Department of Youth and Family, Utrecht University, PO box 80140, Utrecht, 3508TC, the Netherlands.
Department of Forensic Child and Youth Care Sciences, University of Amsterdam, Amsterdam, the Netherlands.
BMC Public Health. 2024 Jan 2;24(1):1. doi: 10.1186/s12889-023-17506-6.
Children from multi-problem families have an increased risk for experiencing mental health problems. These families face problems in several domains that are often found to be chronic and intergenerational. Yet, the effects of mental health care for youths from multi-problem families are small at best, urging research on new treatment programs. The InConnection approach is an integrated care program to improve resilience of youths with mental health needs from multi-problem families by connecting professional expertise from multiple disciplines with the informal social network of the youth. Youths are asked to nominate a youth-initiated mentor (YIM) from the supportive adults in their network.
This quasi-experimental study compared the effectiveness of the InConnection approach to treatment as usual in a sample of 107 families (n = 66 intervention group, n = 41 control group) with n = 115 youths receiving treatment (cases). Youths (n = 102 reports, M = 15.59 years), parents (n = 85 reports) and case managers (n = 107 reports) responded to questionnaires four times over 15 months. Using these data, we measured youth resilience as the primary outcome, seven secondary outcomes, and three intermediate outcomes.
Latent growth models showed only one significant change in outcomes over time across conditions, namely a decrease in case manager-reported child unsafety, and only two condition effects, which were both parent-reported. Parents in the InConnection group reported improvements over time in youth's emotional and behavioral problems and their own positive parenting, whereas control parents reported no changes (ps ≤ 0.013).
The treatment conditions were not effective in improving most of the youth and parental outcomes over time, except for child safety reported by the case manager. The InConnection approach only outperformed care as usual on two parent-reported outcomes. Future research should examine for whom and under what circumstances the InConnection approach works more convincingly.
Netherlands Trial Register NL7565. Retrospectively registered on 05/03/2019.
来自多问题家庭的儿童面临更高的心理健康问题风险。这些家庭在多个领域存在问题，这些问题往往是慢性和代际的。然而，针对多问题家庭青少年的心理健康护理效果甚微，因此需要研究新的治疗方案。InConnection 方法是一种综合护理方案，通过将来自多个学科的专业知识与青少年的非正式社交网络联系起来，来提高有心理健康需求的多问题家庭青少年的适应力。青少年被要求从他们的社交网络中提名一位由青少年发起的导师（YIM）。
本准实验研究比较了 InConnection 方法与常规治疗在 107 个家庭（n=66 个干预组，n=41 个对照组）中 115 名接受治疗的青少年（病例）中的有效性。青少年（n=102 份报告，M=15.59 岁）、父母（n=85 份报告）和个案经理（n=107 份报告）在 15 个月内四次回答问卷。使用这些数据，我们测量了青少年的适应力作为主要结果，七个次要结果和三个中间结果。
潜在增长模型显示，仅在条件下随时间发生了一次显著的结果变化，即个案经理报告的儿童不安全情况减少，且仅发生了两个条件效应，这两个效应都是父母报告的。InConnection 组的父母报告说，随着时间的推移，青少年的情绪和行为问题以及他们自己的积极养育有所改善，而对照组的父母则没有变化（p≤0.013）。
随着时间的推移，治疗条件并没有有效地改善大多数青少年和父母的结果，除了个案经理报告的儿童安全。InConnection 方法仅在两个父母报告的结果上优于常规护理。未来的研究应该研究对于哪些人以及在什么情况下 InConnection 方法更有效。
荷兰试验注册 NL7565。于 2019 年 5 月 3 日回顾性注册。
