Furlong M, McGilloway S
Department of Psychology, National University of Ireland Maynooth, Maynooth, Ireland.
Child Care Health Dev. 2015 Sep;41(5):687-96. doi: 10.1111/cch.12195. Epub 2014 Sep 24.
Child conduct problems are a major public health priority. Group-based parenting programmes are popular in addressing such problems, but evidence for their longer-term effectiveness is limited. Moreover, process evaluations are rare and little is understood about the key facilitative and inhibitive factors associated with maintaining outcomes in the longer term.
This study involved the use of qualitative methods as part of a larger process evaluation to explore the longer-term experiences of parents who participated in a randomized controlled trial (RCT) of the Incredible Years Parenting Programme (IYPP) in disadvantaged settings in Ireland. A series of one-to-one in-depth interviews was conducted with parents at 12- (n = 20) and 18-month follow-up (n = 8) and analysed using constructivist grounded theory.
Most parents reported positive child behaviour despite several challenges, but a substantial subset reported periods of relapse in positive outcomes. A relapse in child behaviour was linked to relinquishing skills in stressful times, the negative influence of an unsupportive environment, and the perceived ineffectiveness of parenting skills. Resilience in implementing skills despite adversity, and the utilization of available social supports, were associated with the maintenance of positive outcomes.
Strengthening resilience and social support capacities may be important factors in maintaining positive longer-term outcomes. Those who design, research and deliver parenting programmes might consider the possibility of including a relapse-prevention module and/or the provision of post-intervention supports for more vulnerable families.
儿童行为问题是公共卫生的一项重大优先事项。基于小组的育儿项目在解决此类问题方面很受欢迎，但其长期有效性的证据有限。此外，过程评估很少见，对于与长期维持结果相关的关键促进因素和抑制因素了解甚少。
本研究采用定性方法，作为一项更大规模过程评估的一部分，以探索参与爱尔兰弱势环境中“不可思议的岁月”育儿项目（IYPP）随机对照试验（RCT）的家长的长期经历。在12个月随访时（n = 20）和18个月随访时（n = 8）对家长进行了一系列一对一的深入访谈，并使用建构主义扎根理论进行分析。
尽管面临诸多挑战，但大多数家长报告孩子行为良好，但有相当一部分家长报告积极结果出现了反复。孩子行为的反复与在压力时期放弃技能、不利环境的负面影响以及育儿技能的感知无效性有关。尽管逆境仍能坚持实施技能，以及利用现有的社会支持，与维持积极结果相关。
增强复原力和社会支持能力可能是维持长期积极结果的重要因素。设计、研究和提供育儿项目的人员可能会考虑纳入复发预防模块和/或为更脆弱家庭提供干预后支持的可能性。
