Generalizability in the Family-to-Family Education Program Randomized Waitlist-Control Trial
Abstract
Objective
Methods
Results
Conclusions
Methods
Participants
Variables
Statistical approach
Overall | Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Covariate and group | Total N | N | % | Total N | N | % | Total N | N | % | Total N | N | % | Total N | N | % | Total N | N | % |
RCT waitlist for Family-to-Family | ||||||||||||||||||
White consumers | 140 | 88 | 63 | 18 | 13 | 72 | 26 | 13 | 50 | 31 | 26 | 84 | 30 | 18 | 60 | 35 | 18 | 51 |
Married or living as if married | 140 | 83 | 59 | 18 | 13 | 72 | 26 | 17 | 65 | 31 | 17 | 55 | 30 | 20 | 67 | 35 | 16 | 46 |
Family income >$50,000 | 140 | 95 | 68 | 18 | 13 | 72 | 26 | 21 | 81 | 31 | 22 | 71 | 30 | 21 | 70 | 35 | 18 | 51 |
Objective daily living assistance rating (M±SD)a | 140 | 1.2±1.0 | 18 | 1.3±1.0 | 26 | 1.6±1.1 | 31 | 1.4±1.0 | 30 | 1.0±.9 | 35 | .9±.9 | ||||||
Attended any formal NAMI educational programs | 140 | 33 | 24 | 18 | 8 | 44 | 26 | 4 | 15 | 31 | 6 | 19 | 30 | 8 | 27 | 35 | 7 | 20 |
Male consumers | 140 | 72 | 51 | 18 | 11 | 61 | 26 | 15 | 58 | 31 | 18 | 58 | 30 | 14 | 47 | 35 | 14 | 40 |
Any psychiatric hospitalization in past 6 months | 140 | 42 | 30 | 18 | 10 | 56 | 26 | 15 | 58 | 31 | 9 | 29 | 30 | 3 | 10 | 35 | 5 | 14 |
Knowledge (M±SD % correct) | 140 | 57.3±17.3 | 18 | 43.9±20.6 | 26 | 55.3±14.9 | 31 | 60.4±17.7 | 30 | 60.5±12.1 | 35 | 60.1±18.0 | ||||||
Problem solving (M±SD)b | 136 | 13.2±2.9 | 18 | 13.8±4.2 | 26 | 13.0±2.5 | 30 | 12.8±2.3 | 30 | 13.1±2.4 | 32 | 13.3±3.3 | ||||||
Anxiety (M±SD)c | 140 | 53.2±10.1 | 18 | 52.7±8.5 | 26 | 49.8±9.2 | 31 | 52.3±9.5 | 30 | 54.1±10.7 | 35 | 56.1±11.0 | ||||||
Global Severity Index (M±SD)d | 140 | 53.2±9.8 | 18 | 51.8±6.2 | 26 | 49.6±8.5 | 31 | 51.9±10.0 | 30 | 52.6±9.1 | 35 | 58.3±11.0 | ||||||
Empowerment in aspect of family (M±SD)e | 140 | 3.4±.7 | 18 | 2.9±.7 | 26 | 3.4±.7 | 31 | 3.3±.6 | 30 | 3.3±.6 | 35 | 3.5±.7 | ||||||
Empowerment in aspect of service (M±SD)e | 140 | 3.1±.9 | 18 | 2.6±.8 | 26 | 3.3±1.1 | 31 | 3.0±.9 | 30 | 2.9±.8 | 35 | 3.5±.9 | ||||||
Empowerment in aspect of community (M±SD)e | 140 | 2.4±.8 | 18 | 1.9±.5 | 26 | 2.4±.8 | 31 | 2.2±.6 | 30 | 2.3±.5 | 35 | 2.9±.9 | ||||||
