NIHR ARC South West Peninsula (PenARC), University of Plymouth, Plymouth, UK.
University of Exeter Medical School, Exeter, UK.
Prev Sci. 2021 Jan;22(1):100-112. doi: 10.1007/s11121-020-01132-4.
The study, a two-arm, randomized controlled, parallel group, superiority trial, aimed to evaluate the implementation and effectiveness of a 12-month one-to-one volunteer mentoring program designed to improve behavioral and emotional outcomes in children aged 5 to 11 years who have teacher- and parent/carer-reported behavioral difficulties. Participants were 246 children (123 intervention, 123 control; mean age 8.4 years; 87% boys) in five sites in London, UK, scoring in the "abnormal" range on the teacher-rated Strengths and Difficulties Questionnaire (SDQ) Total Difficulties measure and in the "borderline" or abnormal range on the parent-rated SDQ Total Difficulties measure. Randomization on a 1:1 ratio took place using a computer-generated sequence and stratifying by site. Data collectors and statisticians were blind to participant allocation status. Outcome measures focused on parent- and teacher-rated child behavior and emotions, and child-rated self-perception and hope. Intention-to-treat analysis on all 246 randomized participants (using imputed data where necessary) showed that at post-intervention (16 months after randomization), there were no statistically significant effects on the primary outcome-parent-rated SDQ Total Difficulties (adjusted standardized mean difference = - 0.12; 95% CI: -0.38 to 0.13; p = 0.33)-or any secondary outcomes. Results from complier average causal effect (CACE) analysis using the primary outcome indicated the intervention was not effective for children who received the recommended duration of mentoring. Exploratory analyses found no sub-group effects on the primary outcome. The article concludes that the mentoring program had no effect on children's behavior or emotional well-being, and that program content needs revising to satisfactorily address key risk and protective factors.
这项研究是一项为期 12 个月的一对一志愿者指导计划的实施和效果评估，采用了随机对照、平行分组、优势试验设计，旨在改善 5 至 11 岁儿童的行为和情绪结果，这些儿童存在教师和家长/照顾者报告的行为困难，其行为和情绪问题由教师评定的长处和困难问卷（SDQ）总困难量表评分和家长评定的 SDQ 总困难量表评分处于“异常”范围界定。参与者为英国伦敦五个地点的 246 名儿童（123 名干预组，123 名对照组；平均年龄 8.4 岁；87%为男孩）。随机分配比例为 1:1，使用计算机生成的序列，并按地点分层。数据收集员和统计人员对参与者的分配情况不知情。主要结局指标为父母和教师评定的儿童行为和情绪，以及儿童自我认知和希望。对所有 246 名随机参与者（必要时使用插补数据）进行意向治疗分析显示，在干预后（随机分组后 16 个月），父母评定的 SDQ 总困难评分（调整后的标准化均数差=−0.12；95%CI：−0.38 至 0.13；p=0.33）或任何次要结局均无统计学意义。使用主要结局的遵从平均因果效应（CACE）分析的结果表明，对于接受推荐的指导时长的儿童，该干预无效。探索性分析发现，主要结局无亚组效应。文章得出结论，指导计划对儿童的行为或情绪健康没有影响，需要修改计划内容以充分解决关键风险和保护因素。
