The Family Foundations Trial

The Depression Anxiety Stress Scale-21 (DASS-21) assesses symptoms of depression, anxiety, and stress in the past week (21 items). The items are rated on a 4-point scale ranging from 0-Never to 3-Almost Always. A total scale score can be created, as well as specific subscales for depressive, anxiety and stress symptoms. Higher scores indicate greater levels of mental health difficulties. Excellent reliability and validity has been demonstrated in Australian population-based samples. The DASS-21 is routinely used by early parenting services.

The Depression Anxiety Stress Scale-21 (DASS-21) assesses symptoms of depression, anxiety, and stress in the past week (21 items). Scores on each scale range from 0-42 with higher scores indicating a greater severity of symptoms. Clinical ranges are available. Excellent reliability and validity has been demonstrated in Australian population-based samples. The DASS-21 is routinely used by early parenting services.

The 6-item Kessler Psychological Distress Scale (K6) assesses general symptoms of depression and anxiety in the last 30 days/4 weeks. The 6 items are rated on a 5-point scale ranging from 0-None of the time to 4-All of the time. Higher scores indicate higher levels of psychological distress. The K6 is widely used in clinical trials for common mental health disorders, and is consistent with a transdiagnostic approach proposing a common set of psychological distress symptoms underlie mood and anxiety disorders . It has well-established symptomatic and clinical cut-points, high specificity (0.96), robust total classification accuracy (0.92) to identify mood and anxiety disorders [32], and correlates with validated measures of suicidality [45]. Australian population data for men are available using the K6 (e.g. National Survey of Mental Health and Wellbeing, Longitudinal Study of Australian Children). The study investigators have published extensively on fathers' mental health.

The 6-item Kessler Psychological Distress Scale (K6) assesses general symptoms of depression and anxiety in the last 30 days/4 weeks. The 6 items are rated on a 5-point scale ranging from 0-None of the time to 4-All of the time. Higher scores indicate higher levels of psychological distress. The K6 is widely used in clinical trials for common mental health disorders, and is consistent with a transdiagnostic approach proposing a common set of psychological distress symptoms underlie mood and anxiety disorders . It has well-established symptomatic and clinical cut-points, high specificity (0.96), robust total classification accuracy (0.92) to identify mood and anxiety disorders [32], and correlates with validated measures of suicidality [45]. Australian population data for men are available using the K6 (e.g. National Survey of Mental Health and Wellbeing, Longitudinal Study of Australian Children). The study investigators have published extensively on fathers' mental health.

The Communication and Problem Solving Scale consists of 35 items and asks parents about a broad range of behaviours (e.g., 'talk it out with one another; change the subject; threaten to end the relationship) when having a disagreement with their co-parent. Items are rated on a 4-point scale from 1 = Never to 4 = Often. There are six subscales assessing Cooperation, Avoidance, Child Involvement, Stalemating, Verbal Aggression and Physical Aggression. Subscale and total scale scores can be computed with higher scores indicating more frequent engagement in conflict behaviours. The scale has established reliability and validity, and has been used in evaluations of FF in Australia.

The Communication and Problem Solving Scale consists of 35 items and asks parents about a broad range of behaviours (e.g., 'talk it out with one another; change the subject; threaten to end the relationship) when having a disagreement with their co-parent. Items are rated on a 4-point scale from 1 = Never to 4 = Often. There are six subscales assessing Cooperation, Avoidance, Child Involvement, Stalemating, Verbal Aggression and Physical Aggression. Subscale and total scale scores can be computed with higher scores indicating more frequent engagement in conflict behaviours. The scale has established reliability and validity, and has been used in evaluations of FF in Australia.

The Coparenting Relationship Scale consists of 35 items (e.g., my co-parent asks my opinion on issues related to parenting, my co-parent has lots of patience with our child, my relationship with my co-parent is stronger now than before we had a child), comprising seven subscales (Coparenting Agreement, Coparenting Closesness, Exposure to Conflict, Coparenting Support, Coparenting Undermining, Endorse Co-parent Parenting, and Division of Labor). Each item is rated on a 7-point scale, ranging from 0=Not true of us/Never to 6=Very true of us/Often. Particular items are reverse scored, and then summed. The scale is ideal for examining the role of coparenting in diverse family contexts. The subscales have excellent internal reliability with parent populations in the US and Australia.

The Coparenting Relationship Scale consists of 35 items (e.g., my co-parent asks my opinion on issues related to parenting, my co-parent has lots of patience with our child, my relationship with my co-parent is stronger now than before we had a child), comprising seven subscales (Coparenting Agreement, Coparenting Closesness, Exposure to Conflict, Coparenting Support, Coparenting Undermining, Endorse Co-parent Parenting, and Division of Labor). Each item is rated on a 7-point scale, ranging from 0=Not true of us/Never to 6=Very true of us/Often. Particular items are reverse scored, and then summed. The scale is ideal for examining the role of coparenting in diverse family contexts. The subscales have excellent internal reliability with parent populations in the US and Australia.

