Evaluating a comprehensive strategy to improve engagement to group-based behavioral parent training for high-risk families of children with ADHD.
Evaluating a comprehensive strategy to improve engagement to group-based behavioral parent training for high-risk families of children with ADHD.
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DOI：
10.1007/s10802-012-9666-z
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发表时间：
2012-11
影响因子：
3.6
通讯作者：
Pelham WE
中科院分区：
文献类型：
--
作者：
Chacko A;Wymbs BT;Chimiklis A;Wymbs FA;Pelham WE
行为父母培训（BPT）是一种基于证据的干预措施，用于治疗儿童期注意力缺陷/多动障碍（ADHD）和相关的破坏性行为障碍。尽管有令人信服的有效性数据，参与BPT，特别是对高风险家庭，一直是一个长期存在，但研究不足的问题。本文介绍了一项综合BPT方法的临床试验数据，以提高参与度和结果（增强积极育儿策略[STEPP]计划）。将STEPP计划与传统的基于组的BPT计划进行了比较，包括参加治疗的倾向，治疗过程中完成作业的倾向以及BPT的脱落。此外，分析了与参与治疗相关的经验因素和STEPP计划的目标，以确定这些因素是否通过参与STEPP计划得到增强。在一个由80名患有ADHD的学龄儿童的单身母亲组成的随机队列中，分析表明，STEPP计划导致随着时间的推移更倾向于参加治疗，并且在治疗过程中更倾向于完成家庭作业。此外，参加STEPP方案与较低的辍学率有关。最后，数据表明，被分配到STEPP计划的父母报告了与STEPP计划中针对的参与相关的经验因素的显着改善（即，来自其团体成员的社会支持的数量和质量、对治疗的期望以及对治疗参与的感知障碍）。这项研究的结果对在整个BPT过程中有针对性的参与，特别是对高风险家庭的影响。
Behavioral parent training (BPT) is an evidence-based intervention for the treatment of attention-deficit/hyperactivity disorder (ADHD) and related disruptive behavioral disorders of childhood. Despite convincing data on effectiveness, engagement to BPT, particularly for high-risk families, has been a long standing, yet understudied, issue. Data from a clinical trial of a comprehensive BPT approach to enhance engagement and outcomes (the Strategies to Enhance Positive Parenting [STEPP] program) are presented herein. The STEPP program was compared to a traditional group-based BPT program on propensity to attend treatment, propensity to complete homework over the course of treatment, and dropout from BPT. Additionally, factors empirically related to engagement to treatment and targeted by the STEPP program were analyzed to determine whether these factors were enhanced by participation in the STEPP program. In a randomized cohort of 80 single-mothers of school-age children with ADHD, analyses demonstrated that the STEPP program lead to greater propensity to attend treatment over time and a greater propensity to complete homework over the course of treatment. Furthermore, participation in the STEPP Program was associated with a lower rate of dropout. Finally, data suggested that parents assigned to the STEPP program reported significant improvements in factors empirically related to engagement that were targeted within the STEPP program (i.e., amount and quality of social support from their group members, expectations for treatment, and perceived barriers to treatment participation). Results of the study have implications for targeting engagement throughout the process of BPT, particularly for high-risk families.
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