Longitudinal Follow-up of Brief Parenting Interventions to Reduce Risk of Child Physical Maltreatment in a Selected Population
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 1,133
- 试验地点
- 2
- 主要终点
- Parent - Change From Baseline Frequency of Corporal Punishment Use at 3 Months and at Long-term Follow-up
研究概览
简要总结
Universal and broad selective parenting education programs that improve parenting skills, increase parents' understanding of child development, and teach positive child discipline strategies can prevent use of corporal punishment and child physical maltreatment. The proposed research addresses this critical need by investigating brief, relatively low-resource intensive primary prevention parenting programs that can be disseminated widely. By reducing cumulative adverse childhood experiences, which include child physical maltreatment, these interventions are expected to reduce long-term health disparities and risks for major public health problems, such as violence, smoking, obesity, drug abuse, risky sexual behavior, mental health disorders, and heart disease, among others
详细描述
- Study design
Our long-term goal is to enlarge the evidence base for low resource-intensive and widely adaptable interventions that effectively target parenting outcomes to reduce risk of child physical abuse in settings with broad reach. The objective of this study is to test the effectiveness of two such interventions in promoting effective parenting and reducing child physical abuse risk as compared with "usual care" parenting education. The central hypothesis is that each of two brief interventions, Triple P-L2 and Play Nicely, will be more effective in improving parenting effectiveness and reducing child behavioral and emotional problems than the "usual care" condition. Full scale Triple-P is an evidence-based, five-level system of interventions shown to reduce risk for child maltreatment when all 5 levels are implemented. However, implementation of a single level would be much less costly, more easily disseminated, and might in itself reduce risk in a broader population. Play Nicely is a brief computer-based intervention that has shown preliminary evidence for shifting attitudes about use of physical discipline when implemented in a pediatric primary care setting. However, it has yet to be tested within a large randomized-controlled trial (RCT). The rationale for this study is to be able to inform policy for parent service or clinic centers serving high-volumes of parents that are interested in adopting relatively low-resource intensive interventions in order to reduce risk of child physical abuse and improve child health and development trajectories.
This is a community-based RCT. Parents (n=1200) with children 2 to 7 years of age will be recruited from local Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics and by open recruitment. Once consented, they will be enrolled, a baseline interview will be conducted, and they will be randomly assigned to one of 3 conditions: (1) Triple P-Level 2 only (L2) intervention, (2) Play Nicely intervention, or (3) a "usual care" control group. Three months later, a follow-up interview will be conducted in order to test for intervention effects. In addition, a long term follow-up will be conducted to test sustained effects of the intervention. Participants' children (n=1200) will be enrolled for the long term follow-up. Children will be invited to participate in order for the adult participant to be observed interacting with the child in several very benign behavioral activities. Adult participants that do not want to enroll their child may participate in the long term follow-up survey which they will have previously consented to. Our study name for presentation in the local community is "Tulane Innovations in Positive Parenting Study" (TIPPS). 2. Subject Population
We will recruit a total number of 2400 participants for this study. We will recruit 1200 adult participants from City of New Orleans and Jefferson Parish WIC Clinics. During the long-term follow-up visit, one child for each adult with be enrolled (n=1200). 3. Procedure
Recruitment: Recruitment has taken place in WIC clinic waiting rooms. If a parent is eligible and interested, the TIPPS Staff Member will then confirm that she has completed all necessary WIC documentation and that she is scheduled for a follow-up appointment with WIC before moving forward with consent and enrollment.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 2 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult participants must be:
- •English-speaking
- •adults, age 18 or older
- •a parent of at least one child between 2 and 7 years of age
- •a primary caregiver of that child
- •able to return to WIC (or recruitment site) for follow-up 3 months later
- •available for up to 2 hours on date of recruitment to complete the baseline visit
- •Child participants:
- •must be the "index child" of the adult participant as indicated in the baseline interview
- •all genders eligible
排除标准
- •anyone who does not meet the above inclusion criteria
结局指标
主要结局
Parent - Change From Baseline Frequency of Corporal Punishment Use at 3 Months and at Long-term Follow-up
时间窗: Baseline, 3 months post-intervention, 4 years post-intervention
The measure was collected at baseline, 3 month post-intervention, and 4 year post-intervention. This question asks participants "How often on average in the past month have you spanked your child?" with seven categories: 0) never, 1) once or twice in the past month, 2) about once a week, 3) about twice a week, 4) about once every other day, 5) about once a day, and 6) more than once a day. Using the 0-6 score response range, the outcome was calculated by subtracting the baseline score from the 3 month or 4 year post-intervention score, such that a negative score indicates decrease in frequency of spanking at the post-intervention timepoint.
Parent - Change From Baseline Attitudes Toward Use of Corporal Punishment at 3 Months and at Long-term Follow-up
时间窗: Baseline, 3 months post-intervention, 4 years post-intervention
The Attitudes Towards Spanking (ATS) scale was collected at baseline, 3 months post-intervention, and 4 years post-intervention. The scale score response range was 0-28, with a higher number being stronger support for spanking. This change outcome was calculated by subtracting the baseline score from the 3 month or 4 year post-intervention score, such that a negative score indicates a decrease in approval of spanking at the post-intervention time point.
次要结局
- RSA Lead/Lag During Social Interaction Task(4 years post-intervention)
- Parent - Child Discipline Practices(Baseline, 3 months post-intervention, 4 years post-intervention)
- Child - Behavioral and Emotional Adjustment(Baseline, 3 months post-intervention, 4 years post-intervention)
- Child - Externalizing, Internalizing, and Total Symptoms(4 years post-intervention)
- Parent Sensitivity(4 years post-intervention)
- Child Social Involvement(4 years post-intervention)
- Child Negative Emotionality(4 years post-intervention)
- Dyadic Negative States(4 years post-intervention)
- Dyadic Reciprocity(4 years post-intervention)
- Parent Limit Setting(4 years post-intervention)
- Child Compliance(4 years post-intervention)
- Parent Baseline RSA(4 years post-intervention)
- Child Baseline RSA(4 years post-intervention)
- RSA Synchrony Challenge Task(4 years post-intervention)
- RSA Lead/Lag During Challenge Task(4 years post-intervention)
- Parent RSA During Challenge Task(4 years post-intervention)
- Child RSA During Challenge Task(4 years post-intervention)
- RSA Synchrony During Social Interaction Task(4 years post-intervention)
- Parent RSA During Social Interaction Task(4 years post-intervention)
- Child RSA During Social Interaction Task(4 years post-intervention)
- Child - Cognitive Flexibility(4 years post-intervention)
- Child - Delay Time(4 years post-intervention)
- Child - Executive Function(4 years post-intervention)
- Child - Distraction Strategy(4 years post-intervention)
- Child - Distress Level(4 years post-intervention)