Moderators of treatment effects for a peer-led intervention for caregivers of children with mental health needs

A number of studies have documented the high unmet mental health needs of children and adolescents in the United States. One way to increase the reach of mental health services to children and adolescents is to utilize Family Peer Advocates (FPAs), caregivers with lived experience of parenting a child with mental illness who are trained to support other caregivers. NAMI Basics is an FPA-led intervention focused on psychoeducation and service navigation delivered to caregivers of children with mental health needs in a group setting. The current study examined treatment moderators using data from a randomized controlled trial of the NAMI Basics curriculum. Caregivers of children ages 3 to 22 ( N = 11, M = 11.93) were randomly assigned to an immediate NAMI Basics course or an eight week waitlist control. Caregivers in the study were primarily biological mothers (77%) who identified as Hispanic/Latinx (43%), Caucasian (33%), and African American (12%). While none of the hypothesized moderators met statistical significance, the effect sizes for the interactions between parent stress and study condition and between child symptoms and study condition were both above the threshold for a small effect size ([eta subscript p]² = 0.02). Group means were plotted to allow for visual examination of these interactions given low power to detect statistical significance. The plotted group means indicated that as hypothesized, caregivers who reported higher stress when entering the course showed greater decreases in child symptoms after taking the course than those caregivers who reported lower baseline stress. Contrary to the direction hypothesized, caregivers who reported higher stress upon beginning the NAMI Basics course reported fewer outpatient mental health services added after the course, as compared to those who reported lower stress upon beginning the course. Clinical implications for these findings and areas for future research are discussed.