Examining the impact of telehealth education on the general health, sleep quality, and resilience of mothers with children diagnosed with autism: a cluster-randomized controlled trial

Autism is one of the most prevalent intellectual disabilities worldwide. Given the lifelong nature of this condition, many families face significant challenges in caring for and raising children with autism, which may jeopardize various aspects of the caregivers’ health, particularly the mothers. This study aimed to determine the impact of Telehealth education on the general health, sleep quality, and resilience of mothers with children diagnosed with autism. In this single-blind, two-arm, cluster-randomized controlled trial with a 2-month follow-up, 80 mothers of children with ASD were recruited from two comprehensive pediatric rehabilitation centers in Shiraz, Iran. The two centers were randomly allocated by lottery, with one center assigned to the telehealth intervention group and the other to the waitlist control group. All eligible mothers at each center were invited to participate, and participants were assigned to the study group corresponding to their center ( n = 40 per group). The intervention comprised 11 weekly interactive virtual group sessions (65 min each). Primary outcome measures included the General Health Questionnaire (GHQ-28), Pittsburgh Sleep Quality Index (PSQI), and Connor–Davidson Resilience Scale (CD-RISC), administered at baseline (T 1 ), immediate post-test (T 2 ), and 2-month follow-up (T 3 ). Trajectories of longitudinal change were evaluated using Two-Way Mixed-Design Repeated Measures Analysis of Variance (RM-ANOVA). Baseline demographic characteristics and clinical baseline scores were equivalent between groups ( p >.05). Mixed-design RM-ANOVA revealed statistically significant Group × Time interaction effects across all primary outcomes: General Health, F(1.526,119.031) = 8.435, p =.001, η p 2 = 0.098 ,Sleep Quality, F(1.768,137.906) = 17.736, p <.001, η p 2 = 0.185;and Resilience, F(1.442,112.453) = 14.360, p <.001, η p 2 = 0.155. Post-hoc longitudinal pairwise comparisons indicated substantial, sustained improvements in psychological distress (GHQ-28: 34.62 ± 9.44→32.42 ± 7.17, p <.001) and resilience (CD-RISC: 64.08 ± 10.90→71.43 ± 8.16, p <.001) in the intervention group. Maternal sleep disturbance (PSQI) demonstrated marked, progressive improvement over time (12.27 ± 2.83→11.15 ± 2.56, p < .001), whereas control group scores remained stable across all measurement waves ( p > .05). The findings of this study suggest that telehealth education can improve the general health, sleep quality, and resilience of mothers with children diagnosed with autism. Therefore, it could be utilized as a cost-effective and accessible method in primary healthcare. Further research is necessary to explore the impact of telehealth on the health of both parents and children with autism. (IRCT20160404027216N12), Date 2024-02-19.