Cluster-randomised controlled trial of an occupational therapy intervention for children aged 11-13 years, designed to increase participation in order to prevent symptoms of mental illness

Journal article

Tokolahi E., Vandal A., Kersten, P., Pearson J. and Hocking C. 2018. Cluster-randomised controlled trial of an occupational therapy intervention for children aged 11-13 years, designed to increase participation in order to prevent symptoms of mental illness. Child and Adolescent Mental Health. 23 (4), pp. 313-327. https://doi.org/10.1111/camh.12270
AuthorsTokolahi E., Vandal A., Kersten, P., Pearson J. and Hocking C.
Abstract

Background
The impact of occupational therapy on mental health outcomes for children is largely unexplored. The aim of this study was to investigate an evidence-based occupational therapy intervention designed to increase participation in daily occupations to prevent symptoms of mental illness for children and run in schools.

Methods
The study used a pragmatic, cluster-randomised controlled trial design with two arms. Fourteen clusters (schools), equating to 151 child participants, were stratified by school decile-rank category and block randomised. Blinding of participants post-randomisation was not feasible; however, outcomes assessors were blinded. Outcomes were measured at baseline, after the parallel and crossover phases, and at follow-up; and were anxiety symptoms (primary), depression symptoms, self-esteem, participation and wellbeing. Intention-to-treat analysis was applied and mixed linear modelling was used to account for clusters and repeated measures, and to adjust for covariates identified.

Results
This trial found significant positive effects of the intervention on child-rated satisfaction with their occupational performance and teacher-rated child anxiety. No evidence was found to support the effect of the intervention on anxiety and depression symptoms, self-esteem and wellbeing.

Conclusions
This was the first known cluster-randomised controlled trial to investigate an occupational therapy intervention promoting emotional wellbeing in a non-clinical sample of children. No compelling evidence was found to support the use of the intervention in schools in its current format, however, results were promising that the focus on occupations influenced participation. Recommendations are made to redesign the intervention as an embedded intervention in the classroom, cotaught by teachers and including parental involvement.

KeywordsActivity level; Early intervention; Self-esteem; Emotional health; School children
Year2018
JournalChild and Adolescent Mental Health
Journal citation23 (4), pp. 313-327
PublisherWiley
ISSN1475-357X
1475-3588
Digital Object Identifier (DOI)https://doi.org/10.1111/camh.12270
Official URLhttps://acamh.onlinelibrary.wiley.com/doi/abs/10.1111/camh.12270
FunderAuckland University of Technology (AUT) Vice Chancellors Scholarship
AUT Centre for Person-Centred Research
Oakley Mental Health Foundation: Youth Fund
Lotteries Translational Research
Warehouse Ltd
Publication dates
Online24 Mar 2018
Publication process dates
Accepted13 Feb 2018
Deposited08 Jul 2022
Accepted author manuscript
License
Output statusPublished
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