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ParentCorps学前班项目对儿童心理健康和学业成绩的影响:一项随机临床试验至8岁的随访

Effects of ParentCorps in Prekindergarten on Child Mental Health and Academic Performance: Follow-up of a Randomized Clinical Trial Through 8 Years of Age.

作者信息

Brotman Laurie Miller, Dawson-McClure Spring, Kamboukos Dimitra, Huang Keng-Yen, Calzada Esther J, Goldfeld Keith, Petkova Eva

机构信息

Center for Early Childhood Health and Development, Department of Population Health, New York University Langone Medical Center, New York.

Center for Early Childhood Health and Development, Department of Population Health, New York University Langone Medical Center, New York2now with the School of Social Work, University of Texas at Austin.

出版信息

JAMA Pediatr. 2016 Dec 1;170(12):1149-1155. doi: 10.1001/jamapediatrics.2016.1891.

Abstract

IMPORTANCE

Low-income minority children living in urban neighborhoods are at high risk for mental health problems and underachievement. ParentCorps, a family-centered, school-based intervention in prekindergarten, improves parenting and school readiness (ie, self-regulation and preacademic skills) in 2 randomized clinical trials. The longer-term effect on child mental health and academic performance is not known.

OBJECTIVE

To examine whether ParentCorps delivered as an enhancement to prekindergarten programs in high-poverty urban schools leads to fewer mental health problems and increased academic performance in the early elementary school years.

DESIGN, SETTING, AND PARTICIPANTS: This is a 3-year follow-up study of a cluster randomized clinical trial of ParentCorps in public schools with prekindergarten programs in New York City. Ten elementary schools serving a primarily low-income, black student population were randomized in 2005, and 4 consecutive cohorts of prekindergarten students were enrolled from September 12, 2005, through December 31, 2008. We report follow-up for the 3 cohorts enrolled after the initial year of implementation. Data analysis was performed from September 1, 2014, to December 31, 2015.

INTERVENTIONS

ParentCorps included professional development for prekindergarten and kindergarten teachers and a program for parents and prekindergarten students (13 two-hour group sessions delivered after school by teachers and mental health professionals).

MAIN OUTCOMES AND MEASURES

Annual teacher ratings of mental health problems and academic performance and standardized tests of academic achievement in kindergarten and second grade by testers masked to the intervention or control group randomization.

RESULTS

A total of 1050 children (4 years old; 518 boys [49.3%] and 532 girls [50.7%]) in 99 prekindergarten classrooms participated in the trial (88.1% of the prekindergarten population), with 792 students enrolled from 2006 to 2008. Most families in the follow-up study (421 [69.6%]) were low income; 680 (85.9%) identified as non-Latino black, 78 (9.8%) as Latino, and 34 (4.3%) as other. Relative to their peers in prekindergarten programs, children in ParentCorps-enhanced prekindergarten programs had lower levels of mental health problems (Cohen d = 0.44; 95% CI, 0.08-0.81) and higher teacher-rated academic performance (Cohen d = 0.21; 95% CI, 0.02-0.39) in second grade.

CONCLUSIONS AND RELEVANCE

Intervention in prekindergarten led to better mental health and academic performance 3 years later. Family-centered early intervention has the potential to prevent problems and reduce disparities for low-income minority children.

TRIAL REGISTRATION

clinicaltrials.gov Identifier: NCT01670227.

摘要

重要性

生活在城市社区的低收入少数族裔儿童面临心理健康问题和学业成绩不佳的高风险。ParentCorps是一项以家庭为中心、针对幼儿园前儿童的校内干预措施,在两项随机临床试验中改善了育儿方式和入学准备情况(即自我调节和学前技能)。其对儿童心理健康和学业成绩的长期影响尚不清楚。

目的

研究在高贫困城市学校作为幼儿园前项目补充实施的ParentCorps是否能减少小学低年级阶段的心理健康问题并提高学业成绩。

设计、地点和参与者:这是一项对ParentCorps在纽约市设有幼儿园前项目的公立学校进行的整群随机临床试验的3年随访研究。2005年,10所主要服务低收入黑人学生群体的小学被随机分组,从2005年9月12日至2008年12月31日招收了4个连续队列的幼儿园前儿童。我们报告实施首年之后招收的3个队列的随访情况。数据分析于2014年9月1日至2015年12月31日进行。

干预措施

ParentCorps包括为幼儿园前和幼儿园教师提供专业发展,以及为家长和幼儿园前儿童开展的项目(由教师和心理健康专业人员在放学后进行13次两小时的小组课程)。

主要结局和测量指标

由对干预或对照组随机分组不知情的测试人员进行的年度教师对心理健康问题和学业成绩的评分,以及幼儿园和二年级学业成就的标准化测试。

结果

99个幼儿园前班级的1050名儿童(4岁;518名男孩[49.3%]和532名女孩[50.7%])参与了试验(占幼儿园前儿童总数的88.1%),2006年至2008年招收了792名学生。随访研究中的大多数家庭(421个[69.6%])为低收入家庭;680个(85.9%)被认定为非拉丁裔黑人,78个(9.8%)为拉丁裔,34个(4.3%)为其他族裔。相对于幼儿园前项目中的同龄人,参与ParentCorps强化幼儿园前项目的儿童在二年级时心理健康问题水平较低(科恩d值 = 0.44;95%置信区间,0.08 - 0.81),教师评定的学业成绩较高(科恩d值 = 0.21;95%置信区间,0.02 - 0.39)。

结论和意义

幼儿园前阶段的干预在3年后带来了更好的心理健康和学业成绩。以家庭为中心的早期干预有可能预防问题并减少低收入少数族裔儿童之间的差距。

试验注册

clinicaltrials.gov标识符:NCT01670227。

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