Promoting First Relationships: Strengthening Child Attachment in Al Communities

促进第一关系：加强儿童在社区中的依恋

• 批准号: 9013408
• 负责人: DEDRA S BUCHWALD
• 金额: $ 17.22万
• 依托单位: WASHINGTON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-03-01 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9013408
• 关键词: Adolescence; Adolescent; Adult; Alcohol or Other Drugs use; American Indians; Attitude; Behavior; Caregivers; Child; Child Behavior; Child Development; Child Rearing; Cognitive; Collaborations; Communities; Community Services; Control Groups; Development; Discipline of Nursing; Domestic Violence; Effectiveness; Ego; Emotional; Exhibits; Exposure to; Family; Feedback; Goals; Head Start Program; Health Personnel; Homelessness; Household; Idaho; Infant; Instruction; Intervention; Interview; Linguistics; Link; Low income; Measurable; Measures; Mediating; Mental Health; Mental disorders; Meta-Analysis; Methods; Modeling; Modification; Mothers; Nez Perce Tribe of Idaho; Outcome; Parents; Personal Satisfaction; Populations at Risk; Poverty; Preventive Intervention; Primary Prevention; Provider; Qualitative Methods; Randomized Controlled Trials; Research; Risk; Rural; School Nursing; Secure; Security; Services; Social Workers; Substance Use Disorder; Testing; Toddler; Training; Tribes; Trust; Universities; Vulnerable Populations; Waiting Lists; Washington; Work; base; behavioral health; caregiving; college; design; early childhood; efficacy testing; evidence base; experience; foster care; improved; infancy; maltreatment; meetings; programs; randomized trial; research study; resilience; self esteem; social; social skills; stressor; theories; tribal community; tribal member

American Indian (Al) children are at elevated risk for experiencing poverty, parental mental health disorders, household exposure to substance use, domestic violence, and maltreatment, all of which increase their risk of developing mental health and substance use problems as adolescents and adults. Very few programs designed to meet their needs within their own tribal communities and consistent with Ai cultural practices exist, and even fewer are based on evidence from high-quality randomized trials. Considerable research points to the importance of caregiver sensitivity and responsiveness in developing secure infant attachment. This proposal aims to implement a theoretically driven, relationship-based intervention strategy: Promoting First Relationships (PFR). PFR promotes trusting and secure caregiver-child relationships and healthy child development, and several studies have shown the positive effects of PFR for at-risk populations. Via collaborations with two tribal partners, we will adapt PFR to Al contexts and deliver the PFR intervention and test its efficacy in a randomized, controlled trial with a wait-list control group. Our primary purpose is to test the efficacy of PFR in improving caregivers' sensitivity and responsiveness to their young children and enhancing children's social and emotional outcomes, especially their attachment security with caregivers. We aim to (1) test the feasibility and effectiveness of training community service providers in the use of PFR by measuring pre- and post-training service provision strategies and interactions with caregivers and infants and (2) assess the extent to which the PFR group, compared with controls, demonstrates improvements in caregivers' sensitivity and responsiveness and children's social and emotional competencies and attachment security. There is a critical need for effective primary prevention interventions aimed at Al children who grow up under stressful circumstances. By promoting sensitive caregiving and child attachment security, we can minimize the impact of contextual stressors on children and Improve their risk outlook. Our community-based methods and perspectives will strengthen our partners' support for the PFR program, contribute to its sustainability, and mitigate against mistrust of the research enterprise.

美洲印第安人（AL）儿童患有贫困，父母心理健康障碍，家庭暴露，家庭暴力和虐待的风险较高，所有这些都增加了他们作为青少年和成年人发展精神健康和吸毒问题的风险。很少有旨在满足其在自己的部落社区中的需求并与AI文化实践一致的计划，甚至基于高质量随机试验的证据，甚至更少。大量的研究表明，护理人员敏感性和反应能力在发展安全的婴儿依恋方面的重要性。该建议旨在实施理论上驱动的基于关系的干预策略：促进第一关系（PFR）。 PFR促进了信任和安全的护理人孩子关系和健康的儿童发展，几项研究表明，PFR对处于危险人群的积极影响。通过与两个部落合作伙伴的合作，我们将在AL上下文中调整PFR，并提供PFR干预并在与候补名单对照组的随机，对照试验中测试其功效。我们的主要目的是测试PFR在改善护理人员对幼儿的敏感性和反应性以及增强儿童的社交和情感成果的功效，尤其是他们与看护人的依恋安全性。我们的目标是（1）测量培训社区服务提供商在使用PFR方面的可行性和有效性，通过测量培训前和培训后服务提供策略以及与护理人员和婴儿的互动，以及（2）评估PFR组与控制相比的程度，证明了护理人员的敏感性和敏感性，响应能力以及儿童社交和情感的能力和相互能力和互相能力和互相能力和互相能力。迫切需要有效的初级预防干预措施，该干预措施针对在压力很大的情况下长大的儿童。通过促进敏感的护理和儿童依恋安全性，我们可以最大程度地减少上下文压力源对儿童的影响并改善其风险前景。我们基于社区的方法和观点将加强我们的合作伙伴对PFR计划的支持，有助于其可持续性，并减轻对研究企业的不信任。