What got in the way? Caregiver-reported challenges to home practice of assigned intervention skills.
What got in the way? Caregiver-reported challenges to home practice of assigned intervention skills.
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DOI：
10.1177/26334895211055994
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发表时间：
2021-01
影响因子：
--
通讯作者：
Camacho-Thompson, Daisy
中科院分区：
文献类型：
--
作者：
Kim, Joanna J.;Gonzales, Nancy A.;Thamrin, Hardian;Mauricio, Anne;Kuckertz, Mary;Camacho-Thompson, Daisy
基于证据的干预（EBI）的有效性受到低比率的照顾者的家庭实践，或照顾者排练的干预技能在家里。虽然家庭实践对干预的成功至关重要，但我们对家庭实践难以完成的原因知之甚少。我们试图确定的挑战，照顾者面临的家庭实践任务的背景下，社区实施以家庭为基础的预防性EBI。我们还旨在确定可能导致家庭实践挑战频率的障碍，感知需求和实施相关因素。在北美三所公立中学的一项随机有效性混合试验中，向照顾者和青少年提供了以家庭为基础的预防性干预桥梁。护理人员（N = 233）完成了自我评估，他们报告了家庭干预技能实践的挑战。护理人员认可的挑战被编码为紧急主题，并归类为高阶家庭实践挑战域。通过多种方法收集了更多数据。除了描述性分析外，还进行了多水平线性回归，以确定与家庭练习挑战域频率相关的因素。超过85%的护理人员报告了一个或多个家庭实践挑战。挑战分为六个领域：日常压力，认知/信念的干预/做法，照顾者的健康/监管，青少年的反应，相关性/可接受性的干预或分配，和外部障碍的做法。青少年外化症状，学习成绩和照顾者参与英语干预组（与西班牙语交付相比）与报告的挑战频率更高。在已经参加干预课程的护理人员中，克服日常压力和对干预/实践的信念的挑战的具体支持可以支持更大的家庭实践依从性，这反过来可能会影响整体干预有效性。研究结果表明，以照顾者的首选语言提供服务可能会避免潜在的挑战。有必要进一步研究家庭实践的挑战，以确定适当的家庭实践实施支持。护理人员在家实践干预技能的低比率和低质量阻碍了干预的有效性，但没有先前的研究确定了护理人员在尝试在家实践干预技能时面临的困难及其发生率。在社区实施的以家庭为基础的预防性干预，我们发现，困难是常见的，主要是在理论上影响参与的领域，如日常压力和信念的干预/实践。研究结果还表明，提供服务和材料在照顾者的首选语言可能会避免潜在的家庭实践的挑战。通过确定常见的家庭实践挑战和不同挑战的相关性，我们的研究结果指出，需要制定适当和有效的家庭实践实施支持。
Evidence-based intervention (EBI) effectiveness is hindered by low rates of caregiver home practice, or caregiver rehearsal of intervention skills at home. Although home practice is essential to intervention success, we know little about what makes home practice difficult to complete. We sought to identify the challenges caregivers face when attempting home practice assignments within the context of community implementation of a family-based preventative EBI. We also aimed to identify barriers, perceived need, and implementation-related factors that may contribute to frequency of home practice challenges. The family-based preventative intervention Bridges was delivered to caregivers and adolescents in three public middle schools in North America within a randomized efficacy-effectiveness hybrid trial. Caregivers (N = 233) completed worksheets in which they reported challenges to home practice of intervention skills. Caregiver-endorsed challenges were coded for emergent themes and categorized into higher-order home practice challenge domains. Additional data was gathered through multiple methods. In addition to descriptive analyses, multilevel linear regressions were conducted to identify factors associated with frequency of home practice challenge domains. Over 85% of caregivers reported one or more home practice challenges. Challenges fell into six domains: daily stresses, cognitions/beliefs about the intervention/practice, caregiver wellness/regulation, adolescent responsiveness, relevance/acceptability of intervention or assignment, and external barriers to practice. Adolescent externalizing symptoms, academic performance, and caregiver participation in the English-language intervention group (compared to Spanish-language delivery) were associated with greater frequency of reported challenges. Among caregivers already attending intervention sessions, specific support to overcome challenges in daily stresses and beliefs about the intervention/practice can support greater home practice compliance, which in turn may impact overall intervention effectiveness. Findings suggest that providing services in caregivers’ preferred language may avert potential challenges. Further research into home practice challenges is necessary to identify appropriate home practice implementation supports. Low rates and poor quality of caregiver home practice of intervention skills hampers intervention effectiveness, but no prior studies have identified the difficulties caregivers face when attempting home practice of intervention skills and their rates of occurrence. Within a community implementation of a family-based preventative intervention, we found that difficulties were common and largely fell in the domains theorized to impact engagement, such as daily stresses and beliefs about the intervention/practice. Findings also suggest that providing services and materials in caregivers’ preferred language may avert potential home practice challenges. By identifying common home practice challenges and correlates of different challenges, our findings point to a need to develop appropriate and effective home practice implementation support.
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DOI：
10.1007/s11121-016-0738-0
发表时间：
2018-07
期刊：
Prevention science : the official journal of the Society for Prevention Research
影响因子：
--
作者：
Berkel C;Sandler IN;Wolchik SA;Brown CH;Gallo CG;Chiapa A;Mauricio AM;Jones S
通讯作者：
Jones S
影响因子：
1.9
作者：
Fawley-King, Kya;Haine-Schlagel, Rachel;Trask, Emily V.;Zhang, Jinjin;Garland, Ann F.
通讯作者：
Garland, Ann F.
影响因子：
1.1
作者：
Chacko, Anil;Anderson, Lindsay;Wymbs, Frances A.
通讯作者：
Wymbs, Frances A.
DOI：
10.1007/s11121-017-0855-4
发表时间：
2018-08
期刊：
Prevention science : the official journal of the Society for Prevention Research
影响因子：
--
作者：
Berkel C;Mauricio AM;Sandler IN;Wolchik SA;Gallo CG;Brown CH
通讯作者：
Brown CH
影响因子：
4.6
作者：
BARNES, HL;OLSON, DH
通讯作者：
OLSON, DH