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比较传统与电子书增强型亲子互动疗法(PCIT):掌上 PCIT 的随机对照试验。

Comparing Traditional and Ebook-Augmented Parent-Child Interaction Therapy (PCIT): A Randomized Control Trial of Pocket PCIT.

机构信息

University of Miami.

University of Miami; Duke University Center for Child and Family Policy.

出版信息

Behav Ther. 2021 Nov;52(6):1311-1324. doi: 10.1016/j.beth.2021.02.013. Epub 2021 Mar 11.

Abstract

Disruptive behavior in young children is one of the most common referrals to behavioral health providers. While numerous effective parenting programs, such as parent-child interaction therapy (PCIT), exist for improving children's behaviors, challenges with treatment engagement and retention limit the intended positive impact on child and caregiver outcomes, particularly for racial and ethnic minority families. In an effort to address barriers contributing to poor engagement and retention in traditional PCIT service delivery and among ethnic and racial minority families, a multimedia PCIT ebook was developed and evaluated. In a sample of the general public that utilized the ebook, users were found to be more engaged in viewing embedded videos within the ebook that were related to expert skill explanations and skill demonstrations than caregiver testimonies. A randomized controlled trial was also conducted to evaluate the extent that the ebook + PCIT improved treatment engagement, retention, parenting skills, skill acquisition efficiency, and child behavior above and beyond traditional PCIT. Participating families were randomly assigned to either the traditional PCIT (n = 71) or ebook + PCIT (n = 107) group using an online random number generator. Forty-nine caregivers (traditional PCIT n = 24, ebook + PCIT n = 25) were excluded from analyses because they were lost to follow-up during the intervention. Families in both the traditional PCIT and ebook + PCIT groups demonstrated generally equivalent positive outcomes in treatment engagement (i.e., attendance, treatment length, completion rate) and caregiver skill acquisition efficiency at midtreatment, posttreatment, and 3-month follow-up. The addition of the ebook to PCIT also reduced child disruptive behavior at midtreatment, above and beyond traditional PCIT, but not at posttreatment or follow-up. Clinical implications and future directions are discussed.

摘要

幼儿的行为问题是行为健康提供者最常遇到的问题之一。虽然有许多有效的育儿计划,如亲子互动治疗(PCIT),可以改善儿童的行为,但治疗参与和保留方面的挑战限制了其对儿童和照顾者结果的预期积极影响,尤其是对少数族裔家庭而言。为了解决导致传统 PCIT 服务提供和少数族裔家庭中参与度和保留率低的障碍,开发并评估了多媒体 PCIT 电子书。在使用电子书的普通公众样本中,发现用户在观看电子书内与专家技能解释和技能演示相关的嵌入式视频时比观看照顾者证词更投入。还进行了一项随机对照试验,以评估电子书+PCIT 在多大程度上提高了治疗参与度、保留率、育儿技能、技能获取效率以及儿童行为,超过了传统 PCIT。参与家庭使用在线随机数生成器随机分配到传统 PCIT(n=71)或电子书+PCIT(n=107)组。由于在干预期间失去随访,49 名照顾者(传统 PCIT n=24,电子书+PCIT n=25)被排除在分析之外。传统 PCIT 和电子书+PCIT 组的家庭在治疗参与度(即出勤率、治疗时长、完成率)和中期、治疗后和 3 个月随访时照顾者技能获取效率方面均表现出相当积极的结果。在中期,PCIT 中添加电子书还可以减少儿童的行为问题,这比传统 PCIT 更有效,但在治疗后和随访时没有效果。讨论了临床意义和未来方向。

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