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鼓励低收入城市社区照顾者培养促进幼儿发展的育儿行为:一项基于初级保健的育儿项目的随机静态组比较试验

Encouraging Parenting Behaviors That Promote Early Childhood Development Among Caregivers From Low-Income Urban Communities: A Randomized Static Group Comparison Trial of a Primary Care-Based Parenting Program.

作者信息

Shah Reshma, Isaia Ashley, Schwartz Alan, Atkins Marc

机构信息

Department of Pediatrics, College of Medicine, The University of Illinois at Chicago, 840 South Wood Street, MC 856, Chicago, IL, 60612, USA.

Department of Psychology, The University of Illinois at Chicago, 1007 West Harrison Street, Chicago, IL, 60608, USA.

出版信息

Matern Child Health J. 2019 Jan;23(1):39-46. doi: 10.1007/s10995-018-2589-8.

Abstract

Objectives Encouraging key parenting behaviors in early infancy may help decrease income-related developmental disparities. In this study we assessed whether a brief, primary care-based program (Sit Down and Play; SDP) could be successful in impacting key parenting behaviors that promote early childhood development. Methods An ethnically diverse group of predominantly low-income caregivers of children 2-6 months of age were enrolled, interviewed, and randomized to intervention (n = 20) or control (n = 20) groups. Intervention families received SDP at recruitment and the subsequent well-child visit. Control families were provided handouts regarding developmental milestones. One month after the second well-child visit, all families were reinterviewed (n = 34; 85% retention rate). Using open-ended questions and standardized measures (i.e., StimQ), parents were asked about parenting behaviors central to children's development: (1) participation in cognitively stimulating activities, (2) provision of learning materials, and (3) the quality of parent-child verbal interactions. Potential impact on perceived parenting confidence was also explored utilizing The Parenting Sense of Competence Scale. Analyses were conducted using chi square tests and analysis of variance. Results A significant main effect of time, and as hypothesized, an interaction between time and condition emerged that favored SDP on play behaviors (p = 0.03). Post-intervention, SDP families had significantly higher levels of interactional activities between a parent and child that promote cognitive development (p = 0.02). Conclusions for Practice Results appear promising for an accessible, low-intensity program delivered in the primary care setting. Further studies to determine the effectiveness of SDP on parenting behaviors and subsequent developmental outcomes are warranted.

摘要

目标 在婴儿早期鼓励关键的育儿行为可能有助于减少与收入相关的发育差距。在本研究中,我们评估了一个简短的、基于初级保健的项目(坐下玩耍;SDP)是否能够成功影响促进儿童早期发展的关键育儿行为。方法 招募了一组种族多样、主要为低收入的2至6个月大儿童的照料者,对他们进行访谈,并随机分为干预组(n = 20)或对照组(n = 20)。干预组家庭在招募时和随后的健康儿童访视时接受SDP。对照组家庭收到有关发育里程碑的宣传资料。在第二次健康儿童访视后一个月,对所有家庭进行再次访谈(n = 34;保留率85%)。通过开放式问题和标准化测量工具(即StimQ),询问家长关于对儿童发展至关重要的育儿行为:(1)参与认知刺激活动,(2)提供学习材料,以及(3)亲子言语互动的质量。还利用育儿能力感量表探讨了对感知育儿信心的潜在影响。使用卡方检验和方差分析进行分析。结果 出现了显著的时间主效应,并且如假设的那样,出现了时间与条件之间的交互作用,表明SDP在玩耍行为方面更具优势(p = 0.03)。干预后,SDP家庭中促进认知发展的亲子互动活动水平显著更高(p = 0.02)。实践结论 对于在初级保健环境中实施的一个可及的、低强度项目,结果似乎很有前景。有必要进一步开展研究以确定SDP对育儿行为及后续发育结果的有效性。

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