Cafatti Mac-Niven Anastassia, Comer Jonathan S, Bagner Daniel M
Department of Psychology, Florida International University, Miami, FL, United States.
Center for Children and Families, Florida International University, Miami, FL, United States.
Front Child Adolesc Psychiatry. 2025 Mar 12;4:1500742. doi: 10.3389/frcha.2025.1500742. eCollection 2025.
Families from racial/ethnic minoritized backgrounds and families of children with developmental delay (DD) often face more obstacles to engaging in psychosocial interventions compared to White families and families of typically developing children. Yet, research on engagement in behavioral parenting interventions has predominantly focused on typically developing children and White families from majority cultural groups. The present study offers the first examination of acculturation and enculturation as predictors of homework engagement among caregivers of children with DD from underrepresented racial/ethnic backgrounds participating in a telehealth behavioral parenting intervention.
Data were collected from 65 caregiver-child dyads participating in the Advancing Child Competencies by Extending Supported Services (ACCESS) Study evaluating Internet-delivered Parent-Child Interaction Therapy (iPCIT) for children with DD. Homework engagement was measured as the proportion of days caregivers practiced "special time" with their child. Acculturation and enculturation were assessed using the Abbreviated Multidimensional Acculturation Scale (AMAS). Linear regression analyses evaluated associations between these two cultural factors and subsequent homework engagement, controlling for caregiver nativity, language of preference, income-to-needs ratio (INR), and caregiver work status.
While higher levels of acculturation ( = .110, = .054) did not significantly predict homework engagement, enculturation ( = .140, = .007) significantly predicted greater homework engagement throughout treatment with small and small-to-medium effect sizes (Cohen's ² = 0.029 and 0.104, respectively).
These findings underscore the nuanced role of acculturation and enculturation in predicting homework engagement in telehealth behavioral interventions for children with DD. Although acculturation did not facilitate homework engagement, caregivers who retained a stronger connection to their cultural heritage demonstrated higher homework engagement within the context of iPCIT. The study highlights the need for incorporating cultural considerations into treatment planning and flexibility in adapting treatment protocols to optimize family engagement and improve outcomes in this population.
ClinicalTrials.gov, identifier (NCT03260816).
与白人家庭和发育正常儿童的家庭相比，来自少数族裔背景的家庭以及发育迟缓（DD）儿童的家庭在参与社会心理干预方面往往面临更多障碍。然而，关于参与行为养育干预的研究主要集中在发育正常的儿童和来自多数文化群体的白人家庭。本研究首次考察了文化适应和文化传承作为参与远程健康行为养育干预的代表性不足的种族/族裔背景的发育迟缓儿童的照顾者家庭作业参与度预测因素的情况。
从65对照顾者-儿童二元组收集数据，这些二元组参与了通过扩展支持服务提高儿童能力（ACCESS）研究，该研究评估了为发育迟缓儿童提供的互联网亲子互动疗法（iPCIT）。家庭作业参与度通过照顾者与孩子进行“特殊时光”练习的天数比例来衡量。使用简化多维文化适应量表（AMAS）评估文化适应和文化传承。线性回归分析评估了这两个文化因素与随后的家庭作业参与度之间的关联，同时控制照顾者的出生地、偏好语言、收入需求比（INR）和照顾者工作状态。
虽然较高水平的文化适应（β = 0.110，p = 0.054）并没有显著预测家庭作业参与度，但文化传承（β = 0.140，p = 0.007）在整个治疗过程中显著预测了更高的家庭作业参与度，效应量较小和中小（科恩d²分别为0.029和0.104）。
这些发现强调了文化适应和文化传承在预测发育迟缓儿童远程健康行为干预中的家庭作业参与度方面的细微作用。虽然文化适应并没有促进家庭作业参与度，但与文化遗产保持更紧密联系的照顾者在iPCIT背景下表现出更高的家庭作业参与度。该研究强调了在治疗计划中纳入文化考虑因素以及在调整治疗方案时保持灵活性的必要性，以优化家庭参与度并改善该人群的治疗效果。
ClinicalTrials.gov，标识符（NCT03260816）。
