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“不可思议的岁月”父母与婴儿项目:一项试点随机对照试验。

The Incredible Years Parents and Babies Program: A Pilot Randomized Controlled Trial.

作者信息

Pontoppidan Maiken, Klest Sihu K, Sandoy Tróndur Møller

机构信息

SFI-The Danish National Centre for Social Research, Department for Child and Family, Copenhagen, Denmark.

Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

出版信息

PLoS One. 2016 Dec 14;11(12):e0167592. doi: 10.1371/journal.pone.0167592. eCollection 2016.

Abstract

INTRODUCTION

Infancy is an important period of life; adverse experiences during this stage can have both immediate and lifelong impacts on the child's mental health and well-being. This study evaluates the effects of offering the Incredible Years Parents and Babies (IYPB) program as a universal intervention.

METHOD

We conducted a pragmatic, two-arm, parallel pilot randomized controlled trial; 112 families with newborns were randomized to the IYPB program (76) or usual care (36) with a 2:1 allocation ratio. The primary outcome was parenting confidence at 20 weeks(Karitane Parenting Confidence Scale and Parental Stress Scale). Secondary outcomes include measures of parent health, parent-child relationship, infant development, parent-child activities, and network. Interviewers and data analysts were blind to allocation status. Multiple linear-regression analyses were used for evaluating the effects of the intervention.

RESULTS

There were no intervention effects on the primary outcomes. Only one effect was detected for secondary outcomes, intervention mothers reported a significantly smaller network than control mothers (β = -0.15 [-1.85,-0.28]). When examining the lowest-functioning mothers in moderator analyses, we found that intervention mothers reported significantly higher parent stress (β = 5.33 [0.27,10.38]), lower parenting confidence (β = -2.37 [-4.45,-0.29]), and worse mental health than control mothers (β = -18.62 [-32.40,-4.84]). In contrast, the highest functioning intervention mothers reported significantly lower parent stress post-intervention (β = -6.11 [-11.07,-1.14]).

CONCLUSION

Overall, we found no effects of the IYPB as a universal intervention for parents with infants. The intervention was developed to be used with groups of low functioning families and may need to be adapted to be effective with universal parent groups. The differential outcomes for the lowest and highest functioning families suggest that future research should evaluate the effects of delivering the IYPB intervention to groups of parents who have similar experiences with parenting and mental health.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01931917.

摘要

引言

婴儿期是人生中的一个重要阶段;这一阶段的不良经历会对儿童的心理健康和幸福产生即时和终身的影响。本研究评估了提供“神奇岁月父母与婴儿”(IYPB)项目作为一种普遍干预措施的效果。

方法

我们进行了一项实用的双臂平行试点随机对照试验;112个有新生儿的家庭按2:1的分配比例随机分为IYPB项目组(76个)或常规护理组(36个)。主要结局是20周时的育儿信心(卡里坦育儿信心量表和父母压力量表)。次要结局包括父母健康、亲子关系、婴儿发育、亲子活动和社交网络的测量指标。访谈者和数据分析人员对分配情况不知情。采用多元线性回归分析来评估干预效果。

结果

干预对主要结局没有影响。在次要结局中仅发现一个影响,干预组母亲报告的社交网络显著小于对照组母亲(β = -0.15 [-1.85, -0.28])。在调节分析中检查功能最低的母亲时,我们发现干预组母亲报告的父母压力显著更高(β = 5.33 [0.27, 10.38])、育儿信心更低(β = -2.37 [-4.45, -0.29]),且心理健康状况比对照组母亲更差(β = -18.62 [-32.40, -4.84])。相比之下,功能最高的干预组母亲在干预后报告的父母压力显著更低(β = -6.11 [-11.07, -1.14])。

结论

总体而言,我们发现IYPB项目作为对有婴儿的父母的一种普遍干预措施没有效果。该干预措施是为与功能低下家庭群体一起使用而开发的,可能需要进行调整才能对普通父母群体有效。功能最低和最高的家庭的不同结局表明,未来的研究应该评估将IYPB干预措施提供给在育儿和心理健康方面有相似经历的父母群体的效果。

试验注册

ClinicalTrials.gov NCT01931917。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2be/5156553/4a73ac507164/pone.0167592.g001.jpg

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