背景:慢性疼痛通常集中在家庭中,父母和他们的后代都会经历慢性疼痛。父母患有肠易激综合征(IBS)的幼儿是腹痛发展的高危人群,残疾,以及童年后期过度的医疗保健访问。父母对儿童不适的表达和母亲对自己疾病行为的建模的关怀反应有助于更加关注躯体感觉,导致儿童的疾病行为。这项随机对照试验将测试早期预防性基于网络的心理社会干预(REACH)[TM]与向患有IBS的父母提供基于教育网络的安全比较条件,以改变父母的反应,改善儿童健康状况并降低医疗保健成本。
方法:通过基于社区的方法招募有4-7岁儿童的IBS父母(例如,社交媒体广告,学校电子发行,研究网络)和医疗保健提供者。目标样本是随机分配到REACH的460个父母,基于网络的社交学习和认知行为治疗(SLCBT)干预或基于网络的教育安全比较条件(EC)。参与者将在基线进行评估,6周(立即干预后),6个月,12个月,和18个月的随访期(干预完成后的几个月)。主要结果是父母关怀/保护行为的变化。次要结果包括父母风险和保护因素,儿童健康和症状结果,以及医疗保健利用率和成本节约。
结论:本研究采用了经过验证的,父母提供的干预措施,以治疗儿童的慢性疼痛,这是一个基于网络的应用程序,旨在防止在很小的时候发生慢性疼痛,高危儿童。如果成功,这种策略既可以防止这种情况的不利后遗症的发展,也可以广泛获得。此外,为家长培训提供预防模式可能会在广泛的疾病中带来显著的短期和长期健康益处.
背景:ClinicalTrials.govNCT05730491。2023年2月15日注册。
BACKGROUND: Chronic pain often clusters in families, where parents and their offspring both experience chronic pain conditions. Young children of parents with irritable bowel syndrome (IBS) represent an at-risk group for the development of abdominal pain, disability, and excess health care visits in later childhood. Parental solicitous responses to children\'s expressions of discomfort and maternal modeling of their own illness behavior contribute to a greater focus on somatic sensations, leading to illness behaviors in children. This randomized controlled trial will test the effectiveness of an early preventive web-based psychosocial intervention (REACH)[TM] vs. an educational web-based safety comparison condition delivered to parents with IBS to alter parental responses and lead to improved child health and decreased health care costs.
METHODS: Parents with IBS who have children ages 4-7 years are recruited via community-based approaches (e.g., social media advertisements, school electronic distribution, research networks) and health care providers. The target sample is 460 parents randomized to REACH, a web-based social learning and cognitive behavior therapy (SLCBT) intervention or an educational web-based safety comparison condition (EC). Participants will be assessed at baseline, 6-week (immediate post-intervention), 6-month, 12-month, and 18-month follow-up periods (months post-completion of intervention). The primary outcome is change in parental solicitous/protective behaviors. Secondary outcomes include parent risk and protective factors, child health and symptom outcomes, and health care utilization and cost savings.
CONCLUSIONS: This study adapts a validated, parent-delivered intervention to treat chronic pain in children to a web-based application designed to prevent the development of chronic pain in very young, high-risk children. If successful, this strategy can both prevent adverse sequelae of this condition from developing as well as be widely accessible. Furthermore, the availability of a prevention model for parent training could result in significant short- and long-term health benefits across a broad spectrum of conditions.
BACKGROUND: ClinicalTrials.gov NCT05730491. Registered on February 15, 2023.