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一项评价在参加‘了不起的孩子父母计划’的高危家庭中增加结构化家庭访问干预以改善结果的有效性的初步研究:一项随机对照试验的研究方案。

A pilot study to evaluate the efficacy of adding a structured home visiting intervention to improve outcomes for high-risk families attending the Incredible Years Parent Programme: study protocol for a randomised controlled trial.

机构信息

Bay of Plenty District Health Board, Private Bag 12024, Tauranga 3141, New Zealand.

出版信息

Trials. 2014 Feb 25;15:66. doi: 10.1186/1745-6215-15-66.

Abstract

BACKGROUND

Antisocial behaviour and adult criminality often have their origins in childhood and are best addressed early in the child's life using evidence-based treatments such as the 'Incredible Years Parent Programme'. However, families with additional risk factors who are at highest risk for poor outcomes do not always make sufficient change while attending such programmes. Additional support to address barriers and improve implementation of positive parenting strategies while these families attend the Incredible Years Programme may improve overall outcomes.The study aims to evaluate the efficacy of adding a structured home visiting intervention (Home Parent Support) to improve outcomes in families most at risk of poor treatment response from the Incredible Years intervention. This study will inform the design of a larger prospective randomised controlled trial.

METHODS/DESIGN: A pilot single-blind, parallel, superiority, randomised controlled trial. Randomisation will be undertaken using a computer-generated sequence in a 1:1 ratio to the two treatments arranged in permuted blocks with stratification by age, sex, and ethnicity. One hundred and twenty six participants enrolled in the Incredible Years Parent Programme who meet the high-risk criteria will be randomly allocated to receive either Incredible Years Parent Programme and Home Parent Support, or the Incredible Years Parent Programme alone. The Home Parent Support is a 10-session structured home visiting intervention provided by a trained therapist, alongside the usual Incredible Years Parent Programme, to enhance the adoption of key parenting skills. The primary outcome is the change in child behaviour from baseline to post-intervention in parent reported Eyberg Child Behavior Inventory Problem Scale.

DISCUSSION

This is the first formal evaluation of adding Home Parent Support alongside Incredible Years Parent Programme for families with risk factors who typically have poorer treatment outcomes. We anticipate that the intervention will help vulnerable families stay engaged, strengthen the adoption of effective parenting strategies, and improve outcomes for both the children and families.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12612000878875.

摘要

背景

反社会行为和成年犯罪往往起源于儿童时期,最好在儿童生命早期使用循证治疗方法,如“难以置信的岁月父母计划”来解决。然而,那些存在额外风险因素且处于不良结果高风险的家庭,在参加此类项目时并不总是能做出足够的改变。在这些家庭参加“难以置信的岁月计划”时,提供额外的支持以解决障碍并改善积极育儿策略的实施,可能会改善整体结果。本研究旨在评估增加结构化家庭访问干预(家庭父母支持)的效果,以改善最有可能对“难以置信的岁月”干预治疗反应不佳的家庭的结果。这项研究将为一项更大的前瞻性随机对照试验的设计提供信息。

方法/设计:这是一项单盲、平行、优势、随机对照试验的试点研究。将使用计算机生成的序列,以 1:1 的比例随机分配到两种治疗方法中,治疗方法以随机排列的块进行排列,并按年龄、性别和种族进行分层。126 名参加“难以置信的岁月父母计划”并符合高危标准的参与者将被随机分配接受“难以置信的岁月父母计划”和“家庭父母支持”,或仅接受“难以置信的岁月父母计划”。“家庭父母支持”是一种由经过培训的治疗师提供的 10 节结构化家庭访问干预措施,与常规的“难以置信的岁月父母计划”一起提供,以增强关键育儿技能的采用。主要结果是家长报告的 Eyberg 儿童行为量表问题量表从基线到干预后的儿童行为变化。

讨论

这是首次对有风险因素的家庭在“难以置信的岁月父母计划”之外增加“家庭父母支持”的正式评估,这些家庭通常治疗效果较差。我们预计,该干预措施将有助于弱势家庭保持参与,加强有效育儿策略的采用,并改善儿童和家庭的结果。

试验注册

澳大利亚新西兰临床试验注册中心 ACTRN12612000878875。

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