Acceptance (M±SD)f | 139 | 12.4±2.6 | 18 | 11.7±3.1 | 26 | 12.8±2.3 | 30 | 12.5±2.2 | 30 | 12.5±2.3 | 35 | 12.5±2.9 | ||||||
Depression (M±SD)g | 139 | 10.1±8.7 | 17 | 8.5±6.5 | 26 | 8.5±6.3 | 31 | 8.4±7.0 | 30 | 9.5±8.1 | 35 | 14.0±11.8 | ||||||
Worry (M±SD)h | 140 | 1.8±.5 | 18 | 1.6±.5 | 26 | 1.8±.5 | 31 | 1.7±.4 | 30 | 1.9±.5 | 35 | 1.8±.5 | ||||||
Subjective burden (M±SD)h | 140 | 2.6±.5 | 18 | 2.4±.5 | 26 | 2.5±.5 | 31 | 2.7±.5 | 30 | 2.7±.5 | 35 | 2.7±.5 | ||||||
RCT Family-to-Family participants | ||||||||||||||||||
White consumers | 152 | 90 | 59 | 18 | 14 | 78 | 21 | 16 | 76 | 34 | 23 | 68 | 41 | 21 | 51 | 38 | 16 | 42 |
Married or living as if married | 152 | 97 | 64 | 18 | 15 | 83 | 21 | 16 | 76 | 34 | 26 | 76 | 41 | 22 | 54 | 38 | 18 | 47 |
Family income >$50,000 | 152 | 104 | 68 | 18 | 14 | 78 | 21 | 19 | 90 | 34 | 21 | 62 | 41 | 29 | 71 | 38 | 21 | 55 |
Objective daily living assistance rating (M±SD)a | 152 | 1.1±.9 | 18 | 1.2±1.0 | 21 | 1.4±.9 | 34 | 1.0±.9 | 41 | .9±.9 | 38 | 1.0±1.0 | ||||||
Attended any formal NAMI educational programs | 152 | 18 | 12 | 18 | 3 | 17 | 21 | 1 | 5 | 34 | 6 | 18 | 41 | 5 | 12 | 38 | 3 | 8 |
Male consumers | 152 | 84 | 55 | 18 | 14 | 78 | 21 | 15 | 71 | 34 | 19 | 56 | 41 | 21 | 51 | 38 | 15 | 39 |
Any psychiatric hospitalization in past 6 months | 152 | 51 | 34 | 18 | 10 | 56 | 21 | 10 | 48 | 34 | 12 | 35 | 41 | 14 | 34 | 38 | 5 | 13 |
Knowledge (M±SD % correct) | 152 | 58.3±17.8 | 18 | 44.4±18.2 | 21 | 61.0±12.4 | 34 | 55.9±18.5 | 41 | 61.7±18.6 | 38 | 61.9±15.7 | ||||||
Problem solving (M±SD)b | 151 | 12.8±2.9 | 18 | 14.0±3.3 | 21 | 13.2±3.0 | 34 | 12.4±2.8 | 40 | 12.3±2.7 | 38 | 12.8±2.9 | ||||||
Anxiety (M±SD)c | 152 | 52.6±9.2 | 18 | 51.6±10.1 | 21 | 48.7±9.9 | 34 | 54.4±10.2 | 41 | 51.7±8.1 | 38 | 54.5±8.0 | ||||||
Global Severity Index (M±SD)d | 152 | 51.9±9.3 | 18 | 50.3±11.6 | 21 | 48.6±8.9 | 34 | 53.6±9.1 | 41 | 50.7±7.9 | 38 | 54.4±9.3 | ||||||
Empowerment in aspect of family (M±SD)e | 152 | 3.5±.6 | 18 | 3.0±.7 | 21 | 3.4±.7 | 34 | 3.4±.6 | 41 | 3.6±.5 | 38 | 3.6±.5 | ||||||
Empowerment in aspect of service (M±SD)e | 152 | 3.2±.9 | 18 | 2.7±1.0 | 21 | 3.0±1.0 | 34 | 3.3±.9 | 41 | 3.3±.7 | 38 | 3.4±.8 | ||||||