The Dimension of Anger Reactions (DAR-5) is a 5-item self- measure of experiences of anger which assesses the frequency, intensity, duration, aggression and impact on a person's social functioning over the past 4-weeks. Items are rated on a 5-point scale, ranging from 1 = None or almost none of the time to 5 = All or almost all of the time, where higher scores indicate worse symptomology, and a score greater than 12 indicated problem anger.

To focus on the positive aspects of mental health, the Warwick Edinburgh Mental Wellbeing Scale Short form (SWEMWBS) will be used to assess thoughts and feelings which relate to mental wellbeing. The 7-items assessing a range of positive thoughts and experiences related to mental health (e.g., I have been feeling optimistic about the future; I've been dealing with problems well; I have been thinking clearly) in the last 2 weeks on a 5-point scale from 1 = None of the time to 5 = All of the time. Items scores were summed, with higher scores indicating higher overall wellbeing.

To focus on the positive aspects of mental health, the Warwick Edinburgh Mental Wellbeing Scale Short form (SWEMWBS) will be used to assess thoughts and feelings which relate to mental wellbeing. The 7-items assessing a range of positive thoughts and experiences related to mental health (e.g., I have been feeling optimistic about the future; I've been dealing with problems well; I have been thinking clearly) in the last 2 weeks on a 5-point scale from 1 = None of the time to 5 = All of the time. Items scores were summed, with higher scores indicating higher overall wellbeing.

The Child-Parent Relationship Scale- short form (CPRS) assesses parents' perceptions of their relationship with their child. The scale consists of 15-items that assess parents' perceptions of their relationship with their child (e.g., 'I share an affectionate, warm relationship with my child'). Items were rated on a 5-point scale ranging from 1= definitely does not apply to 5 = definitely applies. There are two subscales assessing (1) Closeness and (2) Conflict. Item scores were summed with higher scores indicating higher closeness or conflict in the parent-child relationship.

The brief Co-parental Communication Scale used in the Longitudinal Study of Australian Children which consists of five items assessing how often parents engage in verbal conflict (e.g. 'How often do you argue?') and one item assessing how often they engage in physical conflict (e.g. 'How often do you have arguments with your co-parent that end up with people pushing, hitting, kicking or shoving?'). The items are rated on a 5-point scale from 1 = never to 5 = always. Items scores were summed, with higher scores indicating more frequent interparental conflict. The scale has excellent reliability and validity in Australian populations.

The Assessment of Quality of Life 8 dimension (AQoL-8D). It is a validated tool assessing quality of life impacts in the economic evaluation. Australian population normative data are available and will be used to determine preference weighted health related quality of life utility scores ranging from 0-1 with higher scores indicating higher quality of life. The AQoL-8D is particularly suited to measuring mental health aspects of quality of life. Participants will complete the scale via an online REDCap survey.

The brief version of the PTSD Checklist is a self-report 4-item screening tool for the presence of trauma symptoms in the last 4 weeks. The measures asks participants to rate the extent to which they have experienced four diagnostic symptoms of PTSD in the past month. Participants are asked to rate the extent that they are bothered by a traumatic event on a 5 point scale (0 = not at all to 4 = Extremely).

Suicidal ideation will be assessed using the Suicidal Ideation Attributes Scale (SIAS). The SIAS is a self-reported 5-item screening tool for the presence and severity of suicidal thoughts in the last month based on frequency, controllability, closeness to attempt, level of distress, and impact on daily functioning. Any ideation is indicative of risk for suicidal behaviour (scores >1 indicate risk).

Suicidal ideation will be assessed using the Suicidal Ideation Attributes Scale (SIAS). The SIAS is a self-reported 5-item screening tool for the presence and severity of suicidal thoughts in the last month based on frequency, controllability, closeness to attempt, level of distress, and impact on daily functioning. Any ideation is indicative of risk for suicidal behaviour (scores >1 indicate risk).

Suicidal ideation will be assessed using the Suicidal Ideation Attributes Scale (SIAS). The SIAS is a self-reported 5-item screening tool for the presence and severity of suicidal thoughts in the last month based on frequency, controllability, closeness to attempt, level of distress, and impact on daily functioning. Any ideation is indicative of risk for suicidal behaviour (scores >1 indicate risk).

Suicidal ideation will be assessed using the Suicidal Ideation Attributes Scale (SIAS). The SIAS is a self-reported 5-item screening tool for the presence and severity of suicidal thoughts in the last month based on frequency, controllability, closeness to attempt, level of distress, and impact on daily functioning. Any ideation is indicative of risk for suicidal behaviour (scores >1 indicate risk).

Health dervice use will be assessed by self-reported type and costof healthcare services accessed (prior to baseline and during the study period).

Health dervice use will be assessed by self-reported type and number healthcare services accessed (prior to baseline and during the study period).

the Work Productivity and Activity Impairment Questionnaire: General Health (WPAI) which is a measure of impairments in both paid and unpaid work. Participants are asked 6-items (e.g., are you currently employed, hours missed due to a health problem, hours worked and degree health has affected productivity while at work on a Visual Analogue Scale) for the past seven days. It is well validated among specific health problems and between clinical treatment groups.