Background
Anxiety problems are common in children. Fears, worries and anxiety are a normal part of childhood, but for some children anxiety has a negative impact on their day-to-day lives. These children may benefit from support or intervention to help them manage and overcome their difficulties with anxiety.
Psychological treatments work well for children with anxiety difficulties, but very few children access these treatments. Parents report considerable difficulties identifying a child’s anxiety problems and knowing whether a child may benefit from support or not and find it hard to access support and services. We want to find a way to minimise these barriers and help ensure more children with anxiety problems receive effective support when they first need it.
In iCATS-i2i, we are working with parents, children, school staff and others to develop and evaluate a new way of identifying and supporting children with anxiety problems through schools. The project is made up of five different studies. You can find out more about each study below:
Study 1 – Development of a short questionnaire
This study involved 19 schools from across England. In these schools, we asked children in years 4-6, and their parents and teachers, to complete questionnaires about the child’s fears and worries. Children and parents also took part in detailed interviews. We used responses to the questionnaires and the interviews to help us find the best questions to ask to identify which children may be experiencing problems with anxiety.
You can find details of our study protocol below and watch this space for more details on our findings!
Study 2 – Co-design of iCATS-i2i procedures
We worked with parents, children, school staff and other key stakeholders to develop a new way of identifying and supporting children with anxiety problems through schools.
You can find details of our study protocol and other publications below.
Study 3 – Feasibility study
This study involved working with 6 schools to try out the procedures that were developed in Study 2. We wanted to check that the procedures worked well for all involved, and identify any changes that were needed before proceeding to Study 5.
You can find details of our study protocol and other publications below.
Study 4 – Economic impact of elevated child anxiety
Alongside testing the iCATS-i2i procedures in Study 3, our team are also investigating the longer-term impacts and economic costs of child anxiety problems. We are currently conducting a literature review to find studies that have evaluated the outcomes (e.g. future mental health problems) and economic costs (e.g. cost of health care use) of elevated child anxiety. We also plan to use existing UK cohort studies to model the economic impact of elevated child anxiety.
You can find details of our review protocol below.
Study 5 – Cluster Randomised Controlled Trial
Our current ongoing study started in Autumn/Winter 2021. We have recruited 83 schools to work with us to test our ‘identification to intervention’ procedures in a randomised controlled trial.
More than 4500 children and 1500 parents/carers are currently taking part in our study!
You can find details of our study protocol below, and you can find more details about the study here.
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Publications
Please see below for research papers published by the iCATS team:
Study 1 – Development of a short questionnaire
- Study protocol: https://osf.io/ntkga/
Study 2 – Co-design iCATS-i2i procedures
- Study protocol: Codesign and development of a primary school based pathway for child anxiety screening and intervention delivery: a protocol, mixed-methods feasibility study: https://bmjopen.bmj.com/content/bmjopen/11/4/e044852.full.pdf
- Primary school-based screening for childhood mental health problems and intervention delivery: a qualitative study of parents in challenging circumstances: https://www.tandfonline.com/doi/full/10.1080/13632752.2022.2122285
- Primary school based mental health practitioners’ perspectives of school-based screening for childhood mental disorders and intervention delivery: a qualitative study: https://www.tandfonline.com/doi/full/10.1080/13632752.2022.2110704
- School-based screening for childhood anxiety problems and intervention delivery: a codesign approach: https://bmjopen.bmj.com/content/bmjopen/12/6/e058089.full.pdf
Study 3 – Feasibility Study
- Study protocol: https://link.springer.com/article/10.1186/s40814-022-01140-x
- Increasing access to evidence-based treatment for child anxiety problems: online parent-led CBT for children identified via schools: https://acamh.onlinelibrary.wiley.com/doi/full/10.1111/camh.12612
Study 4 – Economic impact of elevated child anxiety
- Study protocol: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=202440
- The multifaceted consequences and economic costs of child anxiety problems: A systematic review and meta‐analysis: https://acamh.onlinelibrary.wiley.com/doi/pdf/10.1002/jcv2.12149
Study 5 – Cluster Randomised Controlled Trial
- Study protocol: https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-022-06773-0
- Statistical Analysis Plan: https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-023-07898-6