University of North Carolina at Chapel Hill, Chapel Hill, NC.
Washington University in St. Louis, St. Louis, MO.
J Dev Behav Pediatr. 2018 Dec;39(9):701-708. doi: 10.1097/DBP.0000000000000608.
Child maltreatment is an adverse childhood experience associated with reductions in child well-being. This study examines whether an evidence-based parenting intervention delivered to families served by the child welfare system (CWS) affects pediatric health-related quality of life (HRQoL).
This study is a randomized controlled trial of Pathways Triple P (PTP) delivered to families with open child welfare cases for child physical abuse or neglect (N = 119). Children were 5 to 11 years old and remained in the home after the investigation. The primary outcome measure for this study was the Pediatric Quality of Life Inventory (PedsQL) 4.0, which measures HRQoL across 4 subdomains: physical functioning, emotional functioning, social functioning, and school functioning. Child- and parent-reported PedsQL 4.0 was assessed at baseline and post-test after the 14-week intervention.
Controlling for other factors, children in families randomly assigned to the PTP condition had a significant improvement in overall HRQoL after the intervention compared with families receiving usual services (βchild-report = 6.08, SE = 2.77, p = 0.03; βparent-report = 3.83, SE = 1.88, p = 0.04). Subdomain effect sizes differed when considering children's self-report or parents' proxy report. Children's self-report yielded the largest improvement in emotional functioning, whereas social functioning had the largest gain based on parents' proxy report.
The PTP parenting intervention was associated with higher pediatric HRQoL as reported by both the child and parent. This intervention holds promise to improve child well-being when implemented in the CWS.
儿童虐待是一种不良的童年经历,与儿童福祉的降低有关。本研究探讨了向儿童福利系统(CWS)服务的家庭提供循证育儿干预是否会影响儿科健康相关生活质量(HRQoL)。
这是一项针对有开放儿童福利案件的家庭(因身体虐待或忽视而立案)实施路径三重 P(PTP)的随机对照试验(N=119)。儿童年龄在 5 至 11 岁之间,在调查后仍留在家中。本研究的主要结局指标是儿科生活质量量表(PedsQL)4.0,它衡量了 4 个亚领域的 HRQoL:身体功能、情绪功能、社会功能和学校功能。在基线和 14 周干预后的后测中,评估了儿童和父母报告的 PedsQL 4.0。
在控制了其他因素后,与接受常规服务的家庭相比,随机分配到 PTP 条件的家庭的儿童在干预后整体 HRQoL 有显著提高(儿童报告β=6.08,SE=2.77,p=0.03;父母报告β=3.83,SE=1.88,p=0.04)。考虑到儿童的自我报告或父母的代理报告,子域的效果大小有所不同。儿童的自我报告在情绪功能方面取得了最大的改善,而基于父母代理报告,社会功能的增益最大。
PTP 育儿干预与儿童和家长报告的儿科 HRQoL 呈正相关。当在 CWS 中实施时,这种干预有望改善儿童的幸福感。