Empowerment in aspect of community (M±SD)e | 152 | 2.6±.8 | 18 | 2.0±.9 | 21 | 2.5±.6 | 34 | 2.3±.7 | 41 | 2.8±.7 | 38 | 2.8±.8 | ||||||
Acceptance (M±SD)f | 151 | 12.9±2.3 | 18 | 12.5±2.5 | 21 | 13.8±1.4 | 33 | 12.4±2.7 | 41 | 12.9±2.3 | 38 | 13.0±2.2 | ||||||
Depression (M±SD)g | 149 | 8.6±7.2 | 18 | 8.7±6.2 | 21 | 6.1±6.9 | 33 | 9.2±6.0 | 39 | 8.5±8.2 | 38 | 9.3±7.7 | ||||||
Worry (M±SD)h | 152 | 1.8±.5 | 18 | 1.7±.4 | 21 | 1.8±.4 | 34 | 1.8±.5 | 41 | 1.9±.6 | 38 | 1.8±.5 | ||||||
Subjective burden (M±SD)h | 152 | 2.6±.5 | 18 | 2.5±.3 | 21 | 2.6±.5 | 34 | 2.7±.5 | 41 | 2.7±.4 | 38 | 2.6±.5 | ||||||
Decliners (no RCT random assignment) | ||||||||||||||||||
White consumers | 117 | 82 | 70 | 46 | 34 | 74 | 35 | 29 | 83 | 17 | 12 | 71 | 11 | 5 | 45 | 8 | 2 | 25 |
Married or living as if married | 117 | 82 | 70 | 46 | 35 | 76 | 35 | 26 | 74 | 17 | 9 | 53 | 11 | 6 | 55 | 8 | 6 | 75 |
Family income >$50,000 | 117 | 91 | 78 | 46 | 42 | 91 | 35 | 27 | 77 | 17 | 13 | 76 | 11 | 7 | 64 | 8 | 2 | 25 |
Objective daily living assistance rating (M±SD)a | 117 | 1.3±1.0 | 46 | 1.6±1.0 | 35 | 1.4±1.1 | 17 | 1.2±.9 | 11 | .7±.6 | 8 | .6±.7 | ||||||
Attended any formal NAMI educational programs | 117 | 30 | 26 | 46 | 18 | 39 | 35 | 6 | 17 | 17 | 4 | 24 | 11 | 2 | 18 | 8 | 0 | — |
Male consumers | 117 | 74 | 63 | 46 | 33 | 72 | 35 | 21 | 60 | 17 | 10 | 59 | 11 | 5 | 45 | 8 | 5 | 63 |
Any psychiatric hospitalization in past 6 months | 117 | 58 | 50 | 46 | 36 | 78 | 35 | 16 | 46 | 17 | 5 | 29 | 11 | 1 | 9 | 8 | 0 | — |
Knowledge (M±SD % correct) | 117 | 54.0±17.5 | 46 | 50.2±18.6 | 35 | 57.3±17.5 | 17 | 60.8±11.7 | 11 | 52.4±18.8 | 8 | 48.8±14.8 | ||||||
Problem solving (M±SD)b | 109 | 13.1±2.4 | 43 | 12.7±2.2 | 31 | 13.2±2.2 | 17 | 13.2±3.1 | 10 | 14.6±2.5 | 8 | 12.9±2.6 | ||||||
Anxiety (M±SD)c | 117 | 51.6±10.2 | 46 | 51.7±11.4 | 35 | 49.7±9.3 | 17 | 52.9±6.8 | 11 | 55.3±8.9 | 8 | 51.5±14.3 | ||||||
Global Severity Index (M±SD)d | 117 | 50.7±10.7 | 46 | 50.2±12.4 | 35 | 49.4±9.2 | 17 | 51.3±7.3 | 11 | 55.3±10.3 | 8 | 51.8±13.6 | ||||||
Empowerment in aspect of family (M±SD)e | 117 | 3.3±.6 | 46 | 3.3±.5 | 35 | 3.3±.6 | 17 | 3.4±.7 | 11 | 3.2±.6 | 8 | 3.6±.7 | ||||||
