A Brief Program Improves Counseling of Mothers With Children Who Have Persistent Aggression
A Brief Program Improves Counseling of Mothers With Children Who Have Persistent Aggression
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DOI：
10.1177/0886260511424501
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发表时间：
2012-04-01
影响因子：
2.5
通讯作者：
Bickman, Len
中科院分区：
文献类型：
--
作者：
Scholer, Seth J.;Reich, Stephanie M.;Bickman, Len
目的：评估多媒体节目是否会影响与晚年暴力最大风险因素之一（持续的幼儿攻击性）相关的咨询行为。方法：设计是一项在临床环境中进行非侵入性测量的对照试验。一位研究人员假装是一个2岁半男孩的母亲，在门诊时间给19名儿科住院医生打电话，询问如何管理她孩子持续的伤害行为。干预是一个40分钟的讲座，重点是一个多媒体程序，玩得好，教接受的策略，管理1-7岁的幼儿的攻击。对居民的反应进行了盲法评估，以确定干预措施的治疗效果。结果如下：与对照组（C）相比，干预组（I）的居民更倾向于建议设置规则（I：100% vs. C：31%，p = .01），重定向（I：83% vs. C：8%，p = 0.003），促进同理心（I：50% vs. C：0%，p = 0.02），更有可能阻止使用体罚（I：83% vs. C：31%）。这些是干预措施鼓励的主要战略。对于这三种策略中的每一种，效应量的大小都非常大，范围从d = 1.1到2.3。结论：一个简短的干预可以改善初级保健医生对持续性儿童攻击的咨询行为。这些发现对预防虐待儿童、预防暴力、医学教育以及如何改善初级保健中的预期指导具有影响。
Objective: To assess whether a multimedia program can affect counseling behavior related to one of the strongest risk factors for violence later in life, persistent early childhood aggression. Method: The design was a controlled trial with unobtrusive measurement in a clinic setting. A researcher, pretending to be the mother of a 2 1/2 year old boy, called 19 pediatric residents during clinic hours and requested advice on how to manage her child's persistently hurtful behavior. The intervention was a 40-min lecture focusing on a multimedia program, Play Nicely, which teaches accepted strategies for managing aggression in young children ages 1-7 years. Residents' responses were blindly assessed to determine the treatment effect of the intervention. Results: Compared with the control group (C), residents in the intervention (I) group were more likely to recommend setting the rule (I: 100% vs. C: 31%, p = .01), redirecting (I: 83% vs. C: 8%, p = .003), promoting empathy (I: 50% vs. C: 0%, p = .02), and more likely to discourage the use of physical punishment (I: 83% vs. C: 31%). These are the primary strategies encouraged by the intervention. The magnitude of the effect size was very large for each of these three strategies, ranging from d = 1.1 to 2.3. Conclusions: A brief intervention can improve the counseling behavior of primary care physicians regarding persistent childhood aggression. The findings have implications for child abuse prevention, violence prevention, medical education, and how to improve anticipatory guidance within primary care.