A Comparison of 2 Online Parent Skills Training Interventions for Early Childhood Brain Injury: Improvements in Internalizing and Executive Function Behaviors
A Comparison of 2 Online Parent Skills Training Interventions for Early Childhood Brain Injury: Improvements in Internalizing and Executive Function Behaviors
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DOI：
10.1097/htr.0000000000000443
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发表时间：
2019-03-01
影响因子：
2.4
通讯作者：
Wade, Shari L.
中科院分区：
文献类型：
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作者：
Aguilar, Jessica M.;Cassedy, Amy E.;Wade, Shari L.
目的：探讨基于网络的父母干预(基于互联网的日常互动：童年脑损伤后恢复[I-InterAct])和简化版(Express)在减少儿童创伤性脑损伤后执行功能障碍和内化问题方面的有效性。方法：113名儿童(3-9岁)的父母被随机分为3个治疗组：I-InterAct组、Express组或互联网资源比较(IRC)组。参加i-InterAct或Express的父母完成了自我指导的网络课程，并通过与治疗师的视频会议接受了育儿技能的现场指导。I-InterAct包括额外的心理教育、压力管理和家庭沟通技能(例如，婚姻、悲伤、痛苦和睡眠)。用协方差分析比较两组在基线和6个月时父母报告的执行功能行为(即执行功能行为评定表)和内化症状(即儿童行为检查表)。结果：参加Express的父母报告的执行功能障碍水平显著低于I-InterAct的父母，β=-0.49；t(2，73)=-2.47，P=0.048；而退出水平显著低于IRC组，β=-0.44；t(2，74)=-2.22，P=0.03。Express组在执行功能行为上与IRC组在执行功能行为上没有显著差异，在内化问题上与I-InterAct组没有显著差异，均P>；0.05。基线问题较多的儿童、教育水平较低的家庭以及抑郁症状较多的父母受益最大。结论：简短的在线家长培训干预在改善早期脑外伤后的执行功能障碍和内化问题方面可能是有效的，特别是在社会经济地位较低或有行为问题的儿童中。
Objective: To examine the effectiveness of a web-based parenting intervention (Internet-Based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT]) and an abbreviated version (Express) in reducing executive dysfunction and internalizing problems among young children following traumatic brain injury (TBI). Method: Parents of 113 children (ages 3-9 years) who had sustained a TBI were randomized to 1 of 3 treatment groups: I-InTERACT, Express, or an Internet Resource Comparison (IRC) group. Parents who participated in either I-InTERACT or Express completed self-guided web sessions and received live coaching of their parenting skills via videoconferencing with a therapist. I-InTERACT included additional psychoeducation, stress management, and family communication skills (eg, marriage, grief, pain, and sleep). Analyses of covariance were utilized to compare the groups on parent-reported executive function behaviors (ie, Behavior Rating Inventory of Executive Function) and internalizing symptoms (ie, Child Behavior Checklist) at baseline and 6 months. Results: Parents who participated in Express reported significantly lower levels of executive dysfunction than those in I-InTERACT, beta = -0.49; t(2, 73) = -2.47, P = .048, and significantly lower levels of withdrawal than those in the IRC group, beta = -0.44; t(2, 74) = -2.22, P = .03. The Express group did not significantly differ from the IRC group on executive function behaviors or the I-InTERACT group on internalizing problems, all P > .05. Children with more problems at baseline, families with lower education levels, and parents with more symptoms of depression benefited most. Conclusion: A brief, online parent training intervention may be efficacious in improving executive dysfunction and internalizing problems following early TBI, particularly among children of lower socioeconomic status or with existing behavioral concerns.