Brazelton Touchpoints Center, Boston Children's Hospital, MA, USA.
Harvard Medical School, Cambridge, MA, USA.
Eval Rev. 2020 Oct;44(5-6):379-409. doi: 10.1177/0193841X20976527. Epub 2020 Dec 14.
In a previous study of the Child-Parent Centers (CPC) education program, preschool participation was linked to a 4.6 percentage point reduction (26%) in depressive symptoms at ages 22-24 over the matched comparison group enrolling the usual programs. The present study reanalyzed these data in the Chicago Longitudinal Study to address potential attrition bias since more than a quarter of the sample was missing on the outcome. Using inverse probability weighting (IPW) involving 32 predictors of sample retention, findings for the 1,142 participants growing up in high-poverty neighborhoods indicated that CPC participation was associated with a 7.1 percentage point reduction (95% CI = [-9.7, -5.4]) in one or more depressive symptoms (39% reduction over the comparison group). Although this marginal effect was within the confidence interval of the original study (95% CI = [-9.5, 0.3]), the 54% increase in the point estimate is substantial and of practical significance, suggesting underestimation in the prior study. Alternative analysis of different predictors and IPW models, including adjustments for program selection and attrition together, yielded similar results. Findings indicate that high-quality early childhood programs continue to be an important strategy for the prevention of depression and its debilitating effects on individuals and families.
在之前的儿童-家长中心（CPC）教育计划研究中，与参加常规项目的匹配对照组相比，学前教育参与与 22-24 岁时的抑郁症状减少了 4.6 个百分点（26%）。本研究重新分析了芝加哥纵向研究中的这些数据，以解决潜在的辍学偏差问题，因为超过四分之一的样本在结果上缺失。使用涉及 32 个样本保留预测因素的逆概率加权（IPW），对于在高贫困社区长大的 1142 名参与者，发现 CPC 参与与一个或多个抑郁症状减少 7.1 个百分点（95%CI=[-9.7, -5.4]）（与对照组相比减少 39%）有关。尽管这一边际效应在原始研究的置信区间内（95%CI=[-9.5, 0.3]），但估计值的 54%增加是实质性的，具有实际意义，表明先前研究存在低估。对不同预测因素和 IPW 模型的替代分析，包括一起调整计划选择和辍学，得出了类似的结果。研究结果表明，高质量的幼儿教育计划仍然是预防抑郁及其对个人和家庭造成的不良影响的重要策略。
