Project EMPOWER: A Randomized Controlled Trial of Web-Based Single Session Intervention for Child Anxiety Among Financially Insecure Parents

Background: Despite advancements in the treatment and implementation of evidence-based child anxiety interventions, up to 80% of anxious youth, especially those experiencing financial insecurity, never access care. Single session interventions (SSIs) offer a promising path toward increasing accessible, rapidly scalable interventions, given their clinical utility, potential for disseminability, and low cost. However, existing trials of child anxiety interventions have historically recruited socioeconomically homogeneous families (e.g. well-educated, affluent)—leaving their applicability to this high need and underserved population largely unknown. There is an urgent need to understand whether anxiety interventions designed for accessibility are effective for and acceptable to financially insecure families. Thus, this study evaluated the effects of Project EMPOWER, an evidence-based SSI designed to help reduce parental accommodation —a parenting behavior identified as a strong risk factor for anxiety in offspring — in financially insecure families. Methods: 101 parents endorsing financial insecurity with an anxious child aged 4-10 were recruited via CloudResearch. Parents self-reported on outcome measures and were randomized to an online, self-guided Project EMPOWER, or an informational control. All methods, hypothesis, and analytical plans were pre-registered on clincialtrials.gov (NCT05990322). Results. Relative to the control condition (N = 50), parents who received Project EMPOWER (N = 51) reported significant reductions in child’s anxiety (ds = 0.60, p = .02), and significant decreases in accommodation (ds= 0.87, p = .02) at 4-week follow-up. Parents who completed Project EMPOWER rated it as highly acceptable (M = 4.57 out of 5, SD = 0.47) and feasible (96.08% were full completers). Conclusions. Results support the effectiveness and feasibility of an online, self-guided SSIs for economically insecure families they are designed to help.