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初级保健中儿童与成人关系强化项目(PriCARE):一项针对儿童行为问题的家长培训随机试验

Child-Adult Relationship Enhancement in Primary Care (PriCARE): A Randomized Trial of a Parent Training for Child Behavior Problems.

作者信息

Schilling Samantha, French Benjamin, Berkowitz Steven J, Dougherty Susan L, Scribano Philip V, Wood Joanne N

机构信息

Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pa; Leonard Davis Institute of Health Economics, University of Pennsylvania School of Medicine, Philadelphia, Pa.

Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pa.

出版信息

Acad Pediatr. 2017 Jan-Feb;17(1):53-60. doi: 10.1016/j.acap.2016.06.009. Epub 2016 Jun 25.

Abstract

OBJECTIVE

Child-Adult Relationship Enhancement in Primary Care (PriCARE) is a 6-session group parent training designed to teach positive parenting skills. Our objective was to measure PriCARE's impact on child behavior and parenting attitudes.

METHODS

Parents of children 2 to 6 years old with behavior concerns were randomized to PriCARE (n = 80) or control (n = 40). Child behavior and parenting attitudes were measured at baseline (0 weeks), program completion (9 weeks), and 7 weeks after program completion (16 weeks) using the Eyberg Child Behavior Inventory (ECBI) and the Adult Adolescent Parenting Inventory 2 (AAPI2). Linear regression models compared mean ECBI and AAPI2 change scores from 0 to 16 weeks in the PriCARE and control groups, adjusted for baseline scores.

RESULTS

Of those randomized to PriCARE, 43% attended 3 or more sessions. Decreases in mean ECBI intensity and problem scores between 0 and 16 weeks were greater in the PriCARE group, reflecting a larger improvement in behavior problems [intensity: -22 (-29, -16) vs -7 (-17, 2), P = .012; problem: -5 (-7, -4) vs -2 (-4, 0), P = .014]. Scores on 3 of the 5 AAPI2 subscales reflected greater improvements in parenting attitudes in the PriCARE group compared to control in the following areas: empathy toward children's needs [0.82 (0.51, 1.14) vs 0.25 (-0.19, 0.70), P = .04], corporal punishment [0.22 (0.00, 0.45) vs -0.30 (-0.61, 0.02), P = .009], and power and independence [0.37 (-0.02, 0.76) vs -0.64 (-1.19, -0.09), P = .003].

CONCLUSIONS

PriCARE shows promise in improving parent-reported child-behavior problems in preschool-aged children and increasing positive parenting attitudes.

摘要

目的

初级保健中的儿童-成人关系强化(PriCARE)是一项为期6节的小组家长培训,旨在教授积极的育儿技巧。我们的目的是衡量PriCARE对儿童行为和育儿态度的影响。

方法

将有行为问题的2至6岁儿童的家长随机分为PriCARE组(n = 80)或对照组(n = 40)。在基线(0周)、项目完成时(9周)以及项目完成后7周(16周),使用艾伯格儿童行为量表(ECBI)和成人青少年养育量表2(AAPI2)对儿童行为和育儿态度进行测量。线性回归模型比较了PriCARE组和对照组从0到16周的平均ECBI和AAPI2变化分数,并对基线分数进行了调整。

结果

在随机分配到PriCARE组的人中,43%参加了3节或更多节课程。PriCARE组在0至16周期间平均ECBI强度和问题分数的下降幅度更大,这反映出行为问题有更大改善[强度:-22(-29,-16)对-7(-17,2),P = 0.012;问题:-5(-7,-4)对-2(-4,0),P = 0.014]。与对照组相比,PriCARE组在AAPI2的5个分量表中的3个分量表上的得分在以下方面反映出育儿态度有更大改善:对儿童需求的同理心[0.82(0.51,1.14)对0.25(-0.19,0.70),P = 0.04]、体罚[0.22(0.00,0.45)对-0.30(-0.61,0.02),P = 0.009]以及权力和独立性[0.37(-0.02,0.76)对-0.64(-1.19,-0.09),P = 0.003]。

结论

PriCARE在改善家长报告的学龄前儿童行为问题以及增强积极的育儿态度方面显示出前景。

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