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促进初次关系:针对转介至儿童保护服务机构的家庭开展的为期10周的家访项目随机试验。

Promoting First Relationships: Randomized Trial of a 10-Week Home Visiting Program With Families Referred to Child Protective Services.

作者信息

Oxford Monica L, Spieker Susan J, Lohr Mary Jane, Fleming Charles B

机构信息

1 Family & Child Nursing, University of Washington, Seattle, WA, USA.

2 School of Social Work, University of Washington, Seattle, WA, USA.

出版信息

Child Maltreat. 2016 Nov;21(4):267-277. doi: 10.1177/1077559516668274. Epub 2016 Sep 21.

Abstract

We conducted a community-based randomized control trial with intent-to-treat analysis on Promoting First Relationships® (PFR), a 10-week home visiting program. The study included 247 families with 10- to 24-month-old children who had a recent, open child protective services investigation of child maltreatment. Families were randomly assigned to receive either the 10-week home visiting PFR service or a telephone-based, three-call resource and referral (R&R) service. Across postintervention time points, parents in the PFR condition scored higher than families in the R&R condition in parent understanding of toddlers' social emotional needs ( d = .35) and observed parental sensitivity ( d = .20). Children in the PFR condition scored lower than children in the comparison condition on an observational measure of atypical affective communication ( d = .19) and were less likely than children in the comparison group to be placed into foster care through 1-year postintervention (6% vs. 13%, p = .042). No significant differences were found on measures of parenting stress or child social-emotional competence, behavior problems, or secure base behavior. Overall, the results show support for the promise of PFR as an intervention for enhancing parent sensitivity and preventing child removals for families in the child welfare system.

摘要

我们开展了一项基于社区的随机对照试验,并对“促进初次关系”(PFR)这一为期10周的家访项目进行意向性分析。该研究纳入了247个家庭,这些家庭中有10至24个月大的孩子,且近期因虐待儿童问题接受了儿童保护服务机构的公开调查。家庭被随机分配接受为期10周的家访PFR服务或基于电话的三次通话资源与转介(R&R)服务。在干预后的各个时间点,接受PFR服务的家长在对幼儿社会情感需求的理解(d = 0.35)和观察到的家长敏感性(d = 0.20)方面的得分高于接受R&R服务的家庭。在非典型情感沟通的观察指标上,接受PFR服务的儿童得分低于对照组儿童(d = 0.19),并且在干预后1年内,他们被送入寄养机构的可能性低于对照组儿童(6% 对13%,p = 0.042)。在育儿压力、儿童社会情感能力、行为问题或安全基地行为的测量指标上未发现显著差异。总体而言,研究结果支持了PFR作为一种干预措施的前景,即增强儿童福利系统中家庭的家长敏感性并防止儿童被带走。

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