Leijten Patty, Shaw Daniel S, Gardner Frances, Wilson Melvin N, Matthys Walter, Dishion Thomas J
Utrecht University, Utrecht, Netherlands,
Prev Sci. 2015 Apr;16(3):397-406. doi: 10.1007/s11121-014-0479-x.
Integration of empirically supported prevention programs into existing community services is a critical step toward effecting sustainable change for the highest-risk members in a community. We examined if the Family Check-Up--known to reduce disruptive behavior problems in young children--can provide a bridge to the use of community treatment services among high-risk indigent families. The study's 731 income-eligible families with a 2-year-old child were screened and randomized to the Family Check-Up (FCU) intervention or a control condition. Families were provided yearly FCUs from age 2 through age 5. Regression analyses on families' service use at child age 7.5 revealed increased service use, compared with that of the control group. Child disruptive behavior and socioeconomic status moderated the effect of the intervention on service use. Families who reported higher levels of disruptive child behavior and lower socioeconomic status showed more service use, suggesting the intervention increased service use among the highest-risk families. Greater use of community services did not mediate the effect of the FCU on reduced oppositional-defiant child behavior. Implications of these findings for the design and ecology of community treatment services in the context of evidence-based practices are discussed.
将经实证支持的预防项目纳入现有的社区服务，是为社区中风险最高的成员实现可持续改变的关键一步。我们研究了已知可减少幼儿破坏性行为问题的家庭检查项目能否为高风险贫困家庭利用社区治疗服务搭建桥梁。该研究对731个符合收入条件且有一名2岁孩子的家庭进行了筛查，并将其随机分为家庭检查（FCU）干预组或对照组。从孩子2岁到5岁，每年为这些家庭提供家庭检查服务。对孩子7.5岁时家庭服务使用情况的回归分析显示，与对照组相比，干预组的服务使用有所增加。儿童破坏性行为和社会经济地位调节了干预对服务使用的影响。报告孩子破坏性行为水平较高且社会经济地位较低的家庭使用的服务更多，这表明该干预增加了风险最高家庭的服务使用。更多地使用社区服务并未介导家庭检查对减少儿童对立违抗行为的影响。本文讨论了这些研究结果对循证实践背景下社区治疗服务设计和生态的启示。
