互联网家长育儿计划预防和早期干预幼儿焦虑问题：随机对照试验。
Internet-Delivered Parenting Program for Prevention and Early Intervention of Anxiety Problems in Young Children: Randomized Controlled Trial.
机构信息
School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
Centre for Emotional Health, Macquarie University, Sydney, Australia.
出版信息
J Am Acad Child Adolesc Psychiatry. 2017 May;56(5):417-425.e1. doi: 10.1016/j.jaac.2017.02.010. Epub 2017 Mar 11.
OBJECTIVE
The Cool Little Kids parenting group program is an effective intervention for preventing anxiety disorders in young children who are at risk because of inhibited temperament. The program has six group sessions delivered by trained psychologists to parents of 3- to 6-year-old children. An online adaptation (Cool Little Kids Online) has been developed to overcome barriers to its wide dissemination in the community. This study tested the efficacy of Cool Little Kids Online in a randomized controlled trial.
METHOD
A total of 433 parents of a child aged 3 to 6 years with an inhibited temperament were randomized to the online parenting program or to a 24-week waitlist. The online program has 8 interactive modules providing strategies that parents can implement with their child to manage their child's avoidant coping, reduce parental overprotection, and encourage child independence. Parents were provided telephone consultation support with a psychologist when requested. Parents completed self-report questionnaires at baseline and at 12 and 24 weeks after baseline.
RESULTS
The intervention group showed significantly greater improvement over time in child anxiety symptoms compared to the control group (d = 0.38). The intervention group also showed greater reductions in anxiety life interference (ds = 0.33-0.35) and lower rates of anxiety disorders than the control group (40% versus 54%), but there were minimal effects on broader internalizing symptoms or overprotective parenting.
CONCLUSION
Results provide empirical support for the efficacy of online delivery of the Cool Little Kids program. Online dissemination may improve access to an evidence-based prevention program for child anxiety disorders. Clinical trial registration information-Randomised Controlled Trial of Cool Little Kids Online: A Parenting Program to Prevent Anxiety Problems in Young Children; http://www.anzctr.org.au/; 12615000217505.
目的
Cool Little Kids 育儿小组计划是一种针对因抑制气质而处于焦虑障碍风险中的幼儿的有效干预措施。该计划有六个小组课程，由经过培训的心理学家为 3 至 6 岁儿童的家长提供。为了克服该计划在社区中广泛传播的障碍，已经开发了一个在线版本（Cool Little Kids Online）。本研究通过随机对照试验测试了 Cool Little Kids Online 的功效。
方法
共有 433 名 3 至 6 岁具有抑制气质的儿童的家长被随机分配到在线育儿计划或 24 周候补名单中。在线计划有 8 个互动模块，为家长提供与孩子一起实施的策略，以管理孩子的回避应对，减少父母过度保护，并鼓励孩子独立。家长可根据需要通过电话向心理学家咨询。家长在基线和基线后 12 周和 24 周完成自我报告问卷。
结果
与对照组相比，干预组的儿童焦虑症状随着时间的推移有显著的改善（d=0.38）。干预组还显示出焦虑生活干扰的减少（ds=0.33-0.35）和焦虑障碍发生率的降低（40%比 54%），但对更广泛的内化症状或过度保护型育儿的影响较小。
结论
结果为 Cool Little Kids 在线计划的有效性提供了实证支持。在线传播可能会提高儿童焦虑障碍的基于证据的预防计划的可及性。临床试验注册信息- Cool Little Kids Online 的随机对照试验：预防幼儿焦虑问题的育儿计划；http://www.anzctr.org.au/；12615000217505。
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