Jesse Logan Boring*, Arizona State University, Odessa, United States Track: Research Presentation Topic: Web 2.0 approaches for behaviour change, public health and biosurveillance Presentation Type: Rapid-Fire Presentation Submission Type: Single Presentation Building: Joseph B. Martin Conference Center at Harvard Medical School Room: A-Pechet Room Date: 2012-09-15 04:45 PM – 05:30 PM Last modified: 2012-09-12

If you are the presenter of this abstract (or if you cite this abstract in a talk or on a poster), please show the QR code in your slide or poster (QR code contains this URL).

Background: An ever expanding body of research has shown that children of divorce are at increased risk for a range of maladaptive outcomes including academic failure, behavior problems, poor psychological adjustment, reduced self-concept, and reduced social competence (Amato, 2001). Furthermore, the widespread prevalence of divorce makes preventing these poor outcomes a pressing public health concern.

Objectives: We hypothesized that an internet-based program based on adaptations of intervention components from traditional group-based programs previously demonstrated to be effective for children from disrupted families (Pedro-Carroll & Alpert-Gillis, 1997; Stolberg & Mahler, 1994; Sandler, et al., 2003) would lead to improvement in several modifiable mediators which we identified with respect to children from disrupted families. The modifiable mediators we targeted were active coping, avoidant coping, coping efficacy, and divorce related cognitive errors. We hypothesized that improvements in these modifiable mediators would lead to reductions in children's internalizing and externalizing problems.

Methods: 147 children ages 11-16 whose family had received a divorce decree from a large urban county in Arizona within 48 months of the intervention were recruited using public court records. Participants were blocked on parent-reported risk scores and then randomly assigned to the control or intervention condition. Participants were assessed via internet delivered surveys which were completed by the parent and the child at pre-test and one month after the 5-week program completion period. Intervention participants were asked to participate in the 5-module Children of Divorce - Coping with Divorce (CoD-CoD) program which addressed the development of coping skills through interactive activities, animations, games, and videos. Control group participants were asked to complete the Best of The Net (BTN) program which guided participants to two divorce support websites and to content quizzes related to site content. The primary outcome measures were child and parent-reported internalizing, externalizing, and total problems. Major secondary outcomes were active coping, avoidant coping, coping efficacy, and divorce related cognitive errors.

Results: The mean age of participants was 13.8 years; the majority of the participants were female (78/147, 53%), and white (110/147, 75%). Of the initial 147 participants, post-intervention data was collected from at least one reporter for 137 families. Analyses indicated that the program effectively reduced the participants total mental health problems and emotional problems as self-reported on the Strengths and Difficulties Questionnaire (SDQ) (d = .37) and for total mental health problems this effect was stronger for children with greater baseline mental health problems (d = .46). The program also had mediated effects on both child and parent-reported total mental health problems whereby the program improved coping efficacy for children with low baseline coping efficacy which led to reduced parent- and child-reported mental health problems.

Conclusions: The CoD-CoD program was effective in reducing mental health problems and was more effective for children with higher baseline pathology. The program also improved coping efficacy for children with low baseline coping efficacy. To the author's knowledge this is the first randomized controlled trail of internet-based mental health program for children or adolescents which utilized an active control condition.