Investigating the Use of a Positive Parenting Programme to Improve Treatment Adherence in Cystic Fibrosis
Investigating the Use of a Positive Parenting Programme to Improve Treatment Adherence in Cystic Fibrosis
Cystic fibrosis (CF) is an illness that makes the lungs clog up with sticky mucus. There is
 no cure and so treatments are used to help make the illness easier to live with. The
 treatment can take lots of time and can feel not very nice sometimes. When children with CF
 become teenagers they need to learn to take charge of their treatment. This can be difficult.
 Teenagers with CF want to fit in with friends and can become more upset about their illness.
 Their parents have to learn to let their child take charge of their illness which can be hard
 for parents. These issues can put strain on parent-child relationships and this can make it
 harder for teenagers to stick to their treatment plans. A parenting program (called Teen
 Triple P) has been shown to help teenagers with other illnesses (such as diabetes) to be able
 to stick to their treatment plans. Parents are given a booklet to work through at home which
 helps them to build on the skills they already have. It aims to help families to support
 positive parent-child relationships, to manage difficult teenage behaviours, and to teach new
 skills and behaviours. So far no one has done any research to see if this program helps
 families of teenagers with CF. This research would like to see if the Triple P program can
 help teenagers with CF stick to their treatment plan. Helping teenagers stick to their
 treatment plan will help them to live happier and healthier lives.
The aim of this case series is to begin to explore whether the Teen Triple P program may
 improve treatment adherence, parent-child relationships, parenting experiences and parent and
 adolescent wellbeing in families with an adolescent with CF. Research commonly reports that
 adherence rates to treatment are consistently lower in this age group, with variables such as
 parent-child conflict, parent stress and the child's increasing independence all being
 influential factors. Previous research has suggested that family based interventions may
 facilitate with treatment adherence in this population, but little research has investigated
 the effectiveness of specific parenting and family based interventions. Triple P is an
 internationally recognized and extensively researched parenting intervention that has been
 found to support families from an array of clinical and non-clinical samples, and has been
 shown to reduce family conflict in other chronic health conditions. No research to date has
 examined the use Triple P interventions in cystic fibrosis and so hence the current research.

 A within subjects clinical case series using an A-B multiple baseline design will be used.
 This type of design exposes participating parents to a multiple baseline period (phase A)
 followed by an intervention phase (phase B). This controls for potential confounds, which
 increases confidence that change is attributable to the use of the parenting intervention.
 The baseline phase will vary in length from 2 to 6 weeks. During this phase, parents will
 complete the treatment adherence questionnaire and parenting scale (outlined in the outcome
 measures section) at weekly intervals which will take 10 minutes each week (the first and
 last baseline session will involve completing all questionnaires stated in the primary and
 secondary outcome measures section). The baseline phase will be followed by the 10 week
 intervention phase. Here parents will commence the self-directed Teen Triple P programme.
 Parents will be posted a copy of the Teen Triple P workbook. They will complete a 1 hour
 module of Triple P each week and will also continue to complete the treatment adherence
 questionnaire and parenting scale each week. At week 5 and 10 of the intervention, the full
 set of outcome questionnaires will be administered, as well as a satisfaction survey to
 determine how parents are finding the Triple P intervention. Once the 10 week Triple P
 intervention has been completed a period of 4 weeks will elapse before the researcher will
 contact the parents again in order for them to complete a set of 1 month follow up
 questionnaires, as well as answering some questions about their experiences of taking part in
 the Triple P intervention.

 Children themselves will not be required to participate in any study related activity as this
 is primarily a parenting intervention.
Inclusion Criteria:

 -  Parents of adolescents (aged 11 to 16) with Cystic Fibrosis.

 -  Self reported difficulties with their child's treatment adherence.

 Exclusion Criteria:

 -  Families already receiving psychological support from specialist Cystic Fibrosis
 clinical psychologists

 -  Parents requiring reading assistance who do not have anyone to help them

 -  Families where the parent/ child is currently being treated for a mental health
 difficulty