Macam Samantha Reyes, Mack Wendy, Palinkas Lawrence, Kipke Michele, Javier Joyce Rivera
Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States.
Department of Social Welfare, Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA, United States.
JMIR Res Protoc. 2022 Feb 17;11(2):e21867. doi: 10.2196/21867.
Filipino Americans underuse mental health and preventive care services even though studies have indicated that Filipino youth experience high rates of suicidal ideation, substance abuse, and teen pregnancies, whereas adults experience immigration stress, discrimination, and depression. Evidence-based parenting interventions provided in early childhood have proven to be effective in preventing the onset and escalation of child mental health disorders. In a pilot randomized controlled trial, we found that participation in the Incredible Years Basic Parent Training Program (IY) improved parenting stress and positive parenting practices and decreased child internalizing and externalizing symptoms among Filipino families. A fully powered trial is needed to determine the efficacy of IY as a prevention program among Filipino families.
The aims of this study are to describe the design and rationale of a randomized controlled trial evaluating the effects of the web-based IY program among parents recruited from multiple community-based settings and its impact on parenting practices, parenting stress, and child problem behavior among Filipino Americans and describe the impact of COVID-19 on our study protocols.
This study uses a randomized controlled 2-arm individually randomized group treatment pretest-posttest design for 180 parent-child dyads. Individuals are eligible if they are ≥18 years, live in California, and have at least one Filipino child aged 8-12 years. Consenting participants are randomly allocated to receive either the 12-week IY parenting intervention (intervention arm) or American Academy of Pediatrics' Bright Future handouts and placed on a waitlist to receive IY posttrial (waitlist control arm). Primary outcomes include the Parent Practices Interview and the Parenting Stress Index. Secondary outcomes will be measured using the Child Behavior Checklist (completed by parent) and will include child internalizing and externalizing behaviors and total problems. Data are collected at baseline and 3- and 6-month follow-ups.
Changes made to the protocol owing to COVID-19 include administration of surveys remotely and implementation of the intervention on the web. The pandemic has provided an opportunity to evaluate the effectiveness of a web-based version of IY that may improve access and increase use of the intervention. Recruitment and data collection procedures are still ongoing and are expected to be completed by December 2022.
Our research will determine whether IY promotes positive parenting practices and prevents child internalizing and externalizing behaviors in healthy but high-risk populations such as Filipino families. It will also uplift cultural narratives and add to the evidence base for web-based parenting programs and their implementation in real-world settings. If found efficacious, IY has the potential to prevent behavioral health disparities in this understudied and high-risk Filipino population and can be scaled, adapted, and implemented in other at-risk racial and ethnic minority communities.
ClinicalTrials.gov NCT04031170; https://clinicaltrials.gov/ct2/show/NCT04031170.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/21867.
尽管研究表明菲律宾裔美国青少年自杀念头、药物滥用和青少年怀孕发生率很高,而成年人则面临移民压力、歧视和抑郁,但他们对心理健康和预防保健服务的利用不足。事实证明,幼儿期提供的循证育儿干预措施可有效预防儿童心理健康障碍的发生和升级。在一项试点随机对照试验中,我们发现参与“不可思议岁月基本家长培训计划”(IY)可改善菲律宾家庭的育儿压力和积极育儿行为,并减少孩子的内化和外化症状。需要进行一项充分有力的试验来确定IY作为菲律宾家庭预防计划的疗效。
本研究的目的是描述一项随机对照试验的设计和基本原理,该试验评估从多个社区环境招募的家长中基于网络的IY计划的效果及其对菲律宾裔美国人育儿行为、育儿压力和儿童问题行为的影响,并描述2019冠状病毒病对我们研究方案的影响。
本研究采用随机对照双臂个体随机分组治疗的前测-后测设计,涉及180对亲子。符合条件的个体需年满18岁、居住在加利福尼亚州且至少有一名8至12岁的菲律宾裔儿童。同意参与的参与者被随机分配接受为期12周的IY育儿干预(干预组)或美国儿科学会的《美好未来手册》,并被列入候补名单以便在试验后接受IY(候补对照组)。主要结果包括“家长行为访谈”和“育儿压力指数”。次要结果将使用“儿童行为清单”(由家长完成)进行测量,包括孩子的内化和外化行为以及总问题。在基线、3个月和6个月随访时收集数据。
由于2019冠状病毒病对方案所做的更改包括远程进行调查以及在网络上实施干预。疫情提供了一个机会来评估基于网络的IY版本的有效性,这可能会改善干预措施的可及性并增加其使用。招募和数据收集程序仍在进行中,预计将于2022年12月完成。
我们的研究将确定IY是否能在菲律宾家庭等健康但高风险人群中促进积极的育儿行为并预防孩子的内化和外化行为。它还将提升文化叙事,并为基于网络的育儿计划及其在现实环境中的实施增加证据基础。如果发现IY有效,它有可能预防这个研究不足的高风险菲律宾人群中的行为健康差异,并可在其他高风险种族和少数族裔社区进行推广、调整和实施。
ClinicalTrials.gov NCT04031170;https://clinicaltrials.gov/ct2/show/NCT04031170。
国际注册报告识别码(IRRID):DERR1-10.2196/21867。