Department of Psychology, Western University, London, Canada.
Department of Family Medicine, Western University, London, Canada.
Child Psychiatry Hum Dev. 2020 Feb;51(1):13-26. doi: 10.1007/s10578-019-00906-4.
Dropout from children's mental health services has negative impacts on children, families and service providers. To target interventions aimed to reduce dropout, it is essential to predict individuals who drop out. This study compares predictors of dropout using a novel need-based definition, to existing definitions of dropout. Children (N = 650; 61% male) aged 5-13 attended five children's mental health agencies in Ontario. A mixed effects logistic regression was used to model binary outcome variables (i.e., dropout or treatment completion), for each definition of dropout. Using the need-based definition, older child age, lower child problem presentation, higher child risk behaviors, higher caregiver needs, and more child strengths predicted an increased likelihood of dropout. The need-based definition results in different predictors of dropout than existing definitions in the literature. High caregiver needs was the only predictor of dropout across all definitions. Caregiver needs represent a prospective target when distributing interventions aimed to reduce dropout.
儿童心理健康服务的辍学对儿童、家庭和服务提供者都有负面影响。为了针对旨在减少辍学的干预措施,预测哪些人会辍学是至关重要的。本研究使用一种新的基于需求的定义来比较辍学的预测因素,以现有的辍学定义进行比较。共有 650 名年龄在 5-13 岁的儿童(61%为男性)参加了安大略省的五家儿童心理健康机构。使用混合效应逻辑回归模型,对每个辍学定义的二项结果变量(即辍学或治疗完成)进行建模。使用基于需求的定义,儿童年龄较大、问题表现较低、风险行为较高、照顾者需求较高和更多的儿童优势,预示着辍学的可能性增加。基于需求的定义导致辍学的预测因素与文献中的现有定义不同。高照顾者需求是所有定义中唯一的辍学预测因素。照顾者的需求代表了在分配旨在减少辍学的干预措施时的一个前瞻性目标。