Vanderbilt University School of Medicine, Nashville, TN, USA.
Tennessee Department of Health, Office of Strategic Initiatives, Nashville, TN, USA.
Prev Sci. 2022 Feb;23(2):306-320. doi: 10.1007/s11121-021-01320-w. Epub 2021 Nov 15.
To prevent diseases, efforts are needed to determine how to address Adverse Childhood Experiences (ACEs), including parenting behaviors. The objective of this study, conducted in Nashville TN in 2017, was to initiate testing the psychometric properties of two new Adverse Childhood Experiences (ACEs) screening tools, the Quick Parenting Assessment (QPA) and Other Childhood Stressors (OCS). In a clinic serving low-income families, caregivers of children ages 2-10 completed assessments of parenting (QPA), other stressors (OCS), child behavior problems ((Strength and Difficulties Questionnaire (SDQ)), and Attitudes Toward Spanking (ATS). The QPA takes 1 min to complete and assesses for healthy and unhealthy parenting behaviors. Seventy-five percent of eligible participants completed the survey (N=558). A reduced 10-item QPA yielded a Cronbach's alpha of 0.79 and, in 4-10-year-olds, was associated with high SDQ conduct, hyperactivity, and total difficulties scores (r=0.44, 0.48, and 0.47; all p< 0.001). Children with QPAs of >4 were nine times more likely than those children with scores of ≤2 to have behavior problems (OR=8.93, 95% CI = 3.74-21.32). Elevated QPAs were associated with the ATS (r=0.47, p < .001). The OCS was also associated with high SDQ total difficulties scores (r=0.28, p< 0.001). Two pediatric ACEs screening tools, the QPA and the OCS, have promising psychometric properties. The findings suggest that parenting behaviors may play an outsized role in the pathogenesis of outcomes associated with ACEs. We discuss the clinical application of QPA at our institution and the theoretical potential for this instrument to reduce the rates of short- and long-term health problems.
为了预防疾病,需要努力确定如何解决不良儿童经历(ACEs),包括养育行为。本研究于 2017 年在田纳西州纳什维尔进行,旨在初步检验两种新的不良儿童经历(ACEs)筛查工具,即快速养育评估(QPA)和其他儿童压力源(OCS)的心理测量特性。在一家为低收入家庭服务的诊所中,2-10 岁儿童的照顾者完成了养育(QPA)、其他压力源(OCS)、儿童行为问题((长处和困难问卷(SDQ))和打屁股态度(ATS)的评估。QPA 完成时间为 1 分钟,用于评估健康和不健康的养育行为。符合条件的 75%的参与者完成了调查(N=558)。简化的 10 项 QPA 产生了 0.79 的克朗巴赫阿尔法,并且在 4-10 岁儿童中,与高 SDQ 行为、多动和总困难评分相关(r=0.44、0.48 和 0.47;均 p<0.001)。QPA 评分>4 的儿童发生行为问题的可能性是评分≤2 的儿童的九倍(OR=8.93,95%CI=3.74-21.32)。QPA 评分升高与 ATS 相关(r=0.47,p<0.001)。OCS 也与高 SDQ 总困难评分相关(r=0.28,p<0.001)。两种儿科 ACEs 筛查工具,QPA 和 OCS,具有有前途的心理测量特性。研究结果表明,养育行为可能在与 ACEs 相关的结果的发病机制中起重要作用。我们讨论了我们机构中 QPA 的临床应用以及该工具在降低短期和长期健康问题发生率方面的理论潜力。