Empowerment in aspect of service (M±SD)e | 117 | 3.1±.8 | 46 | 3.2±.7 | 35 | 3.1±.8 | 17 | 3.1±.7 | 11 | 2.9±.7 | 8 | 3.7±1.0 | ||||||
Empowerment in aspect of community (M±SD)e | 117 | 2.3±.7 | 46 | 2.1±.6 | 35 | 2.2±.7 | 17 | 2.4±.7 | 11 | 2.8±.8 | 8 | 2.5±1.0 | ||||||
Acceptance (M±SD)f | 116 | 12.6±2.2 | 45 | 12.6±2.3 | 35 | 12.9±1.9 | 17 | 13.4±1.5 | 11 | 11.4±2.7 | 8 | 11.6±3.5 | ||||||
Depression (M±SD)g | 117 | 8.8±7.0 | 46 | 9.0±8.0 | 35 | 7.6±5.0 | 17 | 8.3±6.1 | 11 | 11.2±9.0 | 8 | 10.8±6.9 | ||||||
Worry (M±SD)h | 117 | 1.7±.4 | 46 | 1.8±.4 | 35 | 1.8±.4 | 17 | 1.7±.4 | 11 | 1.7±.5 | 8 | 2.0±.5 | ||||||
Subjective burden (M±SD)h | 117 | 2.6±.5 | 46 | 2.5±.5 | 35 | 2.7±.4 | 17 | 2.6±.5 | 11 | 2.3±.6 | 8 | 2.9±.5 |
Effect size estimates for the decliner sample
Results
Baseline differences
Generalizability estimates
Overall | Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Outcome and group | Total N | M | SD | Total N | M | SD | Total N | M | SD | Total N | M | SD | Total N | M | SD | Total N | M | SD |
RCT FTF waitlist | ||||||||||||||||||
Knowledge (% correct) | 114 | 58.8 | 17.4 | 15 | 58.7 | 13.8 | 22 | 60.6 | 17.5 | 25 | 59.6 | 16.8 | 28 | 56.6 | 16.5 | 24 | 58.7 | 21.6 |
Problem solvinga | 113 | 12.9 | 2.9 | 15 | 13.2 | 3.9 | 22 | 12.5 | 2.4 | 24 | 12.5 | 1.8 | 28 | 13.5 | 3.1 | 24 | 12.8 | 3.2 |
Anxietyb | 114 | 52.4 | 9.4 | 15 | 52.1 | 7.4 | 22 | 49.3 | 6.8 | 25 | 51.3 | 10.4 | 28 | 54.6 | 10.1 | 24 | 53.8 | 10.6 |
Global Severity Indexc | 114 | 51.9 | 9.4 | 15 | 50.5 | 5.7 | 22 | 49.0 | 9.1 | 25 | 51.1 | 8.7 | 28 | 53.5 | 10.2 | 24 | 54.5 | 10.9 |
Empowerment in aspect of familyd | 114 | 3.5 | .6 | 15 | 3.2 | .7 | 22 | 3.5 | .6 | 25 | 3.5 | .5 | 28 | 3.4 | .8 | 24 | 3.6 | .6 |
Empowerment in aspect of serviced | 114 | 3.1 | .9 | 15 | 2.8 | .8 | 22 | 3.2 | .8 | 25 | 3.2 | .9 | 28 | 2.9 | .9 | 24 | 3.2 | .9 |
Empowerment in aspect of communityd | 114 | 2.5 | .8 | 15 | 2.1 | .6 | 22 | 2.3 | .6 | 25 | 2.3 | .6 | 28 | 2.5 | .8 | 24 | 2.9 | 1.0 |
Acceptancee | 114 | 12.7 | 2.5 | 15 | 12.0 | 2.4 | 22 | 13.4 | 2.2 | 25 | 12.6 | 2.6 | 28 | 12.4 | 2.7 | 24 | 12.9 | 2.3 |
