一项基于韧性的干预对受 HIV/AIDS 影响儿童的心理社会福祉的随机对照试验：6 个月和 12 个月随访时的效果。
A randomized controlled trial of a resilience-based intervention on psychosocial well-being of children affected by HIV/AIDS: Effects at 6- and 12-month follow-up.
机构信息
Department of Health Promotion, Education, and Behavior, University of South Carolina, 915 Greene St., Columbia, SC, USA.
Department of Psychology, University of South Carolina, 1512 Pendleton St., Columbia, SC, USA.
出版信息
Soc Sci Med. 2017 Oct;190:256-264. doi: 10.1016/j.socscimed.2017.02.007. Epub 2017 Feb 13.
BACKGROUND
Global literature suggests that resilience-based interventions may yield improvements in psychosocial well-being for vulnerable children, but limited data are available regarding the efficacy of such interventions among children affected by parental HIV/AIDS.
OBJECTIVE
To evaluate initial efficacy of a multi-level resilience-based intervention among children affected by parental HIV/AIDS in China in improving children's psychosocial well-being and resilience-related outcomes.
METHOD
Seven hundred-ninety children, 6-17 years of age, were recruited from rural China. Children were either AIDS orphans or were living with one or two parents infected with HIV/AIDS. Children and primary caregivers were randomly assigned to participate in a 4-arm trial to evaluate the Child-Caregiver-Advocacy Resilience (ChildCARE) intervention. This resilience-based psychosocial intervention provides programming at three levels (child, caregiver, community). Survey data were collected at baseline, 6-months, and 12-months in order to examine efficacy of the child-only and child + caregiver arms in improving children's psychological resilience.
RESULTS
Intervention groups displayed improvements in several resilience-related outcomes at 6- and 12-month follow-ups, including self-reported coping, hopefulness, emotional regulation, and self-control. The child-only intervention arm showed some fading of intervention effects by 12-months.
CONCLUSION
Preliminary findings suggest that the ChildCARE intervention is efficacious in promoting psychosocial well-being of children affected by parental HIV/AIDS in rural China. Targeting both children and caregivers for psychosocial intervention may be effective in improving children's resilience. Additional evaluation and modifications, including the inclusion of booster sessions, should be considered to further strengthen the program.
背景
全球文献表明，基于韧性的干预措施可能会改善弱势儿童的心理社会福祉，但关于父母感染艾滋病毒/艾滋病的儿童中此类干预措施的疗效，数据有限。
目的
评估基于多层次韧性的干预措施在中国受父母感染艾滋病毒/艾滋病影响的儿童中改善儿童心理社会福祉和韧性相关结果的初步疗效。
方法
从中国农村招募了 790 名 6-17 岁的儿童。这些儿童要么是艾滋病孤儿，要么是与一名或两名感染艾滋病毒/艾滋病的父母一起生活。儿童及其主要照顾者被随机分配参加一项 4 臂试验，以评估儿童-照顾者倡导韧性（ChildCARE）干预措施。这种基于韧性的心理社会干预措施在三个层面（儿童、照顾者、社区）提供方案。在基线、6 个月和 12 个月收集调查数据，以检验仅儿童和儿童+照顾者干预手臂改善儿童心理韧性的效果。
结果
干预组在 6 个月和 12 个月的随访中，在几个与韧性相关的结果方面显示出改善，包括自我报告的应对能力、希望感、情绪调节和自我控制。仅儿童的干预组在 12 个月时显示出干预效果的一些减弱。
结论
初步结果表明，ChildCARE 干预措施在中国农村地区受父母感染艾滋病毒/艾滋病影响的儿童中促进心理社会福祉是有效的。针对儿童和照顾者进行心理社会干预可能有助于提高儿童的韧性。应考虑进一步评估和修改，包括增加强化课程，以进一步加强该方案。
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