Rotheram-Borus Mary Jane, Swendeman Dallas, Becker Kimberly D
a Semel Institute and Department of Psychiatry , University of California , Los Angeles.
J Clin Child Adolesc Psychol. 2014;43(2):229-43. doi: 10.1080/15374416.2013.836453. Epub 2013 Sep 30.
Hundreds of validated evidence-based intervention programs (EBIP) aim to improve families' well-being; however, most are not broadly adopted. As an alternative diffusion strategy, we created wellness centers to reach families' everyday lives with a prevention framework. At two wellness centers, one in a middle-class neighborhood and one in a low-income neighborhood, popular local activity leaders (instructors of martial arts, yoga, sports, music, dancing, Zumba), and motivated parents were trained to be Family Mentors. Trainings focused on a framework that taught synthesized, foundational prevention science theory, practice elements, and principles, applied to specific content areas (parenting, social skills, and obesity). Family Mentors were then allowed to adapt scripts and activities based on their cultural experiences but were closely monitored and supervised over time. The framework was implemented in a range of activities (summer camps, coaching) aimed at improving social, emotional, and behavioral outcomes. Successes and challenges are discussed for (a) engaging parents and communities; (b) identifying and training Family Mentors to promote children and families' well-being; and (c) gathering data for supervision, outcome evaluation, and continuous quality improvement. To broadly diffuse prevention to families, far more experimentation is needed with alternative and engaging implementation strategies that are enhanced with knowledge harvested from researchers' past 30 years of experience creating EBIP. One strategy is to train local parents and popular activity leaders in applying robust prevention science theory, common practice elements, and principles of EBIP. More systematic evaluation of such innovations is needed.
数百个经过验证的循证干预项目(EBIP)旨在改善家庭福祉;然而,大多数项目并未得到广泛采用。作为一种替代传播策略,我们创建了健康中心,通过预防框架融入家庭日常生活。在两个健康中心,一个位于中产阶级社区,另一个位于低收入社区,当地受欢迎的活动领导者(武术、瑜伽、体育、音乐、舞蹈、尊巴舞教练)以及积极的家长被培训成为家庭导师。培训聚焦于一个框架,该框架传授综合的基础预防科学理论、实践要素和原则,并应用于特定内容领域(育儿、社交技能和肥胖问题)。随后,允许家庭导师根据他们的文化经验调整脚本和活动,但随着时间推移会受到密切监测和监督。该框架在一系列旨在改善社会、情感和行为结果的活动(夏令营、辅导)中得以实施。本文讨论了在以下方面取得的成功与面临的挑战:(a)吸引家长和社区参与;(b)识别和培训家庭导师以促进儿童和家庭的福祉;(c)收集数据用于监督、结果评估和持续质量改进。为了将预防措施广泛传播给家庭,需要更多地尝试采用替代且引人入胜的实施策略,这些策略要借助从研究人员过去30年创建循证干预项目的经验中获取的知识加以强化。一种策略是培训当地家长和受欢迎的活动领导者应用强大的预防科学理论、循证干预项目的常见实践要素和原则。需要对这类创新进行更系统的评估。