Depressionf | 114 | 8.5 | 6.9 | 15 | 7.0 | 4.6 | 22 | 8.0 | 5.9 | 25 | 6.3 | 5.1 | 28 | 9.8 | 8.1 | 24 | 10.7 | 8.6 |
Worryg | 114 | 1.9 | .5 | 15 | 1.8 | .5 | 22 | 1.8 | .4 | 25 | 2.0 | .4 | 28 | 2.1 | .6 | 24 | 2.0 | .5 |
Subjective burdeng | 114 | 2.7 | .5 | 15 | 2.5 | .5 | 22 | 2.5 | .4 | 25 | 2.9 | .6 | 28 | 2.7 | .5 | 24 | 2.8 | .5 |
RCT FTF participants | ||||||||||||||||||
Knowledge (% correct) | 129 | 65.2 | 16.8 | 16 | 58.0 | 18.7 | 21 | 70.5 | 13.2 | 26 | 67.6 | 16.9 | 36 | 64.3 | 18.5 | 30 | 64.1 | 15.1 |
Problem solvinga | 126 | 12.1 | 2.6 | 16 | 13.1 | 2.6 | 21 | 11.6 | 2.5 | 26 | 12.0 | 2.5 | 34 | 11.6 | 2.4 | 29 | 12.6 | 3.0 |
Anxietyb | 129 | 50.6 | 8.1 | 16 | 48.1 | 7.6 | 21 | 48.0 | 7.4 | 26 | 53.6 | 7.2 | 36 | 50.6 | 7.8 | 30 | 51.2 | 9.4 |
Global Severity Indexc | 129 | 50.3 | 9.0 | 16 | 46.9 | 9.2 | 21 | 47.0 | 7.8 | 26 | 53.2 | 7.2 | 36 | 51.2 | 7.9 | 30 | 50.9 | 11.1 |
Empowerment in aspect of familyd | 129 | 3.7 | .6 | 16 | 3.4 | .9 | 21 | 3.7 | .7 | 26 | 3.7 | .6 | 36 | 3.8 | .5 | 30 | 3.7 | .6 |
Empowerment in aspect of serviced | 129 | 3.4 | .8 | 16 | 3.2 | 1.1 | 21 | 3.5 | .8 | 26 | 3.4 | .8 | 36 | 3.5 | .7 | 30 | 3.5 | .8 |
Empowerment in aspect of communityd | 129 | 2.9 | .8 | 16 | 2.4 | .8 | 21 | 2.8 | .7 | 26 | 2.7 | .8 | 36 | 3.1 | .7 | 30 | 3.2 | .7 |
Acceptancee | 128 | 13.6 | 2.0 | 16 | 13.0 | 2.5 | 21 | 14.0 | 1.8 | 26 | 14.1 | 2.0 | 35 | 13.7 | 1.8 | 30 | 13.1 | 2.1 |
Depressionf | 129 | 7.5 | 7.0 | 16 | 6.4 | 6.1 | 21 | 4.6 | 4.3 | 26 | 9.4 | 6.9 | 36 | 6.9 | 5.9 | 30 | 9.3 | 9.4 |
Worryg | 129 | 2.0 | .5 | 16 | 1.7 | .7 | 21 | 1.9 | .4 | 26 | 2.0 | .4 | 36 | 2.1 | .6 | 30 | 2.0 | .5 |
Subjective burdeng | 129 | 2.7 | .5 | 16 | 2.6 | .4 | 21 | 2.6 | .4 | 26 | 2.8 | .5 | 36 | 2.9 | .4 | 30 | 2.7 | .5 |
Decliners (no RCT random assignment) | ||||||||||||||||||
Knowledge (% correct) | 91 | 63.8 | 18.9 | 38 | 65.2 | 19.8 | 27 | 65.8 | 20.1 | 14 | 61.9 | 16.3 | 6 | 61.9 | 10.0 | 6 | 53.2 | 20.7 |
Problem solvinga | 84 | 12.6 | 2.6 | 34 | 12.1 | 2.1 | 26 | 12.9 | 2.5 | 13 | 13.2 | 2.3 | 6 | 15.2 | 3.4 | 5 | 10.4 | 3.8 |
Anxietyb | 89 | 50.1 | 8.1 | 37 | 49.3 | 7.7 | 26 | 52.2 | 7.7 | 14 | 50.0 | 6.4 | 6 | 48.0 | 7.8 | 6 | 48.7 | 14.9 |
