Frantz Inga, Stemmler Mark, Hahlweg Kurt, Plück Julia, Heinrichs Nina
Department of Psychology, University of Bielefeld, Bielefeld, Germany,
Prev Sci. 2015 Aug;16(6):789-800. doi: 10.1007/s11121-015-0554-y.
The primary aim of family-based prevention programs is to promote children's health. Unfortunately, it is difficult to reach families with such evidence-based prevention programs (EBP). Therefore, implementing EBP on a population level could be a promising approach to reach more families, including those faced with socioeconomic challenges who are usually less likely to participate in randomized controlled trials (RCT). Is a population rollout appropriate to reach more and different families than those participating in RCT, especially those representative of the target population? We implemented three EBP in a city in an uncontrolled trial. The effects of this population rollout were tracked on the level of the participating families and on the level of all families living in the city. More than 3480 families (30 % of the population) with children up to 12 years of age participated based on practitioner report. Analyses indicate that a greater percentage of low socioeconomic-status families attended a program compared with a randomly surveyed sample from the city's general population. The sizes of the within-subject effect for parental strategies, child behavior problems, and children's quality of life for a subsample of n = 411 families were similar to those of other uncontrolled EBP studies. The study contributes to highly needed type 2 translation research. The population-based dissemination of EBP could be a promising approach to reach families at risk. However, there are considerable barriers to the implementation process, which currently limit the effectiveness of this rollout in a community.
以家庭为基础的预防项目的主要目标是促进儿童健康。不幸的是，要让家庭参与这类循证预防项目（EBP）并非易事。因此，在人群层面实施循证预防项目可能是一种很有前景的方法，能够惠及更多家庭，包括那些面临社会经济挑战、通常不太可能参与随机对照试验（RCT）的家庭。与参与随机对照试验的家庭相比，在人群层面推广是否适合惠及更多不同的家庭，尤其是那些代表目标人群的家庭呢？我们在一个城市的非对照试验中实施了三项循证预防项目。对参与项目的家庭层面以及该市所有家庭层面的情况都追踪了这种人群推广的效果。根据从业者报告，超过3480个有12岁及以下儿童的家庭（占人口的30%）参与了项目。分析表明，与从该市普通人群中随机抽取的样本相比，社会经济地位较低的家庭中有更大比例的家庭参加了项目。对于n = 411个家庭的子样本，在父母策略、儿童行为问题和儿童生活质量方面的受试者内效应大小与其他非对照循证预防项目研究的结果相似。该研究为迫切需要的2型转化研究做出了贡献。基于人群的循证预防项目推广可能是惠及有风险家庭的一种有前景的方法。然而，实施过程中存在相当多的障碍，目前这些障碍限制了这种在社区推广的效果。
