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一项针对儿童焦虑和抑郁的父母风险和保护因素的定制在线干预:一项随机对照试验的中期结果。

A tailored online intervention to improve parenting risk and protective factors for child anxiety and depression: Medium-term findings from a randomized controlled trial.

机构信息

School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia.

Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia.

出版信息

J Affect Disord. 2020 Dec 1;277:814-824. doi: 10.1016/j.jad.2020.09.019. Epub 2020 Sep 7.

Abstract

BACKGROUND

Despite considerable evidence on parenting risk and protective factors for child anxiety and depressive disorders, the development of interventions based on this evidence is still lagging behind. To address this gap, the web-based Parenting Resilient Kids (PaRK) program was developed to target these risk and protective factors. This study evaluated the effects of the program at 12-month follow-up.

METHODS

A randomized controlled trial was conducted with a community sample of 355 parents and 342 children (M = 9.79). Parents randomized into the web-based PaRK intervention condition received a personalized feedback report about their parenting and were recommended a tailored course of up to 12 interactive modules. Parents in the control condition received a standard set of web-based educational factsheets.

RESULTS

Parents in the intervention group demonstrated significantly greater improvement in self-reported parenting compared to control group parents from baseline to 12-month follow-up, d = 0.24, 95% CI [0.03, 0.45]. Both groups showed reductions in child anxiety and depressive symptoms, parental psychological control and unhealthy family functioning; and improvements in parental acceptance, child- and parent- health-related quality of life.

LIMITATIONS

The PaRK intervention was tailored based on the parents' own report of their parenting behaviors. There was an over-representation of highly-educated mothers and only one parent-child dyad was included per family.

CONCLUSIONS

PaRK improved parenting for up to 12 months, but had no superior effect on children's mental health outcomes compared with an educational-factsheet intervention. Further follow-up is needed to assess longer-term effects.

摘要

背景

尽管有大量关于养育风险和保护因素与儿童焦虑和抑郁障碍的证据,但基于这些证据开发干预措施的进展仍然滞后。为了解决这一差距,开发了基于网络的“养育坚韧儿童”(PaRK)计划,以针对这些风险和保护因素。本研究在 12 个月随访时评估了该计划的效果。

方法

对社区样本中的 355 名父母和 342 名儿童(M=9.79)进行了随机对照试验。随机分配到基于网络的 PaRK 干预条件的父母收到了有关其养育方式的个性化反馈报告,并被推荐了最多 12 个互动模块的个性化课程。对照组的父母收到了一套标准的基于网络的教育手册。

结果

与对照组相比,干预组的父母在自我报告的养育方式方面从基线到 12 个月随访时表现出显著的改善,d=0.24,95%CI[0.03,0.45]。两组儿童的焦虑和抑郁症状、父母的心理控制和不良家庭功能均有所减少,父母的接受度、儿童和父母的健康相关生活质量均有所提高。

局限性

PaRK 干预是根据父母自己报告的养育行为量身定制的。受教育程度高的母亲占比过高,每个家庭仅包括一对父母-子女。

结论

PaRK 改善了长达 12 个月的养育方式,但与教育手册干预相比,对儿童的心理健康结果没有更好的效果。需要进一步随访以评估长期效果。

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