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Factors influencing the efficacy of an online behavioural intervention for children and young people with tics: Process evaluation of a randomised controlled trial

Khan, Kareem; Hollis, Chris; Hall, Charlotte L.; Davies, E. Bethan; Murray, Elizabeth; Andrén, Per; Mataix-Cols, David; Murphy, Tara; Glazebrook, Cris

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Authors

CHRIS HOLLIS chris.hollis@nottingham.ac.uk
Professor of Child and Adolescent Psychiatry and Digital Mental Health

E. Bethan Davies

Elizabeth Murray

Per Andrén

David Mataix-Cols

Tara Murphy

CRIS GLAZEBROOK cris.glazebrook@nottingham.ac.uk
Professor of Health Psychology



Abstract

The Online Remote Behavioural Intervention for Tics (ORBIT) trial found that an internet-delivered, therapist-supported, and parent-assisted Exposure and Response Prevention (ERP) intervention reduced tic severity and improved clinical outcomes. This process evaluation aimed to explore mechanisms of impact and factors influencing efficacy. Participants were 112 children with a tic disorder and their parents randomised to the active intervention arm of the ORBIT trial. Child engagement was assessed by usage metrics and parent engagement by chapter completion. Experiences of the digital intervention were explored by semi-structured interviews. Outcomes (3-months post randomisation) were change in tic severity and overall clinical improvement. Tic severity reduced from baseline to 3-month follow-up and 36% were rated as much improved clinically. Greater tic severity at baseline predicted reduction in tic severity. Parental engagement was the only independent predictor of clinical improvement. There were no statistically significant mediators or moderators of the relationship between level of child engagement and outcome. From the qualitative findings, child participants appreciated working together with parents on the intervention and participants found the intervention engaging. ORBIT may be an effective and acceptable intervention for children and young people with tic disorders, with parental engagement being a key factor in successful outcomes.

Citation

Khan, K., Hollis, C., Hall, C. L., Davies, E. B., Murray, E., Andrén, P., …Glazebrook, C. (2022). Factors influencing the efficacy of an online behavioural intervention for children and young people with tics: Process evaluation of a randomised controlled trial. Journal of Behavioral and Cognitive Therapy, 32(3), 197-206. https://doi.org/10.1016/j.jbct.2022.02.005

Journal Article Type Article
Acceptance Date Feb 21, 2022
Online Publication Date Mar 21, 2022
Publication Date 2022-09
Deposit Date Mar 7, 2022
Publicly Available Date Mar 28, 2024
Journal Journal of Behavioral and Cognitive Therapy
Electronic ISSN 2589-9791
Peer Reviewed Peer Reviewed
Volume 32
Issue 3
Pages 197-206
DOI https://doi.org/10.1016/j.jbct.2022.02.005
Keywords Psychiatry and Mental health; Clinical Psychology; Neuropsychology and Physiological Psychology
Public URL https://nottingham-repository.worktribe.com/output/7562577
Publisher URL https://www.sciencedirect.com/science/article/pii/S2589979122000142

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