Speakers
Margaret Kuklinski, PhD
Endowed Associate Professor of Prevention in Social Work
Director, Social Development Research Group
Acting Director, Center for Communities That Care
School of Social Work, University of Washington
Stacy Sterling, DrPH, MSW
Kaiser Permanente Division of Research
Co-Director, Center for Addiction and Mental Health Research
Associate Adjunct Professor, UCSF Department of Psychiatry and Behavioral Sciences
Associate Professor, Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine
Keywords
Pragmatic Clinical Trial, GGC4H, Prevention
Key Points
- Guiding Good Choices for Health Study (GGC4H) is about the Guiding Good Choices (GGC) intervention, a group-based program for parents and caregivers of younger adolescents (ages 9-14). The intervention has been shown in two previously study trials to better family and adolescent health outcomes.
- GGC4H chose a parent-focused prevention and health promotion because stronger bonds with family results in better health and educational outcomes, and they are cost effective. Across 5 sessions, GGC4H offers strategies for promoting health and wellbeing, such as setting healthy and clear guidelines, positive discipline, dealing with anger constructively, resisting negative influences (with adolescents) and strengthening bonds and building life skills.
- GGC4H is a 5-year, longitudinal cluster-randomized trial that took place in pediatric primary care. The study randomized 75 pediatricians and recruited 1,975 adolescents in 2 cohorts that were gender balanced, racially and ethnically diverse. The study offered GGC to all caregivers in the intervention arm, using 2 modalities, virtual groups and digital self-guided.
- GG4CH conducted 4 studies asking 1) Do caregivers want virtual parenting support? 2) Can virtual GGC be delivered with fidelity? 3) Is virtual GGC satisfying to parents and 4) What do health care system leaders say? The study found that virtual parenting support coincided with the COVID-19 and helped families deal with the impact of the pandemic; GGC was delivered with high fidelity across cohorts, sessions, and sites; parents were satisfied with virtual GGC, with parents valuing the flexibility, connection and community.
- GG4CH identified strengths of the intervention and barriers through interviews with health care system leaders. Resources are a perennial challenge, pediatric well visits are full of competing priorities, and return of investment takes time to unfold. The most effective levers to move toward widespread adoption are systems level support normalizing prevention; national guidelines and performance measures; cost-effectiveness evidence; and a groundswell of interest from parents and clinicians.
Discussion Themes
-How do you most effectively move this toward adoption? There is a growing appreciation for integrated behavior health and the crisis that our adolescents are facing. Health system leaders are aware that and there is an interest in addressing social determinates of health and adverse childhood experiences. Taking advantage of the momentum in terms of screening programs and other programs that will address these factors, hopefully health system leaders will see Guiding Good Choices as a way to help?
-What was the biggest surprise coming out of these studies to you? I don’t know that it is a surprise as much as a heartening thing but to see in the parent quotes the affirmation of wanting bonding and be willing to give their time and to talk about the value of that, it is affirming of a program like GGC. I was surprised and pleased by how well the virtual adaption went. It was a huge amount of work during the scary time of the beginning of COVID.
Tags
#pctGR, @Collaboratory1