Jones Deborah J, Forehand Rex, Cuellar Jessica, Parent Justin, Honeycutt Amanda, Khavjou Olga, Gonzalez Michelle, Anton Margaret, Newey Greg A
a Department of Psychology , University of North Carolina at Chapel Hill.
J Clin Child Adolesc Psychol. 2014;43(1):88-101. doi: 10.1080/15374416.2013.822308. Epub 2013 Aug 7.
Early onset disruptive behavior disorders are overrepresented in low-income families; yet these families are less likely to engage in behavioral parent training (BPT) than other groups. This project aimed to develop and pilot test a technology-enhanced version of one evidence-based BPT program, Helping the Noncompliant Child (HNC). The aim was to increase engagement of low-income families and, in turn, child behavior outcomes, with potential cost-savings associated with greater treatment efficiency. Low-income families of 3- to 8-year-old children with clinically significant disruptive behaviors were randomized to and completed standard HNC (n = 8) or Technology-Enhanced HNC (TE-HNC; n = 7). On average, caregivers were 37 years old; 87% were female, and 80% worked at least part-time. More than half (53%) of the youth were boys; the average age of the sample was 5.67 years. All families received the standard HNC program; however, TE-HNC also included the following smartphone enhancements: (a) skills video series, (b) brief daily surveys, (c) text message reminders, (d) video recording home practice, and (e) midweek video calls. TE-HNC yielded larger effect sizes than HNC for all engagement outcomes. Both groups yielded clinically significant improvements in disruptive behavior; however, findings suggest that the greater program engagement associated with TE-HNC boosted child treatment outcome. Further evidence for the boost afforded by the technology is revealed in family responses to postassessment interviews. Finally, cost analysis suggests that TE-HNC families also required fewer sessions than HNC families to complete the program, an efficiency that did not compromise family satisfaction. TE-HNC shows promise as an innovative approach to engaging low-income families in BPT with potential cost-savings and, therefore, merits further investigation on a larger scale.
早发性破坏性行为障碍在低收入家庭中更为常见；然而，与其他群体相比，这些家庭参与行为家长培训（BPT）的可能性较小。本项目旨在开发并试点测试一种基于证据的BPT项目的技术增强版本，即“帮助不听话儿童”（HNC）。目的是提高低收入家庭的参与度，进而改善儿童行为结果，并通过提高治疗效率实现潜在的成本节约。将有临床显著破坏性行为的3至8岁儿童的低收入家庭随机分组并完成标准HNC（n = 8）或技术增强型HNC（TE-HNC；n = 7）。平均而言，照料者年龄为37岁；87%为女性，80%至少从事兼职工作。超过一半（53%）的青少年为男孩；样本的平均年龄为5.67岁。所有家庭都接受了标准的HNC项目；然而，TE-HNC还包括以下智能手机增强功能：（a）技能视频系列，（b）每日简短调查，（c）短信提醒，（d）家庭练习视频录制，以及（e）周中视频通话。对于所有参与结果，TE-HNC产生的效应量均大于HNC。两组在破坏性行为方面均取得了临床上显著的改善；然而，研究结果表明，与TE-HNC相关的更高项目参与度提高了儿童治疗效果。家庭对评估后访谈的反应揭示了技术带来促进作用的进一步证据。最后，成本分析表明，TE-HNC家庭完成该项目所需的课程也比HNC家庭少，这种效率并未影响家庭满意度。TE-HNC作为一种让低收入家庭参与BPT的创新方法，具有潜在的成本节约，因此有望在更大规模上进行进一步研究。
