背景:对有行为困难的儿童进行基于证据的行为父母培训的访问和吸收(即,反对,反抗,侵略性,过度活跃,冲动,和注意力不集中的行为)目前由于缺乏认证的治疗师和漫长的等待名单而受到限制。这些问题部分是由于大多数基于证据的计划的时间长,有时甚至被视为僵化性质,导致很少有家庭开始行为父母培训和高辍学率。简短且个性化的育儿干预措施可能会减少这些问题,并使行为父母培训更容易获得。这篇协议论文描述了一个双臂,多中心,关于短期和长期有效性和成本效益的随机对照试验,为行为困难儿童量身定制的行为家长培训计划。
方法:2-12岁儿童的父母转诊到儿童精神保健中心,被随机分配到(i)三次行为家长培训,任选加强课程或(ii)照常护理。为了评估有效性,我们的主要结果是父母对4项选定行为困难的5项每日评分的平均严重程度.次要结果包括父母和孩子行为的衡量标准,幸福,和亲子互动。我们探讨儿童和父母特征是否中等干预效果。为了评估成本效益,测量精神保健和公用事业的使用和成本。最后,父母和治疗师对简短计划的满意度进行了探讨。测量发生在基线(T0),简短的家长培训一周后,或基线后八周(在照常护理的情况下)(T1),T1后6个月(T2)和12个月(T3)。
结论:这项试验的结果可能对行为困难儿童及其父母具有有意义的社会意义。如果我们发现简短的行为父母培训比照常的护理更(成本)有效,它可以在临床实践中使用,使家长培训更容易获得。
背景:该试验于10月24日在ClinicalTrials.gov(NCT05591820)进行了前瞻性注册,2022年,并在整个试验过程中进行了更新。
BACKGROUND: The access to and uptake of evidence-based behavioral parent training for children with behavioral difficulties (i.e., oppositional, defiant, aggressive, hyperactive, impulsive, and inattentive behavior) are currently limited because of a scarcity of certified therapists and long waiting lists. These problems are in part due to the long and sometimes perceived as rigid nature of most evidence-based programs and result in few families starting behavioral parent training and high dropout rates.
Brief and individually tailored parenting interventions may reduce these problems and make behavioral parent training more accessible. This protocol paper describes a two-arm, multi-center, randomized controlled trial on the short- and longer-term effectiveness and cost-effectiveness of a
brief, individually tailored behavioral parent training program for children with behavioral difficulties.
METHODS: Parents of children aged 2-12 years referred to a child mental healthcare center are randomized to (i) three sessions of behavioral parent training with optional booster sessions or (ii) care as usual. To evaluate effectiveness, our primary outcome is the mean severity of five daily ratings by parents of four selected behavioral difficulties. Secondary outcomes include measures of parent and child behavior, well-being, and parent-child interaction. We explore whether child and parent characteristics moderate intervention effects. To evaluate cost-effectiveness, the use and costs of mental healthcare and utilities are measured. Finally, parents\' and therapists\' satisfaction with the
brief program are explored. Measurements take place at baseline (T0), one week after the
brief parent training, or eight weeks after baseline (in case of care as usual) (T1), and six months (T2) and twelve months (T3) after T1.
CONCLUSIONS: The results of this trial could have meaningful societal implications for children with behavioral difficulties and their parents. If we find the
brief behavioral parent training to be more (cost-)effective than care as usual, it could be used in clinical practice to make parent training more accessible.
BACKGROUND: The trial is prospectively registered at ClinicalTrials.gov (NCT05591820) on October 24th, 2022 and updated throughout the trial.