Woodfield Melanie J, Cargo Tania, Merry Sally, Hetrick Sarah E
Centre for Infant, Child and Adolescent Mental Health, Department of Psychological Medicine, University of Auckland, Auckland, New Zealand.
Te Toka Tumai Auckland (Health New Zealand), Auckland, New Zealand.
Pilot Feasibility Stud. 2023 May 3;9(1):73. doi: 10.1186/s40814-023-01309-y.
Despite a number of clinicians having been trained in Parent-Child Interaction Therapy (PCIT) in Aotearoa/New Zealand, few are regularly delivering the treatment, with barriers to use including a lack of suitable equipment and lack of professional support. This pragmatic, parallel-arm, randomised, controlled pilot trial includes PCIT-trained clinicians who are not delivering, or only rarely utilising, this effective treatment. The study aims to assess the feasibility, acceptability and cultural responsivity of study methods and intervention components and to collect variance data on the proposed future primary outcome variable, in preparation for a future, larger trial.
The trial will compare a novel 're-implementation' intervention with a refresher training and problem-solving control. Intervention components have been systematically developed to address barriers and facilitators to clinician use of PCIT using implementation theory, and a draft logic model with hypothesised mechanisms of action, derived from a series of preliminary studies. The intervention includes complimentary access to necessary equipment for PCIT implementation (audio-visual equipment, a 'pop-up' time-out space, toys), a mobile senior PCIT co-worker and an optional weekly PCIT consultation group, for a 6-month period. Outcomes will include the feasibility of recruitment and trial procedures; acceptability of the intervention package and data collection methods to clinicians; and clinician adoption of PCIT.
Relatively little research attention has been directed at interventions to resurrect stalled implementation efforts. Results from this pragmatic pilot RCT will refine and shape knowledge relating to what it might take to embed the ongoing delivery of PCIT in community settings, providing more children and families with access to this effective treatment.
ANZCTR, ACTRN12622001022752, registered on July 21, 2022.
尽管在新西兰有许多临床医生接受了亲子互动疗法(PCIT)的培训,但很少有人定期提供这种治疗,使用障碍包括缺乏合适的设备和专业支持。这项务实的、平行组、随机对照试验纳入了接受过PCIT培训但未提供或很少使用这种有效治疗的临床医生。该研究旨在评估研究方法和干预组件的可行性、可接受性和文化适应性,并收集关于拟议的未来主要结局变量的差异数据,为未来更大规模的试验做准备。
该试验将一种新颖的“重新实施”干预措施与复习培训和问题解决对照进行比较。干预组件是根据实施理论系统开发的,以解决临床医生使用PCIT的障碍和促进因素,并从一系列初步研究中得出了一个带有假设作用机制的逻辑模型草案。干预措施包括在6个月内免费提供实施PCIT所需的设备(视听设备、一个“弹出式”暂停空间、玩具)、一名流动的资深PCIT同事和一个可选的每周PCIT咨询小组。结局将包括招募和试验程序的可行性;干预方案和数据收集方法对临床医生的可接受性;以及临床医生对PCIT的采用情况。
相对较少的研究关注旨在挽救停滞不前的实施工作的干预措施。这项务实的随机对照试验的结果将完善和塑造关于在社区环境中持续提供PCIT可能需要什么的知识,为更多儿童和家庭提供获得这种有效治疗的机会。
澳大利亚和新西兰临床试验注册中心,ACTRN12622001022752,于2022年7月21日注册。