Wakȟáŋyeža (Little Holy One) - an intergenerational intervention for Native American parents and children: a protocol for a randomized controlled trial with embedded single-case experimental design.
Wakȟáŋyeža (Little Holy One) - an intergenerational intervention for Native American parents and children: a protocol for a randomized controlled trial with embedded single-case experimental design.
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DOI：
10.1186/s12889-021-12272-9
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发表时间：
2021-12-18
影响因子：
4.5
通讯作者：
Barlow A
中科院分区：
文献类型：
--
作者：
Brockie T;Haroz EE;Nelson KE;Cwik M;Decker E;Ricker A;Littlepage S;Mayhew J;Wilson D;Wetsit L;Barlow A
美洲原住民社区内的创伤损害了父母的养育能力；因此，增加了儿童一生中使用药物和自杀的风险。这份手稿的目的是描述WAKȟáŋyeža(小圣者)干预和评估方案，旨在打破派克堡、阿西尼博因堡和苏族父母及其子女之间代际创伤、自杀和药物使用的循环。采用嵌入单病例实验设计的随机对照试验，以确定模块化预防干预对亲子结局的有效性，以及独特的文化教训成分的附加影响。参与者包括1)佩克堡·阿西尼博因堡和苏族父母，他们有过不良的童年经历，以及2)他们的孩子(3-5 岁)。亲子二人组被随机(1：1)分配到小圣者组或由土著社区卫生工作者教授的12节课组成的对照组。经验教训来自1)共同元素治疗方法和家庭精神，两者都是基于证据的干预措施，以及2)新创建的文化(干预)和营养(仅限对照组)课程。主要结果是父母(主要照顾者)创伤症状和压力。次要结果包括：父母抑郁症状、父母养育方式、父母控制、家庭惯例、药物使用、历史损失、集体掌握、部落认同、历史创伤。儿童的结果包括，外化和内化他们的行为和上学。初级分析将遵循意向治疗方法，次级分析将包括检查变化轨迹，以确定文化课程的影响，并按儿童的年龄和性别以及照顾者类型(例如，父母、祖父母)探索总体效果缓和。许多美洲原住民父母经历了不利的童年经历和创伤，这可能会对积极养育子女的能力产生负面影响。研究结果将为基于文化的干预减少父母痛苦的可能性提供洞察力--一种上游方法，降低儿童后来滥用药物和自杀的风险。干预设计的特点，包括使用社区卫生工作者、文化基础和先行环境中的管理，为可行性、可接受性、可持续性和可扩展性提供了潜力。临床试验网站：NCT04201184。注册于2019年12月11日。
Trauma within Native American communities compromises parents’ parenting capacity; thus, increasing childrens’ risk for substance use and suicide over the lifespan. The objective of this manuscript is to describe the Wakȟáŋyeža (Little Holy One) intervention and evaluation protocol, that is designed to break cycles of intergenerational trauma, suicide, and substance use among Fort Peck Assiniboine and Sioux parents and their children. A randomized controlled trial with an embedded single-case experimental design will be used to determine effectiveness of the modular prevention intervention on parent-child outcomes and the added impact of unique cultural lesson-components. Participants include 1) Fort Peck Assiniboine and Sioux parents who have had adverse childhood experiences, and 2) their children (3–5 years). Parent-child dyads are randomized (1:1) to Little Holy One or a control group that consists of 12 lessons taught by Indigenous community health workers. Lessons were developed from elements of 1) the Common Elements Treatment Approach and Family Spirit, both evidence-based interventions, and 2) newly created cultural (intervention) and nutrition (control group only) lessons. Primary outcomes are parent (primary caregiver) trauma symptoms and stress. Secondary outcomes include: Parent depression symptoms, parenting practices, parental control, family routines, substance use, historical loss, communal mastery, tribal identity, historical trauma. Child outcomes include, externalizing and internalizing behavior and school attendance. Primary analysis will follow an intent-to-treat approach, and secondary analysis will include examination of change trajectories to determine impact of cultural lessons and exploration of overall effect moderation by age and gender of child and type of caregiver (e.g., parent, grandparent). Many Native American parents have endured adverse childhood experiences and traumas that can negatively impact capacity for positive parenting. Study results will provide insights about the potential of a culturally-based intervention to reduce parental distress – an upstream approach to reducing risk for childrens’ later substance misuse and suicidality. Intervention design features, including use of community health workers, cultural grounding, and administration in Head Start settings lend potential for feasibility, acceptability, sustainability, and scalability. ClinicalTrials.gov: NCT04201184. Registered 11 December 2019.
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影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
影响因子：
2.2
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影响因子：
3.7
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影响因子：
6.9
作者：
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通讯作者：
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影响因子：
5.9
作者：
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通讯作者：
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