The Incredible Years Parenting and Child Treatment Programs: A Randomized Controlled Trial in a Child Welfare Setting in Spain

Abstract Introduction. GeneXpert® MTB/RIF (Xpert) is now widely distributed in high human immunodeficiency virus (HIV)/tuberculosis (TB)-burden countries. Yet, whether the test improves patient-important outcomes within HIV treatment programs in limited resource settings is unknown. Methods. To investigate whether use of Xpert for TB screening prior to initiation of antiretroviral treatment (ART) improves patient-important outcomes, in a pragmatic randomized controlled trial we assigned 424 patients to Xpert or fluorescence sputum smear microscopy (FM) at ART initiation. The primary endpoint was a composite of 3-month mortality and ART-associated TB. Results. There was no difference in overall TB diagnosis at ART initiation (20% [n = 43] Xpert vs 21% [n = 45] FM; P = .80), with most patients in both groups treated empirically. There was no difference in time to TB treatment initiation {5 days (interquartile range [IQR], 3–13) vs 8 days [IQR, 3–23; P = .26]} or loss to follow-up (32 [15%] vs 38 [18%]; P = 0.38). Although a nonsignificant reduction in mortality occurred in the Xpert group (11 [6%] vs 17 [10%]; 95% CI, −9% to 2%; P = .19), there was no difference in the composite outcome (9% [n = 17] Xpert vs 12% [n = 21] FM; difference −3%; 95% CI, −9% to 4%). Conclusions. Among HIV-infected initiating ART, centralized TB screening with Xpert did not reduce the rate of ART-associated TB and mortality, compared with fluorescence microscopy.

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Results from a randomized controlled trial of team decision-making in child welfare

Children and Youth Services Review ◽

10.1016/j.childyouth.2021.106263 ◽

2021 ◽

Vol 131 ◽

pp. 106263

Author(s):

Berenice Rushovich ◽

Allison Hebert ◽

David Crampton ◽

Karin Malm

Keyword(s):

Decision Making ◽

Randomized Controlled Trial ◽

Child Welfare ◽

Controlled Trial ◽

Team Decision Making ◽

Randomized Controlled ◽

Team Decision

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Housing instability and child welfare: Examining the delivery of innovative services in the context of a randomized controlled trial

Children and Youth Services Review ◽

10.1016/j.childyouth.2019.104578 ◽

2020 ◽

Vol 108 ◽

pp. 104578 ◽

Cited By ~ 1

Author(s):

Cyleste C. Collins ◽

Rong Bai ◽

Robert Fischer ◽

David Crampton ◽

Nina Lalich ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Child Welfare ◽

Controlled Trial ◽

Housing Instability ◽

Randomized Controlled

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A Randomized Controlled Trial of Family Finding

Evaluation Review ◽

10.1177/0193841x17689971 ◽

2017 ◽

Vol 41 (6) ◽

pp. 542-567 ◽

Cited By ~ 4

Author(s):

Sharon Vandivere ◽

Karin E. Malm ◽

Tiffany J. Allen ◽

Sarah Catherine Williams ◽

Amy McKlindon

Keyword(s):

At Risk ◽

North Carolina ◽

Randomized Controlled Trial ◽

Foster Care ◽

Child Welfare ◽

Controlled Trial ◽

Outcome Data ◽

Randomized Controlled ◽

Older Youth ◽

Youth At Risk

Background: Youth who have experienced foster care are at risk of negative outcomes in adulthood. The family finding model aims to promote more positive outcomes by finding and engaging relatives of children in foster care in order to provide options for legal and emotional permanency. Objectives: The present study tested whether family finding, as implemented in North Carolina from 2008 through 2011, improved child welfare outcomes for youth at risk of emancipating foster care without permanency. Research Design: A randomized controlled trial evaluation was carried out in nine counties in North Carolina. All children eligible for intervention services between 2008 and 2011 underwent random assignment. Effects were tested with an intent-to-treat design. Outcome data were obtained for all subjects from child welfare administrative data. Additional outcome data for a subset of older youth came from in-person interviews. Subjects: Subjects included 568 children who were in foster care, were 10–17 years old (at time of referral), had no identified permanent placement resource, and had no plan for reunification. Measures: The confirmatory outcome was moves to more family-like placements, whether through a step-down in foster care placement or discharge from foster care to legal permanency. Results: No impact on the confirmatory outcome was observed. Findings regarding exploratory impacts are also described; these must be interpreted with caution, given the large number of outcomes compared. Conclusions: The evaluation failed to find evidence that family finding improves the outcomes of older youth at risk of emancipation from foster care.

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Improving Treatment Outcome in Children With Obesity by an Online Self-Control Training: A Randomized Controlled Trial

Frontiers in Pediatrics ◽

10.3389/fped.2021.794256 ◽

2021 ◽

Vol 9 ◽

Author(s):

Eline Vermeiren ◽

Tiffany Naets ◽

Annelies Van Eyck ◽

Leentje Vervoort ◽

Marijke Ysebaert ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Treatment Outcome ◽

Controlled Trial ◽

Obesity Treatment ◽

Self Control ◽

Long Term Results ◽

Treatment Programs ◽

Randomized Controlled ◽

Present Trial

Background: Currently available treatment programs for children with obesity only have modest long-term results, which is (at least partially) due to the poorer self-control observed within this population. The present trial aimed to determine whether an online self-control training, training inhibition, and redirecting attentional bias, can improve the short- and long-term treatment outcome of (in- or outpatient) child obesity treatment programs.Methods: In this double-blind multi-center randomized controlled trial (RCT), participants aged 8–18 years with obesity were allocated in a 1:1 ratio to receive an online self-control or sham training added to their in- or outpatient multidisciplinary obesity treatment (MOT) program. The primary endpoint was BMI SDS. Data were analyzed by linear mixed models and the main interactions of interest were randomization by time and randomization by number of sessions, as the latter was cumulatively expressed and therefore represents the effect of increasing dose over time.Results: One hundred forty-four inpatient (mean age 14.3 ± 2.2 years, BMI 2.7 ± 0.4 SDS, 42% male) and 115 outpatient children (mean age 11.9 ± 2.1 years, BMI 2.4 ± 0.4 SDS, 45% male) were included. Children's BMI lowered significantly during treatment in both the in- and outpatient treatment centers, p < 0.001. In a mixed model with BMI as dependent variable, randomization by time was non-significant, but the number of self-control trainings (randomization * number of sessions) interacted significantly with setting and with age (p = 0.002 and p = 0.047), indicating a potential effect in younger inpatient residents. Indeed, a subgroup analysis on 22 inpatient children of 8–12 years found a benefit of the number of self-control trainings on BMI (p = 0.026).Conclusions: The present trial found no benefit of the self-control training in the entire study population, however a subgroup of young, inpatient participants potentially benefited.

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