A pilot test of a brief eHealth parent-focused prevention intervention with parents referred from primary care clinics

对初级保健诊所转介的家长进行简短的电子健康以家长为中心的预防干预试点测试

• 批准号: 10285797
• 负责人: Christopher J Mehus
• 金额: $ 27.13万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-16 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10285797
• 关键词: 5 year old; Address; Adolescent; Appointment; Behavioral; British Columbia; Caring; Child; Child Rearing; Childhood; Chronology; Clinic; Communication; Communications Personnel; Communities; Consensus; Control Groups; Control Locus; Data; Development; Disease; Effectiveness; Federally Qualified Health Center; Feedback; Future; Goals; Health Benefit; Human Resources; Intervention; Interview; Investments; Knowledge; Logistics; Measures; Mediating; Mental Depression; Mental Health; Mental disorders; Methods; Modeling; Morbidity - disease rate; Nurses; Outcome; Parents; Patient Self-Report; Patients; Persons; Phase; Population; Prevention program; Primary Health Care; Process; Program Accessibility; Program Effectiveness; Provider; Public Health; Randomized; Research; Research Design; Research Personnel; Resources; Running; Sampling; Service setting; Services; Symptoms; Techniques; Telephone; Testing; Time; Training; Trust; Underserved Population; Videoconferencing; Youth; arm; behavioral health; care providers; eHealth; effectiveness implementation study; effectiveness implementation trial; effectiveness outcome; effectiveness testing; evidence base; experience; innovation; mortality; novel; online community; online delivery; population based; prevent; preventive intervention; programs; skills; skills training

ABSTRACT Evidence-based parent-focused prevention programs prevent future mental illness but are not widely available nor well-attended. To address this this critical gap, research must test more accessible delivery strategies. Thus, the long-term goal of this study is to prevent significant behavioral health problems by increasing the reach and accessibility of an evidence-based parenting program, GenerationPMTO (GenPMTO). GenPMTO has been rigorously tested with in-person delivery; however, logistical barriers like a large time-commitment and the need for childcare limit engagement in in-person parenting programs. Delivering programs online (i.e., eHealth) can overcome these barriers, increasing feasibility for parents. To increase reach, these programs must be paired with frequently-accessed service settings. Primary care clinics are frequently accessed and trusted settings; however, primary care personnel are not trained to address behavioral health or parenting topics and pediatric referrals are often not made or completed. To integrate parenting programs with primary care, training for primary care personnel and a well-defined referral process are needed. Therefore, this study has two objectives: In chronological order, the first objective is to develop (Aim 1) and pilot test (Aim 2) a referral process and a brief communication skills training for primary care providers to equip them to effectively refer parents to eHealth GenPMTO, thereby increasing reach. Aim 1 uses an expert consensus method to develop a feasible training and referral process. Aim 2 is a test of the acceptability of the referral process and a pilot test of the training; primary care personnel (n=35) will be randomized to receive the training or a control condition in which they receive written information about referring parents to GenPMTO therapists. Acceptability, appropriateness, and feasibility of the training and referral process will be evaluated through a mixed methods approach. The collaborating clinics in this study are part of a Federally Qualified Health Center, facilitating reach within an under-served population of parents. The second objective of the study is to pilot test the effectiveness of brief eHealth GenPMTO (Aim 3) within a primary-care-referred population. Although GenPMTO has been rigorously tested, a brief eHealth version has not been tested, nor has GenPMTO been examined for effectiveness among a primary care population. In Aim 3, n=60 parents referred by their primary care provider (which occurs in Aim 2) will be assigned to GenPMTO or a single-session control condition in which they are directed to existing parenting resources. Parents of 3-5-year-old children with moderate behavioral concerns will be eligible for referral. Pilot effectiveness outcomes include parenting behaviors and child externalizing and internalizing symptoms. Acceptability, appropriateness, and feasibility of brief eHealth GenPMTO will be evaluated through a mixed methods approach. This study lays groundwork for a fully- powered hybrid effectiveness-implementation trial.

抽象的 以证据为基础、以家长为中心的预防计划可以预防未来的精神疾病，但尚未广泛实施 也没有受到很好的关注。为了解决这一关键差距，研究必须测试更容易获得的交付策略。 因此，这项研究的长期目标是通过增加 循证育儿计划 GenerationPMTO (GenPMTO) 的覆盖范围和可及性。 GenPMTO 经过亲自交付的严格测试；然而，后勤障碍，例如大量的时间投入 以及对儿童保育的需求限制了面对面育儿计划的参与。在线提供课程（即 eHealth）可以克服这些障碍，增加父母的可行性。为了扩大影响范围，这些计划 必须与经常访问的服务设置配对。初级保健诊所经常被访问并且 可信设置；然而，初级保健人员没有接受过解决行为健康或育儿问题的培训 主题和儿科转诊往往没有制定或完成。将育儿计划与小学结合起来 需要对初级保健人员进行护理、培训以及明确的转诊流程。因此，本研究 有两个目标：按时间顺序，第一个目标是开发（目标 1）和试点测试（目标 2） 转诊流程和针对初级保健提供者的简短沟通技巧培训，使他们能够有效地 将家长转介至 eHealth GenPMTO，从而扩大覆盖范围。目标 1 使用专家共识方法 制定可行的培训和转介流程。目标 2 是测试转介流程的可接受性 培训试点测试；初级保健人员（n = 35）将被随机分配接受培训或对照 他们收到有关将父母转介给 GenPMTO 治疗师的书面信息。 培训和转介过程的可接受性、适当性和可行性将通过 混合方法方法。本研究中的合作诊所是联邦合格健康中心的一部分， 促进服务不足的父母群体的接触。研究的第二个目标是进行试点 简短的 eHealth GenPMTO（目标 3）在初级保健转介人群中的有效性。虽然 GenPMTO 已经过严格测试，简短的 eHealth 版本尚未经过测试，GenPMTO 也尚未经过测试 检查了初级保健人群中的有效性。在目标 3 中，n=60 位家长由其主要推荐人推荐 护理提供者（出现在目标 2 中）将被分配到 GenPMTO 或单次控制条件 他们被引导到现有的育儿资源。 3-5岁中度儿童家长 行为问题将有资格获得转介。试点有效性结果包括养育行为和 儿童外化和内化症状。简短的电子医疗保健的可接受性、适当性和可行性 GenPMTO 将通过混合方法进行评估。这项研究为全面的研究奠定了基础 动力混合有效性实施试验。