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提升家庭日托教育者促进儿童社会情感健康的能力:一项探索性集群随机对照试验。

Building the capacity of family day care educators to promote children's social and emotional wellbeing: an exploratory cluster randomised controlled trial.

机构信息

Jack Brockhoff Child Health and Wellbeing Program, McCaughey Centre, University of Melbourne, Carlton, Victoria, Australia.

出版信息

BMC Public Health. 2011 Nov 3;11:842. doi: 10.1186/1471-2458-11-842.

Abstract

BACKGROUND

Childhood mental health problems are highly prevalent, experienced by one in five children living in socioeconomically disadvantaged families. Although childcare settings, including family day care are ideal to promote children's social and emotional wellbeing at a population level in a sustainable way, family day care educators receive limited training in promoting children's mental health. This study is an exploratory wait-list control cluster randomised controlled trial to test the appropriateness, acceptability, cost, and effectiveness of "Thrive," an intervention program to build the capacity of family day care educators to promote children's social and emotional wellbeing. Thrive aims to increase educators' knowledge, confidence and skills in promoting children's social and emotional wellbeing.

METHODS/DESIGN: This study involves one family day care organisation based in a low socioeconomic area of Melbourne. All family day care educators (term used for registered carers who provide care for children for financial reimbursement in the carers own home) are eligible to participate in the study. The clusters for randomisation will be the fieldworkers (n = 5) who each supervise 10-15 educators. The intervention group (field workers and educators) will participate in a variety of intervention activities over 12 months, including workshops; activity exchanges with other educators; and focused discussion about children's social and emotional wellbeing during field worker visits. The control group will continue with their normal work practice. The intervention will be delivered to the intervention group and then to the control group after a time delay of 15 months post intervention commencement. A baseline survey will be conducted with all consenting educators and field workers (n = ~70) assessing outcomes at the cluster and individual level. The survey will also be administered at one month, six months and 12 months post-intervention commencement. The survey consists of questions measuring perceived levels of knowledge, confidence and skills in promoting children's social and emotional wellbeing. As much of this intervention will be delivered by field workers, field worker-family day care educator relationships are key to its success and thus supervisor support will also be measured. All educators will also have an in-home quality of care assessment at baseline, one month, six months and 12 months post-intervention commencement. Process evaluation will occur at one month, six months and 12 months post-intervention commencement. Information regarding intervention fidelity and economics will also be assessed in the survey.

DISCUSSION

A capacity building intervention in child mental health promotion for family day care is an essential contribution to research, policy and practice. This initiative is the first internationally, and essential in building an evidence base of interventions in this extremely policy-timely setting.

TRIAL REGISTRATION NUMBER

摘要

背景

儿童心理健康问题非常普遍,每五个生活在社会经济处于不利地位家庭的孩子中就有一个会经历这些问题。虽然儿童保育机构,包括家庭日托,是在可持续的基础上以群体为单位促进儿童社交和情感健康的理想场所,但家庭日托教育者接受的促进儿童心理健康的培训有限。本研究是一项探索性的等待名单对照群组随机对照试验,旨在测试“茁壮成长”干预计划的适宜性、可接受性、成本和有效性,该计划旨在提高家庭日托教育者促进儿童社交和情感健康的能力。“Thrive”旨在提高教育者在促进儿童社交和情感健康方面的知识、信心和技能。

方法/设计:这项研究涉及位于墨尔本一个社会经济水平较低地区的一个家庭日托组织。所有家庭日托教育者(术语用于注册照顾者,他们为在照顾者自己家中接受经济补偿的儿童提供照顾)都有资格参加这项研究。随机分组的群组将是现场工作人员(n = 5),他们每人监督 10-15 名教育者。干预组(现场工作人员和教育者)将在 12 个月内参加各种干预活动,包括研讨会;与其他教育者进行活动交流;以及在现场工作人员访问期间重点讨论儿童的社会和情感健康。对照组将继续进行正常的工作实践。干预措施将先提供给干预组,然后在干预开始后 15 个月延迟提供给对照组。将对所有同意参加的教育者和现场工作人员(n = ~70)进行基线调查,评估群组和个人层面的结果。该调查还将在干预开始后一个月、六个月和十二个月进行。调查包括衡量促进儿童社交和情感健康的知识、信心和技能的感知水平的问题。由于这项干预措施的大部分内容将由现场工作人员提供,因此现场工作人员与家庭日托教育者的关系是成功的关键,因此还将衡量主管支持情况。所有教育者还将在基线、一个月、六个月和十二个月后进行家庭内护理质量评估。干预开始后一个月、六个月和十二个月将进行过程评估。还将在调查中评估干预措施的可信度和经济性。

讨论

为家庭日托提供儿童心理健康促进方面的能力建设干预措施是对研究、政策和实践的重要贡献。这一举措在国际上是首次,对于在这一极具政策时效性的背景下建立干预措施的证据基础至关重要。

试验注册号

343312。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c06b/3219588/aef24873458e/1471-2458-11-842-1.jpg

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