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为遭受人际暴力和儿童虐待的拉丁裔家庭实施以创伤为导向、循证为基础的干预措施:SafeCare+®试点随机对照试验方案

Implementation of a trauma-informed, evidence-informed intervention for Latinx families experiencing interpersonal violence and child maltreatment: protocol for a pilot randomized control trial of SafeCare+®.

作者信息

Fettes Danielle L, Aarons Gregory A, Brew Valerie, Ledesma Karla, Silovsky Jane

机构信息

Department of Psychiatry, University of California, 9500 Gilman Drive, #0812, La Jolla, San Diego, CA 92093 USA.

Child and Adolescent Services Research Center, San Diego, CA USA.

出版信息

Pilot Feasibility Stud. 2020 Oct 8;6:153. doi: 10.1186/s40814-020-00681-3. eCollection 2020.

Abstract

BACKGROUND

A consistently demonstrated overlap exists between the occurrence of domestic violence and child maltreatment, yet these issues are historically addressed by distinct systems and programming. The randomized control trial pilot study presented in this article adapts, implements, and tests a new approach for addressing family violence for Latinx families with co-occurring risk for domestic violence and child maltreatment. In doing so, this pilot study addresses the clear need for collaboration between the two fields and focuses on Latinx families, who often face specific challenges regarding seeking and receiving needed services. The primary aim of the current study is a pilot implementation of SafeCare+®, an evidence-based parenting curriculum (SafeCare®) augmented with a healthy relationships curriculum (SafeCare+®). The objectives are a reduction of family violence, improved communication, and a healthy home environment for children in Latinx families with co-occurring domestic violence and child maltreatment.

METHODS

This protocol outlines a feasibility, randomized control trial to examine the potential efficacy of SafeCare+. The pilot study is divided into two phases. Components of phase one involve developing a detailed implementation and evaluation plan, including a community needs assessment, determining screening and outcome measures, and assuring all components are culturally appropriate for the target population. Phase two implements the randomization of parents, who are involved in the child welfare system and referred for in-home parenting services, into SafeCare+ or SafeCare as usual. Participants complete assessments regarding mental health, provider-parent relationship, interpersonal violence experiences, and fidelity to the intervention. Analyses will focus on improvement on target outcomes for the intervention group, as well as comparison to the control group.

DISCUSSION

This study will provide evidence on the feasibility and potential effectiveness of an early intervention program aimed at improving communication skills and mental health and reducing incidents of violence for Latinx parents who are involved with the child welfare service system. The findings of the study will inform the decision to progress to a full scale, definitive randomized control trial to test the effectiveness of an intervention, delivered as part of home visitation, for improving outcomes for families with histories of domestic violence.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT03041558; registered 2 February, 2017-retrospectively registered.

摘要

背景

家庭暴力和儿童虐待的发生之间一直存在明显的重叠,但这些问题在历史上由不同的系统和项目来处理。本文介绍的随机对照试验试点研究采用、实施并测试了一种新方法,以解决同时面临家庭暴力和儿童虐待风险的拉丁裔家庭的家庭暴力问题。通过这样做,该试点研究满足了这两个领域之间明确的合作需求,并聚焦于拉丁裔家庭,他们在寻求和获得所需服务方面往往面临特定挑战。本研究的主要目的是对SafeCare+®进行试点实施,SafeCare+®是一种基于证据的育儿课程(SafeCare®),并增加了健康关系课程(SafeCare+®)。目标是减少拉丁裔家庭中同时存在家庭暴力和儿童虐待情况时的家庭暴力,改善沟通,并为儿童营造健康的家庭环境。

方法

本方案概述了一项可行性随机对照试验,以检验SafeCare+的潜在疗效。试点研究分为两个阶段。第一阶段的组成部分包括制定详细的实施和评估计划,包括社区需求评估、确定筛查和结果指标,并确保所有组成部分在文化上适合目标人群。第二阶段将参与儿童福利系统并被转介接受家庭育儿服务的家长随机分为接受SafeCare+或照常接受SafeCare。参与者完成关于心理健康、提供者与家长关系、人际暴力经历以及对干预的忠诚度的评估。分析将集中于干预组目标结果的改善情况,以及与对照组的比较。

讨论

本研究将为一项早期干预项目的可行性和潜在有效性提供证据,该项目旨在提高参与儿童福利服务系统的拉丁裔家长的沟通技巧和心理健康水平,并减少暴力事件。研究结果将为是否推进到全面、确定性随机对照试验以测试作为家访一部分提供的干预措施对改善有家庭暴力史家庭的结果的有效性提供决策依据。

试验注册

ClinicalTrials.gov,NCT03041558;于2017年2月2日注册——追溯注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5534/7545833/6d07739b4051/40814_2020_681_Fig1_HTML.jpg

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