University of Chicago, School of Social Service Administration, Chicago, IL 60637, USA.
Child Abuse Negl. 2013 Aug;37(8):566-77. doi: 10.1016/j.chiabu.2013.03.006. Epub 2013 Apr 25.
This study set out to carry out a feasible, real-world, randomized clinical trial to examine the benefits of home-based paraprofessional parent aide services in reducing physical abuse and neglect risk in high-risk parents.
Families were randomly assigned to receive either parent aide plus case management services (n = 73) or case management services only (n = 65), collecting in-home data on physical child abuse and neglect and proximal risk and protective factors, just prior to service initiation, and again after six months of services.
Mothers receiving parent aide and case management services reported significant improvements from baseline to six-month follow-up in self-reported indicators of physical child abuse risk, as well as improvements on parental stress, mastery, depression, and anxiety, whereas mothers receiving only case management services did not. The slopes of such observed changes across groups, however, were not found to be statistically significantly different. No discernable improvements were found with regard to indicators of risk for child neglect.
As the first randomized clinical trial examining the effectiveness of parent aide services, this study provides the first controlled evidence examining the potential benefits of this service modality. This study suggests promising trends regarding the benefit of parent aide services with respect to physical child abuse risk reduction and related predictors, but evidence does not appear to suggest that such services, as they are presently delivered, reduce child neglect.
These findings support the continued use of parent aide services in cases of physical child abuse and also suggest careful consideration of the ways such services may be better configured to extend their impact, particularly with respect to child neglect risk.
本研究旨在开展一项可行的、真实世界的、随机临床试验，以检验家庭为基础的准专业家长助理服务在降低高危父母身体虐待和忽视风险方面的益处。
将家庭随机分配接受家长助理加个案管理服务（n=73）或仅接受个案管理服务（n=65），在服务开始前和服务六个月后，收集家庭内有关身体虐待和忽视以及近端风险和保护因素的数据。
接受家长助理和个案管理服务的母亲在身体虐待风险的自我报告指标上，以及在父母压力、掌握感、抑郁和焦虑方面，从基线到六个月随访都有显著改善，而仅接受个案管理服务的母亲则没有。然而，两组之间观察到的这些变化的斜率并没有发现有统计学上的显著差异。在儿童忽视风险的指标方面，没有发现明显的改善。
作为第一项检验家长助理服务有效性的随机临床试验，本研究提供了第一个关于这种服务模式潜在益处的对照证据。本研究表明，家长助理服务在降低身体虐待儿童风险和相关预测因素方面具有有希望的趋势，但证据似乎并不表明，按照目前的方式提供此类服务，可以降低儿童忽视的风险。
这些发现支持在身体虐待儿童的情况下继续使用家长助理服务，并建议仔细考虑如何更好地配置此类服务，以扩大其影响，特别是在儿童忽视风险方面。
