Background: A majority of youth who need anxiety treatment never access support. This disparity reflects a need for more accessible, scalable interventions—particularly those that may prevent anxiety in high-risk children, mitigating future need for higher-intensity care. Self-guided single-session interventions (SSIs) may offer a promising path toward this goal, given their demonstrated clinical utility, potential for disseminability, and low cost. However, existing self-guided SSIs have been designed for completion by adolescents already experiencing symptoms, and their potential for preventing anxiety in children—for instance, by mitigating known anxiety risk factors—remains unexplored. Objective: This trial evaluated the acceptability and proximal effects of project EMPOWER: a web-based, self-guided SSI designed to reduce parental accommodation, a parenting behavior known to increase the risk of anxiety in offspring. Methods: In total, 301 parents who reported elevated anxiety symptoms with children aged 4-10 years received either project EMPOWER or an informational control (containing psychoeducational materials and resources); parents self-reported their accommodation of child anxiety and overall distress tolerance at baseline and 2-week follow-up. Results: Relative to control-group parents, those who received the intervention outlined in project EMPOWER reported significant reductions in their accommodation of child anxiety (d_s=0.61; P<.001) and significant increases in their distress tolerance (d_s=0.43; P<.001) from baseline to 2-week follow-up. Additionally, parents rated project EMPOWER as highly acceptable (ie, easy to use, helpful, and engaging) in accordance with preregistered benchmarks. Conclusions: Project EMPOWER is an acceptable self-guided SSI for parents of children at-risk for anxiety, which yields proximal reductions in clinically relevant targets. Trial Registration: ClinicalTrials.gov NCT04453865; https://tinyurl.com/4h84j8t9

中文翻译：

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授权焦虑的父母来管理孩子的回避行为：父母住宿单次干预的随机对照试验

背景：大多数需要焦虑症治疗的青年从未获得支持。这种差异反映了需要更容易获得、可扩展的干预措施——尤其是那些可以预防高危儿童焦虑、减轻未来对更高强度护理的需求的干预措施。自我指导的单次干预 (SSI) 可能为实现这一目标提供了一条有希望的途径，因为它们已被证明具有临床实用性、传播潜力和低成本。然而，现有的自我指导 SSI 是为已经出现症状的青少年设计的，它们预防儿童焦虑的潜力——例如，通过减轻已知的焦虑风险因素——仍有待探索。客观的：该试验评估了 EMPOWER 项目的可接受性和近端效应：一种基于网络的、自我引导的 SSI，旨在减少父母的适应，这是一种已知会增加后代焦虑风险的养育行为。方法：总共有 301 名报告 4-10 岁儿童焦虑症状升高的父母接受了 EMPOWER 项目或信息控制（包含心理教育材料和资源）；父母在基线和 2 周的随访中自我报告了他们对儿童焦虑和整体痛苦耐受性的适应。结果：相对于对照组父母，那些接受 EMPOWER 项目概述的干预的人报告他们对儿童焦虑的适应显着减少（d _s =0.61；P <.001) 和从基线到 2 周随访的痛苦耐受性显着增加 ( d _s =0.43; P <.001)。此外，根据预先注册的基准，家长们将 EMPOWER 项目评为高度可接受（即易于使用、有帮助和参与）。结论：项目 EMPOWER 是一种可接受的自我指导 SSI，适用于有焦虑风险的儿童的父母，这会导致临床相关目标的近端减少。试验注册： ClinicalTrials.gov NCT04453865；https://tinyurl.com/4h84j8t9