Parent Use and Efficacy of a Self-Administered, Tablet-Based Parent Training Intervention: A Randomized Controlled Trial.
Parent Use and Efficacy of a Self-Administered, Tablet-Based Parent Training Intervention: A Randomized Controlled Trial.
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DOI：
10.2196/mhealth.5202
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发表时间：
2016-04-20
影响因子：
5
通讯作者：
Gross D
中科院分区：
文献类型：
--
作者：
Breitenstein SM;Fogg L;Ocampo EV;Acosta DI;Gross D
家长培训计划传统上以面对面的形式提供，需要训练有素的主持人和每周的家长出席。在忙碌的初级保健环境中实施面对面会议是具有挑战性的，父母参加这些会议存在许多障碍。基于平板电脑的父母培训提供了一种替代面对面的交付，使父母培训计划更容易在初级保健环境中提供，更方便和更容易获得父母。我们调整了基于小组的芝加哥家长计划（CPP），将其作为一个自我管理的、基于平板电脑的计划，称为ez家长计划。本研究的目的是（1）通过检查父母对该计划的满意度和完成模块的百分比来评估ez Parentprogram的可行性，（2）通过检查与对照条件相比的效果来测试ez Parentprogram的有效性，以改善从初级保健环境招募的幼儿的低收入少数民族父母的育儿和儿童行为，以及（3）将项目完成情况和疗效与先前基于组的CPP研究进行比较。该研究采用两组随机对照试验（RCT）设计，并进行重复测量随访。受试者（n=79）被随机分配到干预或注意力控制条件。在基线和基线后12周和24周收集数据。父母从一个大型的城市初级保健儿科诊所招募。ez父母模块完成率计算为干预组父母完成六个模块的百分比。基于组的CPP的出席率计算为第1至10次会议的出席率百分比。满意度数据使用项目频率进行总结。父母和孩子的数据进行了分析，使用重复测量方差分析（RM-ANOVA）与简单的对比，以确定是否有显着的干预效果的结果措施。计算所有结局变量的组间比较效应量，并与基于CPP组的存档数据进行比较。 ez家长模块完成率为85.4%（34.2/40; 95%置信区间[CI] = 78.4%-93.7%），显著高于（P<0.05）面对面CPP组出席率（135.2/267，50.6%）。ez父母参与者报告该计划非常有帮助（35/40，88.0%），他们会向另一位父母强烈推荐该计划（33/40，82.1%）。ez父母参与者在第1至3时间段表现出更大的父母温暖改善（F1，77 = 4.82，P<0.05）。没有其他显着差异被发现。科恩的d效果大小的干预组改善父母的温暖，体罚的使用，贯彻到底，父母的压力，和儿童行为问题的强度是可比的或更大的组为基础的CPP。这项研究的数据表明，在低收入，少数民族人口的父母和家长面对面交付的效果大小相当的可行性和可接受的ez Parentprogram。
Parent training programs are traditionally delivered in face-to-face formats and require trained facilitators and weekly parent attendance. Implementing face-to-face sessions is challenging in busy primary care settings and many barriers exist for parents to attend these sessions. Tablet-based delivery of parent training offers an alternative to face-to-face delivery to make parent training programs easier to deliver in primary care settings and more convenient and accessible to parents. We adapted the group-based Chicago Parent Program (CPP) to be delivered as a self-administered, tablet-based program called the ez Parentprogram. The purpose of this study was to (1) assess the feasibility of the ez Parentprogram by examining parent satisfaction with the program and the percent of modules completed, (2) test the efficacy of the ez Parentprogram by examining the effects compared with a control condition for improving parenting and child behavior in a sample of low-income ethnic minority parents of young children recruited from a primary care setting, and (3) compare program completion and efficacy with prior studies of the group-based CPP. The study used a two-group randomized controlled trial (RCT) design with repeated measures follow up. Subjects (n=79) were randomly assigned to an intervention or attention control condition. Data collection was at baseline and 12 and 24 weeks post baseline. Parents were recruited from a large, urban, primary care pediatric clinic. ez Parentmodule completion was calculated as the percentage of the six modules completed by the intervention group parents. Attendance in the group-based CPP was calculated as the percentage of attendance at sessions 1 through 10. Satisfaction data were summarized using item frequencies. Parent and child data were analyzed using a repeated measures analysis of variance (RM-ANOVA) with simple contrasts to determine if there were significant intervention effects on the outcome measures. Effect sizes for between group comparisons were calculated for all outcome variables and compared with CPP group based archival data. ez Parentmodule completion rate was 85.4% (34.2/40; 95% confidence interval [CI] = 78.4%-93.7%) and was significantly greater ( P<.05) than face-to-face CPP group attendance (135.2/267, 50.6%) attendance of sessions; 95% CI = 46.8%-55.6%). ez Parentparticipants reported the program as very helpful (35/40, 88.0%) and they would highly recommend the program (33/40, 82.1%) to another parent. ez Parentparticipants showed greater improvements in parenting warmth (F1,77 = 4.82, P<.05) from time 1 to 3. No other significant differences were found. Cohen’s d effect sizes for intervention group improvements in parenting warmth, use of corporal punishment, follow through, parenting stress, and intensity of child behavior problems were comparable or greater than those of the group-based CPP. Data from this study indicate the feasibility and acceptability of the ez Parentprogram in a low-income, ethnic minority population of parents and comparable effect sizes with face-to-face delivery for parents.