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年轻人,成年人的担忧:针对遭受家庭暴力的青少年和青年成年人的基于互联网的自助方法“感受活力(Feel the ViBe)”的随机对照试验和可行性研究。

Young People, Adult Worries: Randomized Controlled Trial and Feasibility Study of the Internet-Based Self-Support Method "Feel the ViBe" for Adolescents and Young Adults Exposed to Family Violence.

作者信息

van Rosmalen-Nooijens Karin, Lo Fo Wong Sylvie, Prins Judith, Lagro-Janssen Toine

机构信息

Gender & Women's Health, Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands.

Department of Medical Psychology, Radboud university medical center, Nijmegen, Netherlands.

出版信息

J Med Internet Res. 2017 Jun 12;19(6):e204. doi: 10.2196/jmir.6004.

Abstract

BACKGROUND

Adolescents and young adults (AYAs) are of special interest in a group of children exposed to family violence (FV). Past-year prevalence of exposure to FV is known to be highest in AYAs and has severe consequences. Peer support is an effective approach to behavior change and the Internet is considered suitable as a mode of delivery.

OBJECTIVE

The study aimed to evaluate both effectiveness and feasibility of a randomized controlled trial (RCT) and feasibility study of the Internet-based self-support method "Feel the ViBe" (FtV) using mixed-methods approach to fully understand the strengths and weaknesses of a new intervention.

METHODS

AYAs aged 12-25 years and exposed to FV were randomized in an intervention group (access to FtV + usual care) and a control group (minimally enhanced usual care) after they self-registered themselves. From June 2012 to July 2014, participants completed the Impact of Event Scale (IES) and Depression (DEP) and Anxiety (ANX) subscales of the Symptom CheckList-90-R (SCL-90) every 6 weeks. The Web Evaluation Questionnaire was completed after 12 weeks. Quantitative usage data were collected using Google analytics and content management system (CMS) logs and data files. A univariate analysis of variance (UNIANOVA) and mixed model analysis (intention-to-treat [ITT], complete case) were used to compare groups. Pre-post t tests were used to find within-group effects. Feasibility measures structurally address the findings. The CONsolidated Standards Of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth (CONSORT-EHEALTH) checklist was closely followed.

RESULTS

In total, 31 out of 46 participants in the intervention group and 26 out of 47 participants in the control group started FtV. Seventeen participants (intervention: n=8, control: n=9) completed all questionnaires. Mixed model analysis showed significant differences between groups on the SCL-90 DEP (P=.04) and ANX (P=.049) subscales between 6 and 12 weeks after participation started. UNIANOVA showed no significant differences. Pre-post paired sample t tests showed significant improvements after 12 weeks for the SCL-90 DEP (P=.03) and ANX (P=.046) subscales. Reported mean Web-based time per week was 2.83 with a session time of 36 min. FtV was rated a mean 7.47 (1-10 Likert scale) with a helpfulness score of 3.16 (1-5 Likert scale). All participants felt safe. Two-thirds of the intervention participants started regular health care.

CONCLUSIONS

No changes on the IES were found. SCL-90 DEP and ANX showed promising results; however, the calculated sample size was not reached (n=18). FtV functions best as a first step for adolescents and young adults in an early stage of change. FtV can be easily implemented without extensive resources and fits best in the field of public health care or national governmental care.

TRIAL REGISTRATION

Netherlands National Trial Register (NTR): NTR3692; http://www.trialregister.nl/trialreg/admin/ rctview.asp?TC=3692 (Archived by WebCite at http://www.webcitation.org/6qIeKyjA4).

摘要

背景

青少年和青年(AYA)是遭受家庭暴力(FV)的儿童群体中的特殊关注点。已知过去一年中遭受FV的比例在AYA中最高,且会产生严重后果。同伴支持是改变行为的有效方法,而互联网被认为是合适的传播方式。

目的

本研究旨在通过混合方法评估一项随机对照试验(RCT)以及基于互联网的自助方法“感受活力”(FtV)的可行性研究的有效性和可行性,以全面了解新干预措施的优缺点。

方法

12至25岁且遭受FV的AYA在自行注册后被随机分为干预组(可使用FtV+常规护理)和对照组(略有强化的常规护理)。从2012年6月至2014年7月,参与者每6周完成一次事件影响量表(IES)以及症状自评量表90修订版(SCL-90)的抑郁(DEP)和焦虑(ANX)子量表。12周后完成网络评估问卷。使用谷歌分析和内容管理系统(CMS)日志及数据文件收集定量使用数据。采用单因素方差分析(UNIANOVA)和混合模型分析(意向性分析[ITT],完整病例分析)来比较组间差异。采用前后配对t检验来发现组内效应。可行性措施从结构上阐述研究结果。严格遵循电子和移动健康应用及在线远程医疗报告试验的统一标准(CONSORT-EHEALTH)清单。

结果

干预组46名参与者中有31名、对照组47名参与者中有26名开始使用FtV。17名参与者(干预组:n = 8,对照组:n = 9)完成了所有问卷。混合模型分析显示,参与开始后6至12周期间,两组在SCL-90的DEP(P = 0.04)和ANX(P = 0.049)子量表上存在显著差异。UNIANOVA显示无显著差异。前后配对样本t检验显示,12周后SCL-90的DEP(P = 0.03)和ANX(P = 0.046)子量表有显著改善。报告的每周基于网络的平均时间为2.83小时,每次会话时间为36分钟。FtV的平均评分为7.47(1 - 10李克特量表),帮助程度评分为3.16(1 - 5李克特量表)。所有参与者都感到安全。三分之二的干预组参与者开始接受定期医疗保健。

结论

未发现IES有变化。SCL-90的DEP和ANX显示出有前景的结果;然而,未达到计算的样本量(n = 18)。FtV作为处于改变早期阶段的青少年和青年的第一步效果最佳。FtV无需大量资源即可轻松实施,最适合公共卫生保健或国家政府保健领域。

试验注册

荷兰国家试验注册库(NTR):NTR3692;http://www.trialregister.nl/trialreg/admin/rctview.asp?TC = 3692(由WebCite存档于http://www.webcitation.org/6qIeKyjA4)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a890/5484793/a7dea96544c7/jmir_v19i6e204_fig1.jpg

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