Project 1

项目1

基本信息

批准号：
10250322
负责人：
Sheree Lynn Toth
金额：
$ 66.17万
依托单位：
UNIVERSITY OF ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-13 至 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10250322
关键词：
1 year old Age Attention Biological Birth Characteristics Child Child Abuse and Neglect Child Development Child Rearing Childhood Clinical Cognition Communities Community Health Aides Competence Development Developmental Process Dimensions Distal Early Intervention Environment Evaluation Family Relationship Fostering Group Psychotherapy Home visitation Individual Infant Infant Health Interdisciplinary Study Intervention Knowledge Life Cycle Stages Longevity Low income Measurement Mediating Mediator of activation protein Mental Depression Mental Health Methods Modeling Mother-Child Relations Mothers Nuclear Family Outcome Parents Pathogenicity Pathway interactions Physiological Postpartum Period Pregnant Women Prevention Prevention Research Prevention strategy Process Psychopathology Psychotherapy Public Health Randomized Recording of previous events Research Research Project Grants Risk Risk Factors Science Secure Services Stress Third Pregnancy Trimester Time Transact Translating Translational Research Trauma Treatment outcome Vulnerable Populations Woman Work control trial dosage efficacy evaluation follow-up high risk high risk population implementation strategy improved innovation insight intervention effect intimate partner violence maltreatment maternal depression next generation outreach physical conditioning post intervention postnatal prenatal prevent preventive intervention psychologic response service delivery stress reactivity treatment arm uptake

项目摘要

ABSTRACT RESEARCH PROJECT 1 Research Project 1 is integrated into the TRANSFORM Center to promote the next generation of research on child maltreatment, translate research findings into clinical and preventive interventions, and disseminate research and best practice to varied stakeholders. Informed by developmental psychopathology, the research incorporates multiple levels of analysis within a lifespan framework. Increasing knowledge of optimal methods for delivering dual mother and child preventive intervention has crucial public health significance in preventing child maltreatment. Project 1 involves a randomized control trial to evaluate whether expanding a Community Health Worker (CHW) outreach model, by adding Child-Parent Psychotherapy (CPP), an intensive intervention that focuses on parent-infant relationships for families at risk for child maltreatment, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. The efficacy of CPP has been demonstrated with maltreated and other high-risk populations. Through the use of four intervention arms, the evaluation will assess whether more intensive intervention better protects against child maltreatment compared with CHW support alone, and will determine the optimal timing of these interventions (i.e., beginning prenatally or postnatally), the optimal duration of services (i.e., 6 vs. 12 months), mechanisms of effect (mediator analyses), and which intervention strategy works best for mothers with varying risk factors (moderator analyses). Pregnant women (N = 300) and their infants after birth will participate. Longitudinal assessments will occur during the third trimester of pregnancy, at infant's ages of 3 and 9 months, and a post-intervention follow-up at 12 months old. The measurements obtained at each time- point constitute a rich multi-level perspective of maternal and child functioning over time in response to the interventions. Maternal parenting behaviors, representational models, cognitions, and physiological reactivity, and infants' health and development will be assessed longitudinally. CPP groups are hypothesized to improve sensitive and responsive parenting and secure attachment, relative to CHW home visitation alone, thereby reducing risks for child maltreatment. Improvements in maternal attachment representations, parenting cognitions, and stress reactivity are hypothesized to mediate treatment outcomes. Moderators, including maternal histories of trauma, psychopathology, and intimate partner violence, will advance determination of differential responsiveness to CHW and CPP (what works for whom and why?) and allow for tailored preventive strategies. Identification of timing, dosage, and intensity of service delivery, along with outcome mediators and moderators is innovative and will facilitate development of targeted prevention and intervention strategies that support parenting and decrease child maltreatment for this vulnerable population.

摘要研究项目1 研究项目1被整合到转换中心，以促进下一代研究儿童虐待，将研究结果转化为临床和预防性干预，并传播研究和各种利益相关者的最佳实践。在发育心理病理学的信息中，研究在寿命框架内结合多个分析。提高最佳方法的知识为了提供双重母亲和儿童预防性干预，在防止公共卫生方面具有至关重要的意义儿童虐待。项目1涉及一项随机控制试验，以评估是否扩大社区卫生工作者（CHW）外展模型，通过添加儿童父母心理治疗（CPP），这是一种密集的干预措施这重点是为有虐待儿童虐待风险的家庭的父母关系，提高了疗效改善母子关系，更敏感的育儿，更健康的儿童发展和虐待预防。 CPP的功效已通过虐待和其他高风险人群证明。通过使用四个干预臂，评估将评估更密集的干预措施是否更好与仅CHW支持相比，可以防止儿童虐待，并将确定最佳时机在这些干预措施（即从产前或产后开始），最佳服务持续时间（即6 vs. 12 几个月），效果机制（调解人分析），哪种干预策略最适合母亲具有不同的风险因素（主持人分析）。孕妇（n = 300）及其出生后的婴儿参加。纵向评估将在妊娠三个月期间进行，婴儿的年龄3岁和9个月，以及12个月大的干预后随访。每个时间获得的测量值点构成了随着时间的流逝，孕产妇和儿童在响应时的功能丰富的多层次观点干预措施。孕产妇育儿行为，代表性模型，认知和生理反应性，婴儿的健康和发展将进行纵向评估。 CPP组被假设以改进仅相对于CHW家庭探视，敏感且反应迅速的育儿和安全的依恋降低儿童虐待的风险。孕产妇依恋表示，育儿的改善假设认知和压力反应性以介导治疗结果。主持人，包括孕产妇的创伤，心理病理学和亲密伴侣暴力的历史，将推进确定对CHW和CPP的差异响应能力（对谁和为什么有效？），并允许量身定制预防策略。定时，剂量和服务交付强度的识别以及结果调解人和主持人具有创新性，将有助于开发有针对性的预防和干预支持育儿并减少儿童虐待的策略。