highlights areas of parenting strength and/or confidence, and provides practical strategies for identified areas for improvement. The feedback report is displayed to parents online (via their 'personal dashboard' as part of the PiP website).


3) Parents are recommended up to 10 interactive online modules.
All parents in the current trial will be required to select the following modules, regardless of PRADAS responses, as these are considered critical foundational topics for the program: 1) understanding anxiety and depression, and 2) relapse prevention. Similarly, the parent-teen relationships module will always be recommended, regardless of PRADAS responses. The remaining modules will be recommended based on identified areas for improvement (scores on corresponding PRADAS subscales).


The modules provide practical strategies to support parents to make changes to their parenting, in order to align more closely with the parenting recommendations in the Guidelines. Parents can further tailor their program by selecting additional modules or de-selecting optional modules recommended to them. In addition to the 2 mandatory modules, parents can select between 1 to 8 additional modules to comprise their personalised program. By default, modules will ‘unlock’ (i.e. become available for parents to complete) at a rate of one module per week, until all selected modules have been unlocked. Parents are notified by email and SMS (if they opt in to SMS notifications) when a new module unlocks. If they prefer, parents can choose to override the default unlock date, and unlock modules at an earlier date. After all initially-selected modules have been unlocked, all remaining modules, including those not initially selected, will automatically become available for parents to complete if they wish. Parents can revisit any modules they have already completed at any time.


The interactive modules can be accessed online, from any device with internet access (including smartphones). The modules include educational materials, illustrations, audio clips, videos, vignettes, interactive activities, goal-setting exercises, and an end-of-module quiz with immediate feedback to consolidate learning. Each module takes approximately 20-35 minutes to complete, depending on the topic and how parents engage with the module. Parents are invited to complete their first module immediately after they have completed their baseline survey and received their personalised feedback report.


4) In parallel, parents will attend a maximum of 10 one-on-one PiP-P2P coaching sessions with a PiP-P2P coach via online videoconference. Parents will have a maximum of 14 weeks to complete the 10 PiP-P2P coaching sessions and be encouraged to attend weekly. In each session parents will be guided by their coach through a check-in, a review of the module content, completion of an activity, and a goal-setting exercise, with a view to work towards their selected module goal between PiP-P2P coaching sessions.


Intervention adherence will be monitored through website analytics (e.g., module completion) and attendance records (coaching sessions). Intervention engagement will be explored through: 1) percentage of selected modules completed; and 2) percentage of selected module goals completed.


Modules are considered completed if 80% of pre-specified mandatory activities are completed.
Goal completion will be defined as: a user (the parent, or coach, if applicable) indicates that the selected module goal was ‘attempted’.


Intervention outcomes will be assessed through parent and adolescent online surveys completed at two timepoints: baseline and at post-intervention (120 days/4 months after the parent baseline assessment); and a post-intervention interview with a subgroup of n~15 parents.


Reference:
Cardamone-Breen, M. C., Jorm, A. F., Lawrence, K. A., Mackinnon, A. J., & Yap, M. B. (2017). The Parenting to Reduce Adolescent Depression and Anxiety Scale: Assessing parental concordance with parenting guidelines for the prevention of adolescent depression and anxiety disorders. PeerJ, 5, e3825.
Intervention code [1] 331297 0
Behaviour
Comparator / control treatment
Self-guided PiP - Parents will receive the self-guided version of PiP, as described below.

1) Parents first complete an online self-assessment of their parenting practices associated with risk of adolescent depression and anxiety disorders (the PRADAS). The PRADAS assesses parenting practices in relation to the recommendations in the evidence-base parenting guidelines, the Guidelines, which form the basis of the program content.


2) Based on their responses to the PRADAS, parents receive an individually-tailored feedback report. The feedback highlights areas of parenting strength and/or confidence, and provides practical strategies for identified areas for improvement. The feedback report is displayed to parents online (via their 'personal dashboard' as part of the PiP website).


