Gray Gemma R, Totsika Vasiliki, Lindsay Geoff
Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, United Kingdom.
Department of Psychology, University of Warwick, Coventry, United Kingdom.
Front Psychol. 2018 Oct 26;9:2035. doi: 10.3389/fpsyg.2018.02035. eCollection 2018.
Despite ample evidence of the efficacy and effectiveness of evidence-based parenting programs (EBPPs) within research-led environments, there is very little evidence of maintenance of effectiveness when programs are delivered as part of regular service provision. The present study examined the effectiveness of EBPPs provided during a period of sustained service-led implementation in comparison to research-led effectiveness evaluation. Data from 3706 parents who received EBPPs during sustained implementation by services were compared to data from 1390 parents who had participated in an earlier researcher-led effectiveness trial of a national roll-out of EBPPs in England. In both phases, parents completed measures of child behavior problems, parenting style and parental mental well-being prior to starting parenting programs (pre-test), at the end of the programs (post) and at 12-months follow up. Results from Generalized Estimating Equations controlling for potential covariates indicated significant improvements in child behavior problems during sustained implementation, similar to the effectiveness phase; significant improvements in parenting style which were larger than the effectiveness phase at 12-month follow up; and significant improvements in parental mental well- being. Our findings demonstrate effective maintenance of gains when EBPPs are provided as part of regular provision across a large sample of English parents. Successful long-term implementation should consider effectiveness of EBPPs across the population, given the large contextual changes that take place between researcher-led evaluations and service take-up. Our findings support the integration of EBPPs in public health approaches to addressing child behavior problems and parent well-being.
尽管在以研究为主导的环境中有充分证据表明循证育儿项目（EBPPs）有效且有成效，但几乎没有证据表明当这些项目作为常规服务提供的一部分时，其效果能得以维持。本研究考察了在以服务为主导的持续实施期间提供的EBPPs的效果，并与以研究为主导的效果评估进行比较。将在服务持续实施期间接受EBPPs的3706名家长的数据，与1390名曾参与过英国全国范围内EBPPs推广的早期研究者主导的效果试验的家长的数据进行比较。在两个阶段中，家长们在开始育儿项目之前（预测试）、项目结束时（后测）以及12个月随访时，都完成了关于儿童行为问题、育儿方式和父母心理健康的测量。控制潜在协变量的广义估计方程结果表明，在持续实施期间儿童行为问题有显著改善，类似于效果阶段；育儿方式有显著改善，在12个月随访时比效果阶段更大；父母心理健康也有显著改善。我们的研究结果表明，当EBPPs作为英国大量家长常规服务的一部分提供时，收益能得到有效维持。鉴于在研究者主导的评估和服务采用之间发生了巨大的背景变化，成功的长期实施应考虑EBPPs在整个人口中的效果。我们的研究结果支持将EBPPs纳入解决儿童行为问题和父母福祉的公共卫生方法中。
