Evaluating an Online Parenting Support System Disseminated by Pediatric Practices

评估儿科诊所传播的在线育儿支持系统

• 批准号: 8819113
• 负责人: CAROL W METZLER
• 金额: $ 63.71万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-04-15 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8819113
• 关键词: 8 year old; Address; Alcohol or Other Drugs use; Attitude; Behavior; Behavior Therapy; Caring; Child; Child Behavior; Child Rearing; Childhood; Clinic; Communities; Community Services; County; Distress; Evaluation; Exposure to; Failure; Family; Family Practice; Future; Health; Internet; Intervention; Knowledge; Measures; Mediating; Medicaid; Mental Health; Methods; Modeling; Online Systems; Oregon; Outcome; Paper; Parents; Patients; Population; Prevalence; Prevention; Preventive; Primary Health Care; Problem behavior; Protocols documentation; Public Health; Queensland; Randomized; Recruitment Activity; Research Institute; Research Project Grants; Resources; Risk; Rural; Sampling; Schools; Self Efficacy; Self-Administered; Series; Services; Single Parent; Substance abuse problem; Support System; System; Testing; Text; Time; Touch sensation; Training; Universities; Washington; Work; adverse outcome; base; behavior change; behavioral health; clinical practice; cost; design; dosage; early onset; evidence base; experience; flexibility; follow-up; improved; innovation; pediatrician; population based; post intervention; prevent; programs; response; satisfaction; skills; treatment as usual; uptake

DESCRIPTION (provided by applicant): Disruptive behavior problems are among the most prevalent mental health conditions for young children, and they carry significant risks for later socioemotional, conduct, and academic problems, such as substance abuse, delinquency, and school failure. How parents handle these challenging behaviors strongly influences their children's long-term trajectory. Evidence-based parenting programs have shown much value in reducing early-onset disruptive behavior problems, thereby reducing risks for later substance abuse and other behavioral health problems. The reach of parenting programs is limited, however, by significant challenges in recruiting, engaging, and retaining parents, such that most parents who could benefit from parenting assistance never receive it. A public health approach for improving parenting practices that makes evidence- based parenting programs widely available and accessible in a range of formats could reduce the prevalence of disruptive behavior problems, and thus the population-level risk for substance abuse and other adverse outcomes. Internet-based intervention offers significant potential as part of a population-wide strategy for bringing evidence-based parenting practices to a broad range of parents experiencing challenges in raising their children. Furthermore, pediatricians could be a natural touch point for reaching families with evidence- based parenting supports. The field knows little, however, about the potential of the internet to strengthen parenting practices, or about how pediatric practitioners might be engaged in improving the reach of an online parenting program. This study will experimentally evaluate an internet-based version of the Triple P Positive Parenting Program, the Triple P Online System (TPOS), which presents the Triple P content in an interactive, video-enriched, and personalized format with 3-levels of flexible dosage, and will compare it against usual community services. Thirty pediatric clinics involving 100 practitioners in 8 counties across western Washington will be recruited and randomized to receive (a) access for their patients to the Triple P Online System and training in how to effectively promote TPOS and advise parents on their children's behavior problems or (b) Usual Care Community-Waitlist Control, in which parents will be assisted with an appropriate referral for services in the community. Practitioners will recruit into their respective conditions 500 families of 3-8 year-old children with elevated behavior problems. Measures of parents' parenting practices, family functioning, children's disruptive behavior problems, and practitioners' protocols for advising on behavior problems will be obtained at baseline, post-intervention, and 1-year follow-up. The efficacy of the Triple P Online System in improving these outcomes will be examined, as well as dosage-response relationships. This study will further our understanding of the potential value of promoting internet-based parenting programs through pediatric practitioners. Maximizing the reach of evidence-based parenting programs has the potential to reduce the prevalence of children's behavior problems, and thus reduce risks for later problems such as substance abuse.

描述（由申请人提供）：破坏性行为问题是幼儿最普遍的心理健康状况之一，它们对日后的社会情感、行为和学业问题（如药物滥用、犯罪和学业失败）带来重大风险。父母如何处理这些具有挑战性的行为会极大地影响孩子的长期发展轨迹。基于证据的育儿计划在减少早期发生的破坏性行为问题方面显示出很大的价值，从而降低了以后滥用药物和其他行为健康问题的风险。然而，由于在招募、吸引和留住家长方面面临重大挑战，育儿计划的覆盖范围受到限制，因此大多数可以从育儿援助中受益的父母从未获得过援助。改善育儿实践的公共卫生方法，使基于证据的育儿计划以多种形式广泛提供和获取，可以减少破坏性行为问题的发生率，从而降低人口层面的药物滥用和其他不良后果的风险。作为全民战略的一部分，基于互联网的干预措施具有巨大的潜力，可以为在抚养孩子方面遇到挑战的广大父母提供基于证据的育儿实践。此外，儿科医生可能是为家庭提供基于证据的育儿支持的自然接触点。然而，该领域对互联网加强育儿实践的潜力，或者儿科从业人员如何参与扩大在线育儿计划的影响力知之甚少。本研究将实验评估 Triple P 积极育儿计划的互联网版本，即 Triple P 在线系统 (TPOS)，该系统以交互式、视频丰富和个性化的格式呈现 Triple P 内容，具有 3 个级别的灵活剂量，并将其与通常的社区服务进行比较。将招募和随机分配来自华盛顿州西部 8 个县的 30 个儿科诊所，涉及 100 名从业人员，以接受 (a) 患者访问 Triple P 在线系统以及如何有效推广 TPOS 并就孩子的行为问题向家长提供建议的培训，或者（ b) 常规护理社区候补名单控制，其中将协助家长适当转介社区服务。实践者将根据各自条件招募500个3-8岁家庭 行为问题严重的儿童。将在基线、干预后和一年的随访中获得对父母养育方式、家庭功能、儿童破坏性行为问题以及从业者针对行为问题提供建议的方案的测量。将检查 Triple P 在线系统在改善这些结果方面的功效以及剂量-反应关系。这项研究将进一步让我们了解通过儿科医生推广基于互联网的育儿计划的潜在价值。最大限度地扩大循证育儿计划的影响范围有可能减少儿童行为问题的发生率，从而降低以后出现药物滥用等问题的风险。