Tuning in to Kids: An Online, Group Program Tailored for Parents of Children With Congenital Heart Disease

Mental health conditions are common among children with congenital heart disease (CHD) and are strongly associated with cardiovascular morbidity and mortality, as well as lower quality of life. Despite increasing awareness, the mental health needs of children with CHD remain largely unmet, especially among those from historically marginalized and underserved communities. To address this gap, this study will test, for the first time in CHD, a virtually-delivered, group-based psychological intervention, called Tuning in to Kids, designed to teach parents how to help their children understand, regulate, and manage their emotions. The intervention includes six, 90-minute, weekly, online group sessions and two 'booster' sessions, coupled with educational resources and home practice activities to improve parent-child interactions, and enhance child emotional and behavioral functioning. Each group is facilitated by two qualified health professionals who are trained in, and certified to deliver, the Tuning in to Kids intervention. In this pilot randomized controlled trial, we will enroll 40 parents (or other primary caregivers) of children aged 3 or 6 years with CHD who underwent surgical intervention in infancy. The primary aim of this study is to assess intervention acceptability and feasibility, and the results generated will directly inform the design of, and provide preliminary data for, a multicenter efficacy trial to examine short- and longer-term intervention effects.

Inclusion criteria

• Child is aged between 3 and 6 years.
• Child is receiving care from the Cincinnati Children's Heart Institute (at least one cardiology visit in the past 12 months).
• Child has congenital heart disease requiring cardiopulmonary bypass during infancy (i.e., by age 12 months).
• Parent or primary caregiver can give consent and participate in the study in English.

Exclusion criteria

• Child has a diagnosed neurodevelopmental disorder (e.g., autism, Trisomy 18), is not speaking, or is not functioning at the developmental level of a typical 3-year-old at the time of study recruitment.
• Child current medical status or treatment precludes study participation.
• Parent is aged under 18 years.
• Parent is currently participating in another parent-focused or parent training program (e.g., Parent-Child Interaction Therapy).
• Parent suffers from substance misuse or severe, unmanaged mental illness.
• Parent has an intellectual disability impacting capacity to independently provide informed consent.
• The child's treating physician or the study interventionalist identifies the parent or child as having a condition or circumstance that is contraindicative to engagement with the Tuning in to Kids program.