Peer Review Report For: Supporting parents with psychosis in adult mental health services: protocol for a feasibility trial of the self-directed Triple P Positive Parenting Programme (The PIPPA study) [version 1; peer review: 1 approved with reservations]

Abstract

Background Caring for children while experiencing psychosis can be difficult for parents, and their children risk poorer outcomes. Despite strong evidence for parenting interventions in the general population, it is not known if parents with psychosis find them acceptable or useful. This paper describes a study designed to investigate the feasibility and acceptability of conducting a randomised controlled trial (RCT) of an evidence-based parenting intervention for parents with psychosis in adult mental health services. Methods/Design In this two-arm rater-blind feasibility RCT of the self-directed version of the Triple P Positive Parenting Programme, participants will be allocated 2:1 to Triple P plus treatment as usual (TAU), or TAU alone. We will determine if we can recruit and retain 50 parents and assess if the intervention and study procedures are acceptable. A nested mixed methods process evaluation will also inform feasibility and acceptability. Self-report and observer-rated assessments will be conducted at baseline, 16 weeks post-randomisation and six and nine months post-randomisation to examine changes in clinical and economic outcomes including parenting stress, parental mental health, child behaviour, health-related quality of life and health status. Results Descriptive summaries will be produced for feasibility outcomes including consent, recruitment and retention rates; engagement with the intervention; outcome completion rate and number of adverse events. Randomised groups will be compared on clinical and economic outcomes using ANCOVA, adjusting for their baseline values and prognostic variables. Interview data will be analysed using framework analysis (care coordinators and parents) and interpretive phenomenological analysis (children). Discussion This is the first controlled trial to test feasibility, acceptability, uptake, retention, and potential efficacy of a parenting intervention for parents with psychosis. This study is essential to examine the contextual challenges involved in this setting with this population to optimise intervention delivery and study design for a future definitive full-scale RCT. Trial Registration Prospective ISRCTN registration (08/01/2024): ISRCTN 11847322; https://doi.org/10.1186/ISRCTN11847322