Bending the Curve: A Community-Based Behavioral Parent Training Model to Address ADHD-Related Concerns in the Voluntary Sector in Denmark
Bending the Curve: A Community-Based Behavioral Parent Training Model to Address ADHD-Related Concerns in the Voluntary Sector in Denmark
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DOI：
10.1007/s10802-017-0310-9
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发表时间：
2018-04-01
影响因子：
3.6
通讯作者：
Scavenius, Christoffer
中科院分区：
文献类型：
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作者：
Chacko, Anil;Scavenius, Christoffer
解决注意力缺陷/多动症（ADHD）问题的基于证据的行为家长培训（BPT）的机会有限，已成为国际上日益关注的问题。需要改善 BPT 获取的模型，特别是那些可以在社区环境中轻松实施并利用潜在劳动力来提高提供 BPT 能力的模型。本研究的目的是评估 BPT 模型，其中包括常用的 BPT 内容、方法、流程（共同要素）、非专业提供（任务转移/共享）BPT 干预，以及针对父母担心 ADHD 的青少年家庭的有效辅助支持系统（培训、忠诚度和监督方法）。在一项针对 161 个儿童家庭（79% 为男性；平均年龄 7.04 [1.55]）的随机对照试验中，由丹麦 12 个社区站点的社区志愿者提供的混沌关怀 (CiC) BPT 模型与等待名单控制条件在治疗后立即和 4 个月的随访评估点的关键儿童和家长结果进行了比较。结果表明，与治疗后立即等待的情况相比，CiC 模型在养育行为、养育能力感、儿童功能障碍、父母压力和父母抑郁症状方面带来显着更大的改善，并且在后续评估中大多数这些领域的进展得以维持。没有发现干预对多动症症状有影响。本研究的结果表明，开发有效的 BPT 干预模型（例如 CiC 模型）可以使社区环境中的各种个人轻松实施干预措施。这些模型对于解决关注多动症的青少年家庭未得到满足的需求而言是必要的。
Limited access to evidence-based behavioral parent training (BPT) for addressing attention deficit/hyperactivity disorder (ADHD) has been a growing concern internationally. Models to improve access to BPT are needed, particularly those that can be readily implemented in community settings and that leverage the potential workforce to increase capacity to deliver BPT. The purpose of this study was to evaluate a BPT model which included oft-used content, methods, processes of BPT (common-elements), non-professionally delivered (task-shifted/shared) BPT intervention, and an efficient ancillary support system (training, fidelity, and supervision methods) for families of youth with parental concerns about ADHD. In a randomized controlled trial of 161 families of children (79% male; mean age 7.04 [1.55]), the Caring in Chaos (CiC) BPT model, delivered by community volunteers across 12 community-based sites in Denmark, was compared to a wait-list control condition on key child and parent outcomes at immediate post-treatment and 4-month follow-up assessment points. Results suggested that the CiC model led to significantly greater improvement in parenting behavior, parenting sense of competence, child functional impairment, parental stress and parental depressive symptoms compared to the wait list condition at immediate post-treatment, with maintenance of gains in most of these areas at follow-up assessment. No effect of intervention was found on ADHD symptoms. The results of this study suggest that developing efficient BPT intervention models, such as the CiC model, can result in readily implemented interventions by a variety of individuals in community settings. Such models are necessary to bend the curve on addressing unmet needs of families of youth with concerns about ADHD.