Can we achieve better trial recruitment by presenting patient information through multimedia? Meta-analysis of 'studies within a trial' (SWATs).

BACKGROUND: People need high-quality information to make decisions about research participation. Providing information in written format alone is conventional but may not be the most effective and acceptable approach. We developed a structure for the presentation of information using multimedia which included generic and trial-specific content. Our aim was to embed 'Studies Within A Trial' (SWATs) across multiple ongoing trials to test whether multimedia presentation of patient information led to better rates of recruitment. METHODS: Five trials included a SWAT and randomised their participants to receive a multimedia presentation alongside standard information, or standard written information alone. We collected data on trial recruitment, acceptance and retention and analysed the pooled results using random effects meta-analysis, with the primary outcome defined as the proportion of participants randomised following an invitation to take part. RESULTS: Five SWATs provided data on the primary outcome of proportion of participants randomised. Multimedia alongside written information results in little or no difference in recruitment rates (pooled odds ratio = 0.96, 95% CI: 0.79 to 1.17, p-value = 0.671, I2 = 0%). There was no effect on any other outcomes. CONCLUSIONS: Multimedia alongside written information did not improve trial recruitment rates. TRIAL REGISTRATION: ISRCTN71952900, ISRCTN 06710391, ISRCTN 17160087, ISRCTN05926847, ISRCTN62869767.

Collaborative Problem Solving reduces children's emotional and behavioral difficulties and parenting stress: Two key mechanisms.

OBJECTIVES: This study aimed to evaluate the effectiveness of the Collaborative Problem Solving (CPS) approach in home-based family therapy and to explore two hypothesized mechanisms of change. METHOD: Sixty-seven families with children aged 3-12 years old completed a 12-week home-based CPS treatment program. Parent-report measures were completed pre- and post-intervention, including measures on parents' fidelity of using CPS, parents' empathy, children's executive functioning, children's behavioral difficulties, and parenting stress. RESULTS: There were significant reductions in children's behavioral difficulties and parenting stress, and significant improvements in children's executive functioning and parents' empathy. These improvements were greatest for parents who had the greatest fidelity to CPS. Improvements in children's executive functioning and parents' empathy mediated the relationship between parents' CPS fidelity and outcomes. CONCLUSIONS: These results provide evidence that home-based family treatment with CPS may achieve positive child and family outcomes by building children's executive function skills and improving parents' empathy.