Child Study Center, School of Medicine, Yale University, New Haven, Connecticut.
Arab Resource Collective, Beirut, Lebanon.
J Am Acad Child Adolesc Psychiatry. 2020 Jun;59(6):727-738. doi: 10.1016/j.jaac.2019.12.010. Epub 2020 Jan 31.
Few randomized controlled trials (RCTs) have explored the implementation and impact of early childhood parenting education programs in very fragile contexts and humanitarian settings. We tested the effects of a group-based intervention, the Mother-Child Education Program (MOCEP), on parenting stress and practices among two refugee communities and one other marginalized community in Beirut, Lebanon.
A pilot wait-list RCT was conducted to assess the program's impact on maternal, child (average age: 4 years), and dyadic outcomes. A total of 106 mother-child dyads were randomly assigned to either the intervention group (n = 53) or the wait-list control group (n = 53). Analysis was conducted by modified intention-to-treat and supplemental analyses through multiple imputation of missing post-intervention data.
Forty families (38%) withdrew early from the study. After completing the program, mothers in the intervention group showed a reduction in their harsh parenting practices, as indexed by the Disciplinary Style Questionnaire (Cohen's d = -0.76, 95% CI = -1.24, -0.27) and in their level of parenting stress, as indexed by the Parenting Stress Index-Short Form (PSI-SF; Cohen's d = -0.90, 95% CI = -1.39, -0.40). Exploratory but underpowered analyses of dyadic interactions revealed reductions in the PSI were associated with a reduction in harsh parenting after the intervention. However, we did not detect any positive impact on behavioral or emotional outcomes among the children.
Our analyses suggest that MOCEP had a positive impact on disciplinary practices and parenting stress in a context of high fragility, but that broader effects on maternal and child outcomes may be dependent on program attendance and the availability of other services. We discuss implications of this pilot study for practice and research of a largely unexplored area of program evaluation.
Mother and Child Education Program in Palestinian Refugee Camps; https://clinicaltrials.gov; NCT02402556.
在非常脆弱的环境和人道主义环境中，很少有随机对照试验（RCT）探讨幼儿养育教育计划的实施和影响。我们测试了基于小组的干预措施——母子教育计划（MOCEP）对黎巴嫩贝鲁特两个难民社区和另一个边缘化社区的养育压力和实践的影响。
进行了一项试点候补名单 RCT，以评估该计划对母婴（平均年龄：4 岁）和对偶结果的影响。共有 106 对母婴被随机分配到干预组（n=53）或候补名单对照组（n=53）。通过修改后的意向治疗分析和通过缺失后干预数据的多重插补进行补充分析来进行分析。
40 个家庭（38%）提前退出了研究。在完成该计划后，干预组的母亲表现出其严厉养育行为的减少，这是通过纪律风格问卷（Cohen's d=-0.76，95%置信区间=-1.24，-0.27）和养育压力指数-短表（PSI-SF；Cohen's d=-0.90，95%置信区间=-1.39，-0.40）来衡量的。对对偶相互作用的探索性但效力不足的分析表明，PSI 的降低与干预后严厉养育行为的减少有关。然而，我们没有发现该计划对儿童的行为或情感结果有任何积极影响。
我们的分析表明，在高脆弱性背景下，MOCEP 对纪律实践和养育压力产生了积极影响，但对母婴结果的更广泛影响可能取决于计划的参与度和其他服务的提供情况。我们讨论了这项试点研究对该计划评估这一尚待探索领域的实践和研究的意义。
巴勒斯坦难民营中的母子教育计划；https://clinicaltrials.gov；NCT02402556。
