J. M. Green, BA, MA, MBBS, DCH, FRCPsych, Institute of Brain Behaviour and Mental Health, The University of Manchester, Manchester; N. Biehal, BA, MA, PhD, Department of Social Policy and Social Work, University of York, York; C. Roberts, BSc, MSc, PhD, Centre for Biostatistics, Institute of Population Health, University of Manchester, Manchester; J. Dixon, BA, MA, Social Policy Research Unit (SPRU), University of York, York; C. Kay, BSc, PhD, Institute of Brain Behaviour and Mental Health, The University of Manchester, Manchester; E. Parry, BA, MSc, Mood Disorders Centre, University of Exeter, Exeter; J. Rothwell, BSc, PhD, A. Roby, BSc, MSc, ClinPsyD, D. Kapadia, BSc, MSc, Institute of Brain Behaviour and Mental Health, The University of Manchester, Manchester; S. Scott, MB BChir, FRCP, FRCPsych, Institute of Psychiatry, King's College London, London; I. Sinclair, BA, PhD, Social Policy Research Unit (SPRU), University of York, York, UK.
Br J Psychiatry. 2014 Mar;204(3):214-21. doi: 10.1192/bjp.bp.113.131466. Epub 2013 Dec 19.
Children in care often have poor outcomes. There is a lack of evaluative research into intervention options.
To examine the efficacy of Multidimensional Treatment Foster Care for Adolescents (MTFC-A) compared with usual care for young people at risk in foster care in England.
A two-arm single (assessor) blinded randomised controlled trial (RCT) embedded within an observational quasi-experimental case-control study involving 219 young people aged 11-16 years (trial registration: ISRCTN 68038570). The primary outcome was the Child Global Assessment Scale (CGAS). Secondary outcomes were ratings of educational attendance, achievement and rate of offending.
The MTFC-A group showed a non-significant improvement in CGAS outcome in both the randomised cohort (n = 34, adjusted mean difference 1.3, 95% CI -7.1 to 9.7, P = 0.75) and in the trimmed observational cohort (n = 185, adjusted mean difference 0.95, 95% CI -2.38 to 4.29, P = 0.57). No significant effects were seen in secondary outcomes. There was a possible differential effect of the intervention according to antisocial behaviour.
There was no evidence that the use of MTFC-A resulted in better outcomes than usual care. The intervention may be more beneficial for young people with antisocial behaviour but less beneficial than usual treatment for those without.
受照料儿童的结局往往较差。对于干预措施的评估性研究较少。
研究青少年多维治疗寄养（MTFC-A）与英国寄养中处于风险的年轻人的常规护理相比的疗效。
一项包含在观察性准实验病例对照研究中的 2 臂单（评估者）盲随机对照试验（RCT），涉及 219 名 11-16 岁的年轻人（试验注册：ISRCTN68038570）。主要结局是儿童总体评估量表（CGAS）。次要结局是教育出勤率、成绩和犯罪率的评定。
MTFC-A 组在随机队列（n = 34，调整后的平均差异 1.3，95%CI -7.1 至 9.7，P = 0.75）和修剪后的观察队列（n = 185，调整后的平均差异 0.95，95%CI -2.38 至 4.29，P = 0.57）中，CGAS 结局均未见显著改善。次要结局未见显著效果。干预可能根据反社会行为产生不同的效果。
没有证据表明使用 MTFC-A 会比常规护理产生更好的结果。对于有反社会行为的年轻人，该干预措施可能更有益，但对于没有反社会行为的年轻人，其益处可能不如常规治疗。
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