3) Parents are recommended up to 10 interactive online modules.
All parents in the current trial will be required to select the following modules, regardless of PRADAS responses, as these are considered critical foundational topics for the program: 1) understanding anxiety and depression, and 2) relapse prevention. Similarly, the parent-teen relationships module will always be recommended, regardless of PRADAS responses. The remaining modules will be recommended based on identified areas for improvement (scores on corresponding PRADAS subscales).


The modules provide practical strategies to support parents to make changes to their parenting, in order to align more closely with the parenting recommendations in the Guidelines. Parents can further tailor their program by selecting additional modules or de-selecting optional modules recommended to them. In addition to the 2 mandatory modules, parents can select between 1 to 8 additional modules to comprise their personalised program. By default, modules will ‘unlock’ (i.e. become available for parents to complete) at a rate of one module per week, until all selected modules have been unlocked. Parents are notified by email and SMS (if they opt in to SMS notifications) when a new module unlocks. If they prefer, parents can choose to override the default unlock date, and unlock modules at an earlier date. After all initially-selected modules have been unlocked, all remaining modules, including those not initially selected, will automatically become available for parents to complete if they wish. Parents can revisit any modules they have already completed at any time.


The interactive modules can be accessed online, from any device with internet access (including smartphones). The modules include educational materials, illustrations, audio clips, videos, vignettes, interactive activities, goal-setting exercises, and an end-of-module quiz with immediate feedback to consolidate learning. Each module takes approximately 20-35 minutes to complete, depending on the topic and how parents engage with the module. Parents are invited to complete their first module immediately after they have completed their baseline survey and received their personalised feedback report.


Intervention adherence will be monitored through website analytics (e.g., module completion). Intervention engagement will be explored through: 1) percentage of selected modules completed; and 2) percentage of selected module goals completed.


Modules are considered completed if 80% of pre-specified mandatory activities are completed.
Goal completion will be defined as: a user (the parent, or coach, if applicable) indicates that the selected module goal was ‘attempted’.


Intervention outcomes will be assessed through parent and adolescent online surveys completed at two timepoints: baseline and at post-intervention (120 days/4 months after the parent baseline assessment).


Reference:
Cardamone-Breen, M. C., Jorm, A. F., Lawrence, K. A., Mackinnon, A. J., & Yap, M. B. (2017). The Parenting to Reduce Adolescent Depression and Anxiety Scale: Assessing parental concordance with parenting guidelines for the prevention of adolescent depression and anxiety disorders. PeerJ, 5, e3825.
Control group
Active

