Early prevention of anxiety disorders in young children: The implementation of a live, online, targeted group-based parenting program

Anxiety problems are highly prevalent and often develop during early childhood. Targeted, group-based parenting programs have shown promise in preventing anxiety disorders in young children. However, these programs can be challenging to implement and comprehensive evaluations of their implementation in real-world settings remain scarce. Therefore, this study investigated the implementation of an online group-based anxiety prevention program for parents of anxiety-prone toddlers in a naturalistic setting in the Netherlands. A hybrid effectiveness-implementation design was used, including participants involved in a randomized controlled trial ( n = 156) and those who received the intervention outside the trial ( n = 45), representing parents of 201 children in total. Recruitment and delivery were facilitated through collaboration with child professionals, Public Health Services, and mental health organizations. Implementation indicators included recruitment, reach, dose delivered and received, fidelity, satisfaction, sustainability, and context. These were assessed using parental questionnaires, intervention observations, qualitative interviews, and research logs. The intervention was largely implemented as intended with adequate recruitment, high fidelity and satisfaction, and sustained use of the intervention strategies over time. However, the population reached predominantly consisted of highly educated parents with a non-migrant background, limiting the generalizability of the findings to more diverse populations. This study demonstrated the potential of implementing an online, group-based parenting anxiety prevention program to increase accessibility while maintaining high-quality delivery and participant satisfaction. Addressing challenges related to inclusivity could enhance the intervention's reach and impact, enabling it to play a significant role in early prevention of anxiety disorders across diverse populations and settings.