Department of Pediatrics, School of Medicine, New York University and Bellevue Hospital Center, New York, New York;
Department of Pediatrics, School of Medicine, New York University and Bellevue Hospital Center, New York, New York.
Pediatrics. 2018 May;141(5). doi: 10.1542/peds.2017-3393. Epub 2018 Apr 9.
To determine impacts on social-emotional development at school entry of a pediatric primary care intervention (Video Interaction Project [VIP]) promoting positive parenting through reading aloud and play, delivered in 2 phases: infant through toddler (VIP birth to 3 years [VIP 0-3]) and preschool-age (VIP 3 to 5 years [VIP 3-5]).
Factorial randomized controlled trial with postpartum enrollment and random assignment to VIP 0-3, control 0 to 3 years, and a third group without school entry follow-up (Building Blocks) and 3-year second random assignment of VIP 0-3 and control 0 to 3 years to VIP 3-5 or control 3 to 5 years. In the VIP, a bilingual facilitator video recorded the parent and child reading and/or playing using provided learning materials and reviewed videos to reinforce positive interactions. Social-emotional development at 4.5 years was assessed by parent-report Behavior Assessment System for Children, Second Edition (Social Skills, Attention Problems, Hyperactivity, Aggression, Externalizing Problems).
VIP 0-3 and VIP 3-5 were independently associated with improved 4.5-year Behavior Assessment System for Children, Second Edition T-scores, with effect sizes (Cohen's d) ∼-0.25 to -0.30. Receipt of combined VIP 0-3 and VIP 3-5 was associated with d = -0.63 reduction in Hyperactivity ( = .001). VIP 0-3 resulted in reduced "Clinically Significant" Hyperactivity (relative risk reduction for overall sample: 69.2%; = .03; relative risk reduction for increased psychosocial risk: 100%; = .006). Multilevel models revealed significant VIP 0-3 linear effects and age × VIP 3-5 interactions.
Phase VIP 0-3 resulted in sustained impacts on behavior problems 1.5 years after program completion. VIP 3-5 had additional, independent impacts. With our findings, we support the use of pediatric primary care to promote reading aloud and play from birth to 5 years, and the potential for such programs to enhance social-emotional development.
通过婴儿至学步期（VIP 出生至 3 岁[VIP 0-3]）和学前阶段（VIP 3 至 5 岁[VIP 3-5]）两个阶段实施的儿科初级保健干预措施（视频互动项目[VIP]）促进通过朗读和游戏进行积极育儿，来确定其对儿童入学时社会情感发展的影响。该干预措施通过朗读和游戏促进积极的亲子互动，使用提供的学习材料由双语协调员对父母和孩子进行视频记录，并对视频进行回顾以加强积极互动。
采用产后入组、随机分配的析因随机对照试验，将参与者分为 VIP 0-3 组、对照组 0-3 年组和无入学后随访组（积木），以及 3 岁时第二次随机分配 VIP 0-3 组和对照组 0-3 年组至 VIP 3-5 组或对照组 3-5 年组。在 VIP 组中，双语协调员使用提供的学习材料对父母和孩子的阅读和/或游戏进行视频记录，并对视频进行回顾以加强积极的互动。4.5 岁时通过家长报告的儿童行为评估系统第二版（社交技能、注意力问题、多动、攻击、外化问题）评估社会情感发展。
VIP 0-3 和 VIP 3-5 与改善的 4.5 岁儿童行为评估系统第二版 T 评分独立相关，效果大小（Cohen's d）为-0.25 至-0.30。接受 VIP 0-3 和 VIP 3-5 的综合干预与多动的 d = -0.63 减少有关（P =.001）。VIP 0-3 导致“临床显著”多动减少（总体样本的相对风险降低：69.2%；P =.03；增加心理社会风险的相对风险降低：100%；P =.006）。多层次模型显示 VIP 0-3 具有显著的线性效应和年龄×VIP 3-5 的交互作用。
VIP 0-3 阶段在项目完成后 1.5 年仍持续对行为问题产生影响。VIP 3-5 具有独立的额外影响。有了我们的研究结果，我们支持使用儿科初级保健从出生到 5 岁促进朗读和游戏，并且此类项目有可能增强社会情感发展。