Global Severity Indexc | 89 | 49.4 | 8.6 | 37 | 47.8 | 8.8 | 26 | 50.5 | 8.0 | 14 | 51.1 | 6.2 | 6 | 48.0 | 10.0 | 6 | 51.5 | 12.8 |
Empowerment in aspect of familyd | 90 | 3.5 | .6 | 37 | 3.6 | .5 | 27 | 3.5 | .5 | 14 | 3.4 | .7 | 6 | 3.8 | .6 | 6 | 3.7 | .7 |
Empowerment in aspect of serviced | 90 | 3.4 | .7 | 37 | 3.4 | .7 | 27 | 3.3 | .7 | 14 | 3.3 | .7 | 6 | 3.5 | .9 | 6 | 3.5 | 1.1 |
Empowerment in aspect of communityd | 90 | 2.7 | .7 | 37 | 2.6 | .6 | 27 | 2.7 | .8 | 14 | 2.9 | .8 | 6 | 3.2 | .9 | 6 | 2.8 | .9 |
Acceptancee | 91 | 13.3 | 2.2 | 38 | 13.4 | 2.0 | 27 | 13.7 | 2.3 | 14 | 13.0 | 2.5 | 6 | 11.8 | 2.8 | 6 | 12.7 | 2.0 |
Depressionf | 89 | 7.8 | 6.6 | 37 | 5.7 | 6.0 | 26 | 9.3 | 5.9 | 14 | 8.4 | 6.7 | 6 | 10.7 | 6.4 | 6 | 10.2 | 10.0 |
Worryg | 90 | 2.0 | .4 | 37 | 1.9 | .4 | 27 | 2.0 | .4 | 14 | 1.9 | .5 | 6 | 2.0 | .4 | 6 | 2.2 | .8 |
Subjective burdeng | 90 | 2.7 | .5 | 37 | 2.7 | .4 | 27 | 2.8 | .5 | 14 | 2.7 | .5 | 6 | 2.7 | .5 | 6 | 3.0 | .9 |
Measure | Generalizability estimatea | 95% CI | Effect size |
---|---|---|---|
Knowledge | |||
RCT | 5.28 | 3.33 to 7.23 | .31 |
Decliners | 4.94 | 2.09 to 7.79 | .29 |
Problem solving | |||
RCT | –.70 | –.99 to –.41 | –.23 |
Decliners | –.56 | –1.09 to –.03 | –.19 |
Anxiety | |||
RCT | −1.95 | –2.89 to –1.01 | –.21 |
Decliners | −2.00 | –3.23 to –.77 | –.22 |
Global Severity Index | |||
RCT | −1.62 | –2.53 to –.71 | –.18 |
Decliners | −2.17 | –3.56 to –.78 | –.24 |
Family empowerment | |||
RCT | .14 | .08 to .20 | .23 |
Decliners | .21 | .08 to .34 | .35 |
Service system empowerment | |||
RCT | .23 | .15 to .31 | .26 |
Decliners | .35 | .19 to .51 | .39 |
Community empowerment | |||
RCT | .26 | .19 to .33 | .37 |
Decliners | .40 | .28 to .52 | .58 |
Acceptance | |||
RCT | .74 | .48 to 1.00 | .32 |
Decliners | .93 | .52 to 1.34 | .40 |
Depression | |||
RCT | −1.23 | –2.18 to –.28 | –.16 |
Decliners | −1.17 | –2.13 to –.21 | –.15 |
Worry | |||
RCT | .04 | –.04 to .12 | .08 |
Decliners | –.01 | –.11 to .09 | –.02 |
Subjective burden | |||
RCT | –.10 | –.09 to .07 | –.20 |
Decliners | .07 | –.01 to .15 | .13 |
Discussion
Conclusions
Acknowledgments and disclosures
Supplementary Material
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