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健康公平与预防性育儿项目的参与情况:对菲律宾父母的定性研究

Health Equity and Enrollment in Preventive Parenting Programs: A Qualitative Study of Filipino Parents.

作者信息

Javier Joyce R, Deavenport-Saman Alexis, Florendo Ellynore, Bantol Kamil Evy A, Palinkas Lawrence A

机构信息

Children's Hospital Los Angeles, California, USA.

Department of Pediatrics, Keck School of Medicine of University of Southern California, Los Angeles, California, USA.

出版信息

Evid Based Pract Child Adolesc Ment Health. 2022;7(2):245-259. doi: 10.1080/23794925.2021.2013141. Epub 2021 Dec 22.

Abstract

This qualitative study identified the parent health beliefs and normative beliefs related to child behavioral and mental health problems and examined the benefits and barriers of enrolling in an evidence-based parenting intervention among Filipino parents of school-aged children. A secondary aim was to also use the results to inform the development of a theory-based video intervention to increase enrollment in parenting interventions. Semi-structured interviews were conducted with fifteen parents who had or had not participated in the Incredible Years® parenting program, an evidence-based parenting intervention. Interviews were recorded and transcribed verbatim. Using a "Coding Consensus, Co-occurrence, and Comparison" methodology, emergent themes were mapped into a matrix against a priori-coded health belief model (HBM) and Theory of Planned Behavior (TPB) constructs. Parents believed that perceived susceptibility could be influenced by including knowledge of health disparities affecting Filipino youth in the U.S. Perceived severity was related to behavioral and mental health concerns about school, family dynamics, bullying and parent coping strategies. Perceived benefits included strengthening parent-child relationships, creating support systems, and learning positive parenting skills. Perceived barriers included logistics, stigma, and the perception of the relevance of the program, cultural factors such as generational differences about parenting, and family issues. Social norms and subjective norms related to parent participation were also discussed. Applying the HBM and TPB to enrollment in parenting interventions may explain low enrollment rates. Future interventions need to target perceived susceptibility to future behavioral health problems, barriers, and benefits to enrollment, and influence subjective and social norms.

摘要

这项定性研究确定了与儿童行为和心理健康问题相关的家长健康信念和规范信念,并考察了菲律宾学龄儿童家长参与循证育儿干预措施的益处和障碍。次要目标是利用研究结果为基于理论的视频干预措施的开发提供信息,以提高育儿干预措施的参与率。对15位家长进行了半结构化访谈,这些家长参与或未参与过“不可思议的岁月”育儿项目,这是一项循证育儿干预措施。访谈进行了录音并逐字转录。采用“编码共识、共现和比较”方法,将新出现的主题对照预先编码的健康信念模型(HBM)和计划行为理论(TPB)构建映射到一个矩阵中。家长们认为,通过纳入有关影响美国菲律宾裔青少年的健康差异的知识,可以影响感知易感性。感知严重性与对学校、家庭动态、欺凌和家长应对策略的行为和心理健康担忧有关。感知益处包括加强亲子关系、建立支持系统以及学习积极的育儿技巧。感知障碍包括后勤问题、耻辱感、对项目相关性的认知、诸如育儿方面代际差异等文化因素以及家庭问题。还讨论了与家长参与相关的社会规范和主观规范。将HBM和TPB应用于育儿干预措施的参与情况可能解释了参与率较低的原因。未来的干预措施需要针对对未来行为健康问题的感知易感性、障碍和参与益处,并影响主观规范和社会规范。

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