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Background: Public health advocates have highlighted internalising problems as a leading cause of global burden of disease. Internalising problems (anxiety/depression) affect up to 20% of school‐age children and can impact peer relations, school engagement and later employment and mortality. This translational trial aimed to determine whether a selective/indicated parenting group programme to prevent internalising distress in shy/inhibited preschool children had sustained effects in middle childhood. Translational design aspects were a brief parent‐report screening tool for child inhibition offered universally across the population via preschools in the year before school, followed by an invitation to parents of all inhibited children to attend the parenting programme at venues in their local community. Methods: Design of the study was a randomised controlled trial. The setting was 307 preschool services across eight socioeconomically diverse government areas in Melbourne, Australia. Participants were 545 parents of inhibited four‐year‐old children of which 456 (84%) were retained during middle childhood (age of seven to 10 years). Early intervention was the Cool Little Kids parenting group programme, and control was 'usual care' access to available support services in the community. Primary outcomes were child anxiety and depression symptoms (parent and child report) and DSM‐IV anxiety disorders (assessor masked). Secondary outcomes were parenting practices and parent mental health. Results: There was no significant difference in anxiety disorders between the intervention and control group during the three annual follow‐ups of the cohort in middle childhood (2015 43% vs. 41%, 2016 40% vs. 36%, 2017 27% vs. 30%, respectively; p's >.05). There were also no significant differences in child anxiety or depression symptoms (by child or parent report), parenting practices or parent mental health, between the intervention and control group during middle childhood. However, a priori interaction tests suggested that for children with anxious parents, early intervention attenuated risk for middle childhood internalising problems. Conclusions: An issue for population translation is low levels of parent engagement in preventive interventions. Initial effects of the Cool Little Kids parenting group programme in reducing shy/inhibited preschool children's internalising distress at school entry dissipated over time, perhaps due to low engagement. Future translational research on early prevention of internalising problems could benefit from screening preschool children in the population at higher risk (combining temperamental inhibition and parent distress) and incorporating motivational techniques to facilitate family engagement. Trial registration ISRCTN30996662 http://www.isrctn.com/ISRCTN30996662. [ABSTRACT FROM AUTHOR]

Background: The aim was to determine outcomes in the first year of school of a population‐delivered parenting program to prevent internalising problems in temperamentally inhibited preschool children and predictors of engagement in parenting groups. Method: Design: Randomised controlled trial. Setting: 307 preschool services across eight socio‐economically diverse government areas in Melbourne, Australia. Participants: 545 parents of inhibited 4‐year‐old children; 469 (86%) retained at two‐year follow‐up. Intervention: Cool Little Kids program. Primary outcomes were child internalising symptoms and anxiety disorders. Secondary outcomes were parenting, parent well‐being and engagement. Trial registration ISRCTN30996662 http://www.isrctn.com/ISRCTN30996662. Results: In the first year of school (M (SD) age 6.7 (0.4) years), child anxiety symptoms were reduced in the intervention versus control arm (PAS‐R M (SD): total 36.2 (17.2) versus 39.4 (18.5); adjusted difference −3.26, 95% CI −6.46 to −0.05, p =.047; specific fears 9.1 (6.2) versus 10.7 (6.8), adjusted difference −1.53; 95% CI −2.69 to −0.38, p =.009). However, there was little difference in broader child internalising (CMFWQ M (SD): 2.2 (0.5) versus 2.3 (0.6); adjusted difference −0.03, 95% CI −0.13 to 0.06, p =.489) or anxiety disorders (37.6% vs. 42.6%; adjusted OR 0.79, 95% CI 0.53 to 1.18, p =.242). Lower income, younger mothers, less educated and more culturally diverse fathers engaged less with the intervention. Continued skills practice was less frequent for parents of girls and in advantaged neighbourhoods. Conclusions: There were population effects of Cool Little Kids in the first year of school for anxiety symptoms but not disorders. Considering motivation techniques to engage subgroups of families would be helpful in translation research. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Method Results Discussion Prevention programs for eating disorders (EDs) and high body index mass (BMI) have the potential to reduce the onset of these interconnected public health concerns. However, it remains unclear whether routine implementation of such programs would be cost‐effective. This study aims to determine the cost‐effectiveness of an intervention that aims to prevent both ED and high BMI.A Markov model was developed to evaluate the incremental cost‐effectiveness of a targeted school‐based program, Healthy Weight, that aims to prevent both EDs and high BMI among Australian adolescents with body image concerns (aged 15–18 years), versus a “no intervention” comparator. A cost‐utility analysis was conducted from a “healthcare and education” sector perspective with costs (measured in 2019 Australian dollars) and health impacts modeled over the lifetime of the target population. An incremental cost‐effectiveness ratio (ICER), expressed as cost per health‐adjusted life year (HALY) gained, was calculated. Sensitivity analyses were done to test model assumptions.The mean intervention cost and HALYs gained were AUD$2.13 million (95% CI, AUD$1.83–2.43 million) and 146 (95% CI, 90–209), respectively. With healthcare cost‐savings (AUD$3.97 million) included, the intervention was predicted to be cost‐saving (AUD$1.83 million; 95% CI, AUD$0.51–3.21 million). Primary findings were robust to extensive sensitivity analyses.The Healthy Weight intervention is likely to represent good value‐for‐money. To ensure the successful implementation of this program at the population level, further research on its feasibility and acceptability among schools and the wider community is required. [ABSTRACT FROM AUTHOR]