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研究综述:在对 Incredible Years 父母培训计划的益处和危害进行荟萃分析中利用个体参与者数据的力量。

Research Review: Harnessing the power of individual participant data in a meta-analysis of the benefits and harms of the Incredible Years parenting program.

机构信息

University of Oxford, Oxford, UK.

University of Amsterdam, Amsterdam, The Netherlands.

出版信息

J Child Psychol Psychiatry. 2018 Feb;59(2):99-109. doi: 10.1111/jcpp.12781. Epub 2017 Jul 11.

Abstract

BACKGROUND

Parenting programs aim to reduce children's conduct problems through improvement of family dynamics. To date, research on the precise benefits and possible harms of parenting programs on family well-being has been unsystematic and likely to be subject to selective outcome reporting and publication bias. Better understanding of program benefits and harms requires full disclosure by researchers of all included measures, and large enough numbers of participants to be able to detect small effects and estimate them precisely.

METHODS

We obtained individual participant data for 14 of 15 randomized controlled trials on the Incredible Years parenting program in Europe (total N = 1,799). We used multilevel modeling to estimate program effects on 13 parent-reported outcomes, including parenting practices, children's mental health, and parental mental health.

RESULTS

Parental use of praise, corporal punishment, threats, and shouting improved, while parental use of tangible rewards, monitoring, or laxness did not. Children's conduct problems and attention deficit hyperactivity disorder (ADHD) symptoms improved, while emotional problems did not. Parental mental health (depressive symptoms, self-efficacy, and stress) did not improve. There was no evidence of harmful effects.

CONCLUSIONS

The Incredible Years parenting program improves the aspects of family well-being that it is primarily designed to improve: parenting and children's conduct problems. It also improves parent-reported ADHD symptoms in children. Wider benefits are limited: the program does not improve children's emotional problems or parental mental health. There are no signs of harm on any of the target outcomes.

摘要

背景

育儿计划旨在通过改善家庭动态来减少儿童的行为问题。迄今为止,关于育儿计划对家庭福祉的具体益处和可能危害的研究一直缺乏系统性,并且很可能受到选择性结果报告和发表偏倚的影响。要更好地了解计划的益处和危害,研究人员需要充分披露所有纳入的措施,并且参与者的数量要足够大,以便能够检测到小的影响并精确估计。

方法

我们获得了欧洲 15 项关于不可思议的岁月育儿计划的随机对照试验中的 14 项的个体参与者数据(总计 N=1799)。我们使用多层建模来估计计划对 13 项父母报告的结果的影响,包括育儿实践、儿童心理健康和父母心理健康。

结果

父母使用表扬、体罚、威胁和喊叫的方式有所改善,而使用有形奖励、监督或宽松的方式则没有。儿童的行为问题和注意力缺陷多动障碍(ADHD)症状有所改善,而情绪问题则没有。父母的心理健康(抑郁症状、自我效能和压力)没有改善。没有证据表明有不良影响。

结论

不可思议的岁月育儿计划改善了它主要旨在改善的家庭福祉方面:育儿和儿童的行为问题。它还改善了父母报告的儿童 ADHD 症状。更广泛的益处有限:该计划不能改善儿童的情绪问题或父母的心理健康。在任何目标结果上都没有出现危害的迹象。

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