Bywater Tracey, Hutchings Judy, Daley David, Whitaker Chris, Yeo Seow Tien, Jones Karen, Eames Catrin, Edwards Rhiannon Tudor
School of Psychology, Bangor University, Gwynedd, Wales, UK.
Br J Psychiatry. 2009 Oct;195(4):318-24. doi: 10.1192/bjp.bp.108.056531.
The typical pattern for intervention outcome studies for conduct problems has been for effect sizes to dissipate over time with decreasing effects across subsequent follow-ups.
To establish whether the short-term positive effects of a parenting programme are sustained longer term. To observe trends, and costs, in health and social service use after intervention.
Parents with children aged 36-59 months at risk of developing conduct disorder (n = 104) received intervention between baseline and first follow-up (6 months after baseline n = 86) in 11 Sure Start areas in North Wales. Follow-ups two (n = 82) and three (n = 79) occurred 12 and 18 months after baseline. Child problem behaviour and parenting skills were assessed via parent self-report and direct observation in the home.
The significant parent-reported improvements in primary measures of child behaviour, parent behaviour, parental stress and depression gained at follow-up one were maintained to follow-up three, as were improved observed child and parent behaviours. Overall, 63% of children made a minimum significant change (0.3 standard deviations) on the Eyberg Child Behavior Inventory problem scale between baseline and follow-up (using intention-to-treat data), 54% made a large change (0.8 standard deviations) and 39% made a very large change (1.5 standard deviations). Child contact with health and social services had reduced at follow-up three.
Early parent-based intervention reduced child antisocial behaviour and benefits were maintained, with reduced reliance on health and social service provision, over time.
针对品行问题的干预效果研究的典型模式是,效应量会随着时间推移而消散,在后续随访中效果逐渐减弱。
确定育儿项目的短期积极效果是否能长期持续。观察干预后健康和社会服务使用方面的趋势及成本。
在北威尔士的11个“确保开端”地区,对有品行障碍风险、年龄在36至59个月的儿童的父母(n = 104)在基线期和首次随访(基线期后6个月,n = 86)之间进行干预。在基线期后12个月和18个月进行第二次(n = 82)和第三次随访(n = 79)。通过家长自我报告和在家中的直接观察来评估儿童问题行为和育儿技能。
在第一次随访中家长报告的儿童行为、家长行为、家长压力和抑郁等主要指标的显著改善一直维持到第三次随访,观察到的儿童和家长行为的改善情况也是如此。总体而言,在埃伯格儿童行为量表问题量表上,63%的儿童在基线期和随访期之间有至少显著变化(0.3个标准差)(使用意向性分析数据),54%有较大变化(0.8个标准差),39%有非常大的变化(1.5个标准差)。在第三次随访时,儿童与健康和社会服务机构的接触减少了。
早期基于家长的干预减少了儿童的反社会行为,且随着时间推移,益处得以维持,同时对健康和社会服务提供的依赖减少。