Outcomes
Primary outcome [1] 342432 0
Parenting risk and protective factors for adolescent depression and anxiety disorders (henceforth ‘parenting skills’; quantitative)
Timepoint [1] 342432 0
1) Pre-intervention (baseline survey package). 2) Post-intervention: 4-months (120 days, primary timepoint) from baseline assessment completion date. 3) Follow-up: 12-months (360 days) from baseline assessment completion date.
Secondary outcome [1] 450789 0
Parental self-efficacy for managing the risk of adolescent depression and anxiety (quantitative)
Timepoint [1] 450789 0
1) Pre-intervention (baseline survey package). 2) Post-intervention: 4-months (120 days) from baseline assessment completion date. 3) Follow-up: 12-months (360 days) from baseline assessment completion date.
Secondary outcome [2] 450790 0
Parent anxiety symptoms (quantitative)
Timepoint [2] 450790 0
1) Pre-intervention (baseline survey package). 2) Post-intervention: 4-months (120 days) from baseline assessment completion date. 3) Follow-up: 12-months (360 days) from baseline assessment completion date.
Secondary outcome [3] 450791 0
Parent depressive symptoms (quantitative)
Timepoint [3] 450791 0
1) Pre-intervention (baseline survey package). 2) Post-intervention: 4-months (120 days) from baseline assessment completion date. 3) Follow-up: 12-months (360 days) from baseline assessment completion date.
Secondary outcome [4] 450792 0
Carer burden (quantitative)
Timepoint [4] 450792 0
1) Pre-intervention (baseline survey package). 2) Post-intervention: 4-months (120 days) from baseline assessment completion date. 3) Follow-up: 12-months (360 days) from baseline assessment completion date.
Secondary outcome [5] 450793 0
Carer gains (quantitative)
Timepoint [5] 450793 0
1) Pre-intervention (baseline survey package). 2) Post-intervention: 4-months (120 days) from baseline assessment completion date. 3) Follow-up: 12-months (360 days) from baseline assessment completion date.
Secondary outcome [6] 450794 0
Adolescent anxiety symptoms by parent report (quantitative)
Timepoint [6] 450794 0
1) Pre-intervention (baseline survey package). 2) Post-intervention: 4-months (120 days) from baseline assessment completion date. 3) Follow-up: 12-months (360 days) from baseline assessment completion date.
Secondary outcome [7] 450795 0
Adolescent depression symptoms by parent report (quantitative)
Timepoint [7] 450795 0
1) Pre-intervention (baseline survey package). 2) Post-intervention: 4-months (120 days) from baseline assessment completion date. 3) Follow-up: 12-months (360 days) from baseline assessment completion date.
Secondary outcome [8] 450796 0
Adolescent anxiety symptoms by adolescent report (quantitative)
Timepoint [8] 450796 0
1) Pre-intervention (baseline survey package). 2) Post-intervention: 4-months (120 days) from parent baseline assessment completion date. 3) Follow-up: 12-months (360 days) from baseline assessment completion date.
Secondary outcome [9] 450797 0
Adolescent depression symptoms by adolescent report (quantitative)
Timepoint [9] 450797 0
1) Pre-intervention (baseline survey package). 2) Post-intervention: 4-months (120 days) from parent baseline assessment completion date. 3) Follow-up: 12-months (360 days) from baseline assessment completion date.
Secondary outcome [10] 450798 0
Adolescent perceived quality of parental support (quantitative)
Timepoint [10] 450798 0
1) Pre-intervention (baseline survey package). 2) Post-intervention: 4-months (120 days) from parent baseline assessment completion date. 3) Follow-up: 12-months (360 days) from baseline assessment completion date.
Secondary outcome [11] 450799 0
Parent satisfaction with the program (quantitative)
Timepoint [11] 450799 0
1) Post-intervention: 4-months (120 days) from baseline assessment completion date.
Secondary outcome [12] 450800 0
Process evaluation: Intervention Group only (qualitative)
Timepoint [12] 450800 0
1) Post-intervention: Approximately 4-months (120 days) from baseline assessment completion date.

Eligibility
Key inclusion criteria
Group 1:
Parents and/or guardians of adolescents aged 12-17 years who:
- Are concerned about their adolescent’s anxiety and/or depression
- Have sought professional support for their adolescent’s mental health problems (i.e., depression or anxiety) within the past 6 months
- Have regular contact with their adolescent
- Can read, write, speak, and hear in English
- Have regular access to the internet (including email) and a device with video-conferencing capabilities
- Live in Victoria

Group 2:
Adolescents (aged 12-17 years) of participating parents who:
- Are the identified adolescent of the parent participant
Minimum age
12 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
Yes
Key exclusion criteria
Group 1: Parents
1. Parents of an adolescent with a principal mental health condition of sufficient severity to require immediate clinical prioritisation (e.g. current alcohol/substance dependence, acute mental health crisis, recent suicide attempt or inpatient treatment) will not be eligible to participate in the trial.
Justification: The intensity of the program is unlikely to be sufficient for families with such complexities, who would likely require more targeted and multidisciplinary treatment.

2. Parents who are already engaged in another form of parenting intervention (e.g., parenting program, family therapy) with or without their adolescent.
Justification: The PiP intervention involves parenting work, hence it may be contra-indicated alongside other parenting or family therapy treatment.

