Maternal outcomes of a randomized controlled trial of a community-based support program for families of children with chronic illnesses

Background: Parents of children with chronic illnesses are at high risk for secondary mental health problems, such as anxiety and depression. Objective: To evaluate maternal outcomes of a support intervention for families of children with selected chronic illnesses. Design: A randomized controlled clinical trial design with repeated measures 1 year apart. Setting: A community-based family support intervention linked to subspecialty and general pediatric clinics and practices in a metropolitan area. Participants: A population-based sample of 193 mothers of children aged 7 to 11 years; the children were diagnosed as having diabetes, sickle cell anemia, cystic fibrosis, or moderate to severe asthma. About 15% of the persons contacted refused to participate in the research, and 14% of the families were lost to follow-up. Intervention: The 15-month intervention, the Family-to-Family Network, was designed to enhance mothers' mental health by linking mothers of school-aged children with selected chronic illnesses with mothers of older children with the same condition. The program included telephone contacts, face-to-face visits, and special family events. Main Outcome Measures: Beck Depression Inventory score and the Psychiatric Symptom Index. Results: Maternal anxiety scores for participants in the experimental group decreased during the intervention period for all diagnostic groups and for the total group; scores for the control group increased (F=5.07, P=.03). In multiple regression analyses, the intervention group was a significant predictor of posttest anxiety scores (P=.03). Effects were greater for mothers with high baseline anxiety (P<.001) and for those who were themselves in poor health (P<.01). Conclusions: A family support intervention can have beneficial effects on the mental health status of mothers of children with chronic illnesses. This type of intervention can be implemented in diverse pediatric settings.