Evidence map›Paper›PMID 42435385›Full record

ArticleJournal of pediatric psychology2026

Evaluating the Visible Difference Parenting Toolkit: an ACT-based intervention to improve parental/carer stress and psychosocial well-being of carers of children with appearance affecting conditions and injuries.

Maia Thornton, Emma Waite, Paul White, Anna Zarola, Nymfodora Antoniou, Alex Clarke, Diana Harcourt

Abstract read
In one paragraph

Article in Journal of pediatric psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Maia ThorntonCentre for Appearance Research, School of Social Sciences, College of Health, Science & Society, University of the West of England, Bristol, United Kingdom.ORCID 0000-0003-3547-8840
Emma WaiteCentre for Appearance Research, School of Social Sciences, College of Health, Science & Society, University of the West of England, Bristol, United Kingdom.ORCID 0009-0002-9148-2617
Paul WhiteCentre for Appearance Research, School of Social Sciences, College of Health, Science & Society, University of the West of England, Bristol, United Kingdom.ORCID 0000-0002-7503-9896
Anna ZarolaCentre for Appearance Research, School of Social Sciences, College of Health, Science & Society, University of the West of England, Bristol, United Kingdom.
Nymfodora AntoniouCentre for Appearance Research, School of Social Sciences, College of Health, Science & Society, University of the West of England, Bristol, United Kingdom.
Alex ClarkeCentre for Appearance Research, School of Social Sciences, College of Health, Science & Society, University of the West of England, Bristol, United Kingdom.ORCID 0000-0001-5479-9733
Diana HarcourtCentre for Appearance Research, School of Social Sciences, College of Health, Science & Society, University of the West of England, Bristol, United Kingdom.ORCID 0000-0002-4285-5678

Funding

VTCT Foundation
6 · The paper itself

Abstract

objectiveAlongside the typical challenges of parenting, parents and carers of children with visible differences can experience additional psychosocial challenges including anxiety, stress, guilt, and concerns about stigma and discrimination. The Visible Difference Parenting Toolkit is an ACT-based intervention aimed at improving psychosocial well-being for this group of parents/carers. This study examined the acceptability and potential benefit of the intervention utilizing a mixed-methods single-arm pre-post design.

methodParents/carers (baseline n = 173) completed an online survey at three time points: (1) baseline, (2) post-intervention, and (3) 2-month follow-up. Paired t-tests on available matched data assessed differences in outcome measures between timepoints (83 pairs at post-intervention, 62 at follow-up). Open-ended responses were analyzed using content analysis.

resultsStatistically significant reductions in parent-reported depression and anxiety and statistically significant improvements in parent-reported self-efficacy were found between baseline and post-intervention. Additionally, significant reductions in parent-reported depression and anxiety and significant improvements in self-compassion, self-efficacy, and psychological flexibility were found between baseline and follow-up. Parenting stress did not significantly improve post-intervention immediately, but showed significant change at follow-up. Responses to open-ended questions indicated that although some ongoing concerns remained about future challenges, the intervention helped parents/carers feel more knowledgeable and confident in supporting their child.

conclusionsThis study suggests the Visible Difference Parenting Toolkit is an acceptable and potentially useful intervention for supporting parents/carers of children with a visible difference. This novel intervention addresses a gap in the current support provision in the visible difference field and is now freely available through www.VisibleDifferenceSupportHub.com.

Indexed as

CaregiversParentingParentsStress, PsychologicalAdultAnxietyChildDepressionFemaleHumansMalePsychological Well-BeingSelf Efficacycoping skills and adjustmenteHealth/mHealth/digital healthevidence-based practiceparent psychosocial functioningpsychosocial interventionvisible difference

Identifiers

PMID42435385
PMCPMC13594659

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.