University of Edinburgh, Scotland, UK.
Mellow Parenting, Scotland, UK.
J Affect Disord. 2019 Mar 1;246:820-827. doi: 10.1016/j.jad.2018.12.120. Epub 2018 Dec 26.
Parental risk factors can have a significant detrimental impact on child development, yet most parenting interventions do not address parental mental health. There is also a dearth of evidence regarding parenting interventions for families with children under two years old. Mellow Parenting (MP) is a suite of parenting interventions targeting at-risk families with complex needs, including those with very young children. Preliminary studies suggest that MP can improve both parent and child outcomes, but no evaluation has been conducted in routine practice.
Using a real-world design we analysed routine data from a UK cohort of n = 183 mother-child dyads, collected over a 21-month period. Data were gathered immediately pre- and post-intervention. Outcomes included maternal mental health, parenting confidence, daily parenting stress, and child behaviour. Intention-to-treat and 'completer' analyses were performed. Associations between attendance, participant demographics, and pre-post change in outcomes were modelled.
MP participation was associated with improvements in maternal mental health (d = 0.36), parenting confidence (d = 0.42), and a component of child psychosocial behaviour (conduct problems; d = 0.36), but not overall child difficulties, or daily parenting stress. Mothers with a partner experienced larger benefits in mental health and parenting confidence compared to single mothers. Younger mothers, and those with a history of mental health problems, attended more intervention sessions.
The study used real-world data and was thus uncontrolled, limiting causal interpretations.
This is the first study to explore MP participation on a multi-site national level and suggests that group-based parenting interventions may be effective for at-risk families. These results should be expanded upon via controlled studies that incorporate follow-up data.
父母的风险因素会对儿童的发展产生重大不利影响,但大多数育儿干预措施都没有解决父母的心理健康问题。对于两岁以下儿童的家庭的育儿干预措施,也缺乏证据。柔和育儿(MP)是一套针对有复杂需求的高危家庭的育儿干预措施,包括那些有年幼子女的家庭。初步研究表明,MP 可以改善父母和孩子的结果,但在常规实践中尚未进行评估。
我们使用真实世界的设计,分析了来自英国队列的 n=183 对母婴对的常规数据,该队列在 21 个月内收集。数据是在干预前和干预后立即收集的。结果包括母亲的心理健康、育儿信心、日常育儿压力和儿童行为。进行了意向治疗和“完成者”分析。分析了出勤率、参与者人口统计学特征与干预前后结果变化之间的关联。
MP 参与与母亲心理健康(d=0.36)、育儿信心(d=0.42)和儿童心理社会行为的一个组成部分(行为问题;d=0.36)的改善相关,但与整体儿童困难或日常育儿压力无关。有伴侣的母亲在心理健康和育儿信心方面的受益大于单身母亲。年轻的母亲和有心理健康问题史的母亲参加了更多的干预课程。
该研究使用了真实世界的数据,因此是不受控制的,限制了因果关系的解释。
这是第一项在多地点全国范围内探索 MP 参与情况的研究,表明基于小组的育儿干预措施可能对高危家庭有效。这些结果应通过纳入随访数据的对照研究来进一步扩展。