Children's Hospital of Philadelphia, 2716 South St, 8th Floor, Philadelphia, Pennsylvania, 19146, United States.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St, 19104, Pennsylvania, PA, United States.
Adm Policy Ment Health. 2023 May;50(3):357-365. doi: 10.1007/s10488-022-01243-w. Epub 2022 Dec 16.
Parent coaching is a complex, psychosocial intervention with multiple core components. Clinicians' use of these core components may be influenced by distinct factors; no research has examined whether clinician perceptions of parent coaching vary across core coaching components. This study aimed to examine the extent to which clinicians working with families of young autistic children in publicly funded early intervention intend to use core parent coaching components, and to examine how closely psychological factors relate to providers' intentions to use each component.
Using the Theory of Planned Behavior as a framework, this study compared the strength of clinicians' intentions across five core parent coaching components: collaboration with parents, delivering the intervention within daily routines, demonstrating the intervention, providing in-vivo feedback, and reflection and problem solving. We examined the associations between intentions and psychological determinants of intentions (i.e., attitudes, norms, and self-efficacy) for each component.
Clinicians' average intentions varied by core component, with strongest intentions for demonstrating the intervention strategy for a parent. The associations between intentions and psychological determinants also varied by core component. Attitudes, injunctive norms, and self-efficacy, but not descriptive norms, significantly related to clinicians' intentions to use collaboration and daily routines, whereas attitudes and descriptive norms, but not injunctive norms and self-efficacy, significantly related to clinicians' intentions to use feedback and reflection and problem solving.
These results suggest that implementation strategies should be tailored to the specific intervention component to be most efficient and effective. The results also provide examples of potentially malleable factors that implementation strategies can strategically target.
家长培训是一种复杂的心理社会干预,具有多个核心组成部分。临床医生使用这些核心组成部分的方式可能受到不同因素的影响;目前还没有研究检验临床医生对家长培训的看法是否因核心培训组成部分的不同而有所不同。本研究旨在考察在为接受公共资金资助的早期干预的年轻自闭症儿童家庭提供服务的临床医生中,有多少人打算使用核心家长培训组成部分,并考察心理因素与提供者使用每个组成部分的意图之间的密切程度。
本研究以计划行为理论为框架,比较了在五个核心家长培训组成部分中,临床医生使用意图的强度:与家长合作、在日常生活中提供干预、示范干预、提供现场反馈以及反思和解决问题。我们检验了意图与意图的心理决定因素(即态度、规范和自我效能感)之间的关联。
临床医生的平均意图因核心组成部分而异,对于向家长示范干预策略的意图最强。意图与心理决定因素之间的关联也因核心组成部分而异。态度、规范和自我效能感,但不是描述性规范,与临床医生使用合作和日常惯例的意图显著相关,而态度和描述性规范,但不是规范和自我效能感,与临床医生使用反馈和反思和解决问题的意图显著相关。
这些结果表明,实施策略应根据要实施的特定干预组成部分进行定制,以实现最高效和最有效的效果。这些结果还提供了潜在的可塑因素的示例,实施策略可以有策略地针对这些因素。