3. Parents who are experiencing a crisis or ongoing, high level of distress.
Justification: The focus and intensity of the program is not sufficient for parents who are in crisis and likely require targeted support for their own mental health and wellbeing. The program is focused on their adolescent's emerging anxiety and depression.


Group 2: Adolescents
There are no additional exclusion criteria beyond the above mentioned criteria for parents. All adolescents of parents deemed eligible will be eligible to participate.

Study design
Purpose of the study
Educational / counselling / training
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Stratified permuted block randomisation will be used to conceal allocation.

When parents submit their baseline assessment on the trial website, they will be automatically allocated to the intervention or active-control group through stratified permuted block randomisation, through the website. Parents find out their allocation immediately thereafter: both groups receive their tailored feedback, the Parenting Guidelines, and the online parenting program as described above. The intervention group will be contacted by a member of the coaching team to introduce the coach and the coaching program to the parent, and confirm their first session. As such, allocation is concealed from both participants and researchers prior to random assignment.
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Stratified permuted block randomisation. The random sequence generation will be automated within the dedicated trial website. Each parent will be assigned to the intervention or active-control condition in a 1:1 ratio via stratified permuted block randomisation, using pre-generated lists of blocks of 4 or 6 for each strata. Parents will be stratified on two variables:
1. Adolescent age on parent date of registration
2. Whether the adolescent is elevated on either or both of the RCADS-P subscales
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?


The people assessing the outcomes
Intervention assignment
Parallel
Other design features
Phase
Not Applicable
Type of endpoint/s
Efficacy
Statistical methods / analysis

Recruitment
Recruitment status
Not yet recruiting
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
VIC

Funding & Sponsors
Funding source category [1] 319241 0
Government body
Name [1] 319241 0
The Medical Research Future Fund (MRFF), Department of Health
Country [1] 319241 0
Australia
Primary sponsor type
University
Name
Monash University
Address
Country
Australia
Secondary sponsor category [1] 321708 0
None
Name [1] 321708 0
Address [1] 321708 0
Country [1] 321708 0

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 317819 0
Monash University Human Research Ethics Committee
Ethics committee address [1] 317819 0
Ethics committee country [1] 317819 0
Australia
Date submitted for ethics approval [1] 317819 0
21/01/2025
Approval date [1] 317819 0
04/03/2025
Ethics approval number [1] 317819 0
46221

Summary
Brief summary
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 142258 0
Prof Marie Yap
Address 142258 0
School of Psychological Sciences, Building 17, 18 Innovation Walk, Monash University, Clayton, Victoria 3800
Country 142258 0
Australia
Phone 142258 0
+61 3 9905 0723
Fax 142258 0
Email 142258 0
Contact person for public queries
Name 142259 0
Marie Yap
Address 142259 0
School of Psychological Sciences, Building 17, 18 Innovation Walk, Monash University, Clayton, Victoria 3800
Country 142259 0
Australia
Phone 142259 0
+61 3 9903 4042
Fax 142259 0
Email 142259 0
Contact person for scientific queries
Name 142260 0
Marie Yap
Address 142260 0
School of Psychological Sciences, Building 17, 18 Innovation Walk, Monash University, Clayton, Victoria 3800
Country 142260 0
Australia
Phone 142260 0
+61 3 9905 0723
Fax 142260 0
Email 142260 0

Data sharing statement
Will the study consider sharing individual participant data?
Yes
Will there be any conditions when requesting access to individual participant data?
Persons/groups eligible to request access:
Anyone
Conditions for requesting access:
Available to anyone based on Primary Investigator discretion.

What individual participant data might be shared?
De-identified individual participant data:
What types of analyses could be done with individual participant data?
Any purpose approved by the Primary Investigator.

When can requests for individual participant data be made (start and end dates)?
From:
After publication of main results
To:
No end date
Where can requests to access individual participant data be made, or data be obtained directly?
Access subject to approval by Principal Investigator, Prof Marie Yap - [email protected]


Are there extra considerations when requesting access to individual participant data?
No


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.