Prevention Research Center, Pennsylvania State University, Park, Pennsylvania 16802, USA.
Pediatrics. 2010 Jan;125(1):e130-6. doi: 10.1542/peds.2009-0322. Epub 2009 Dec 14.
We tested the impact of the Fast Track conduct disorder prevention program on the use of pediatric, general health, and mental health services in adolescence.
Participants were 891 public kindergarten boys and girls screened from a population of 9594 children and found to be at risk for conduct disorder. They were assigned randomly (by school) to intervention or control conditions and were followed for 12 years. Intervention lasted 10 years and included parent training, child social-cognitive skills training, reading tutoring, peer-relations enhancement, and classroom curricula and management. Service use was assessed through annual interviews of parents and youth.
Youth assigned to preventive intervention had significantly reduced use of professional general health, pediatric, and emergency department services relative to control youth on the basis of parent-report data. For control-group youth, the odds of greater use of general health services for any reason and general health services use for mental health purposes were roughly 30% higher and 56% higher, respectively. On the basis of self-report data, the intervention reduced the likelihood of outpatient mental health services among older adolescents for whom odds of services use were more than 90% higher among control-group youth. No differences were found between intervention and control youth on the use of inpatient mental health services. Statistical models controlled for key study characteristics, and potential moderation of the intervention effect was assessed.
Random assignment to the Fast Track prevention program is associated with reduced use of general health and outpatient mental health services in adolescents. Future studies should examine the mechanism of this impact and service use patterns as subjects reach young adulthood.
我们检验了“快速通道品行障碍预防方案”对青春期儿科、一般健康和心理健康服务利用的影响。
研究对象为 891 名来自 9594 名儿童人群的公共幼儿园男孩和女孩，他们经筛选被认为存在品行障碍风险。这些儿童被随机（按学校）分配到干预组或对照组，并随访 12 年。干预持续 10 年，包括家长培训、儿童社会认知技能训练、阅读辅导、同伴关系增强以及课堂课程和管理。服务利用情况通过对家长和青少年的年度访谈进行评估。
基于家长报告数据，与对照组青少年相比，接受预防干预的青少年接受专业一般健康、儿科和急诊服务的利用显著减少。对于对照组青少年，出于任何原因使用一般健康服务和出于心理健康目的使用一般健康服务的可能性分别高出 30%和 56%。基于自我报告数据，干预降低了大龄青少年接受门诊心理健康服务的可能性，因为对照组青少年接受服务的可能性高出 90%以上。干预组和对照组青少年在使用住院心理健康服务方面没有差异。统计模型控制了研究的主要特征，并评估了干预效果的潜在调节作用。
随机分配到“快速通道”预防方案与青少年一般健康和门诊心理健康服务利用减少有关。未来的研究应该检查这种影响的机制和服务利用模式，因为研究对象进入成年早期。
