Warwick Medical School, University of Warwick, Gibbet Hill Road, Coventry, UK.
Trials. 2013 Jul 11;14:210. doi: 10.1186/1745-6215-14-210.
Many babies in the UK are born to drug-dependent parents, and dependence on psychoactive drugs during the postnatal period is associated with high rates of child maltreatment, with around a quarter of these children being subject to a child protection plan. Parents who are dependent on psychoactive drugs are at risk of a wide range of parenting problems, and studies have found reduced sensitivity and responsiveness to both the infant's physical and emotional needs. The poor outcomes that are associated with such drug dependency appear to be linked to the multiple difficulties experienced by such parents.An increase in understanding about the crucial importance of early relationships for infant well-being has led to a focus on the development and delivery of services that are aimed at supporting parenting and parent-infant interactions. The Parents under Pressure (PuP) programme is aimed at supporting parents who are dependent on psychoactive drugs or alcohol by providing them with methods of managing their emotional regulation, and of supporting their new baby's development. An evaluation of the PuP programme in Australia with parents on methadone maintenance of children aged 3 to 8 years found significant reductions in child abuse potential, rigid parenting attitudes and child behaviour problems.
METHODS/DESIGN: The study comprises a multicentre randomised controlled trial using a mixed-methods approach to data collection and analysis in order to identify which families are most able to benefit from this intervention.The study is being conducted in six family centres across the UK, and targets primary caregivers of children less than 2.5 years of age who are substance dependent. Consenting participants are randomly allocated to either the 20-week PuP programme or to standard care.The primary outcome is child abuse potential, and secondary outcomes include substance use, parental mental health and emotional regulation, parenting stress, and infant/toddler socio-emotional adjustment scale.
This is one the first UK studies to examine the effectiveness of a programme targeting the parenting of substance-dependent parents of infants and toddlers, in terms of its effectiveness in improving the parent-infant relationship and reducing the potential for child abuse.
International Standard Randomised Controlled Trial Number Register: ISRCTN47282925.
在英国，许多婴儿的父母都有药物依赖问题，而产后依赖精神活性药物与儿童虐待率高有关，其中约四分之一的儿童受到儿童保护计划的保护。依赖精神活性药物的父母面临着广泛的育儿问题，研究发现，他们对婴儿的身体和情感需求的敏感性和反应性都降低了。与这种药物依赖相关的不良后果似乎与这些父母所经历的多种困难有关。
对早期关系对婴儿健康至关重要的认识不断提高，促使人们关注支持育儿和母婴互动的服务的发展和提供。“压力下的父母”（PuP）计划旨在通过提供情绪调节管理方法来支持依赖精神活性药物或酒精的父母，并支持他们新婴儿的发展。在澳大利亚对接受美沙酮维持治疗的 3 至 8 岁儿童的父母进行的 PuP 计划评估发现，儿童虐待倾向、僵化的育儿态度和儿童行为问题显著减少。
方法/设计：本研究采用多中心随机对照试验，采用混合方法收集和分析数据，以确定哪些家庭最能从这种干预中受益。该研究在英国六家家庭中心进行，针对的是依赖物质的 2.5 岁以下儿童的主要照顾者。同意参加的参与者被随机分配到 20 周的 PuP 计划或标准护理组。主要结果是儿童虐待倾向，次要结果包括物质使用、父母心理健康和情绪调节、育儿压力以及婴儿/学步儿社会情感适应量表。
这是英国首次研究针对婴儿和学步儿依赖物质的父母的育儿计划的有效性，该计划旨在改善母婴关系，减少儿童虐待的可能性。
国际标准随机对照试验注册号：ISRCTN47282925。
