The Cool Little Kids randomised controlled trial: Population-level early prevention for anxiety disorders
The Cool Little Kids randomised controlled trial: Population-level early prevention for anxiety disorders
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DOI：
10.1186/1471-2458-11-11
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发表时间：
2011-01-05
影响因子：
4.5
通讯作者：
Wake, Melissa
中科院分区：
文献类型：
--
作者：
Bayer, Jordana K.;Rapee, Ronald M.;Wake, Melissa
背景：世界卫生组织预测，到2030年，内化问题（e。G.抑郁症和焦虑症）将成为仅次于艾滋病毒/艾滋病的国际疾病负担。内化问题影响到七分之一的学龄儿童，影响到同伴关系，学校参与，以及后来的心理健康，关系和就业。儿童早期预防内化问题的发展尚处于起步阶段。目前的研究遵循了两个成功的“功效”试验的父母组干预，以减少内在障碍的气质抑制学龄前儿童。酷小孩子是一个人口水平的随机试验，以确定系统地筛选学龄前儿童的抑制，然后提供一个家长组干预的影响，对儿童内化的问题和经济成本在学校entry.Methods/Design：这个随机试验将进行学前服务系统内，参加了超过95%的澳大利亚儿童在一年前开始上学。2011年初，澳大利亚墨尔本四个地方政府地区的学前服务机构将分发筛查工具。约16%（n约500）的气质抑制患者将进入试验。干预父母将提供酷小孩子，在当地社区的6个会议小组计划，重点是如何通过减少过度保护的养育互动，以发展他们的孩子的勇敢技能。基线后1年和2年的结果将包括儿童内化诊断和症状、父母互动和父母福祉。经济评估（成本-后果框架）将从社会角度比较干预儿童与对照儿童的成本增量差异与结果增量差异。分析将使用意向治疗原则，使用逻辑和线性回归模型（二元和连续的结果分别），以比较结果之间的试验arms.Discussion：本试验解决的差距，在2004年世界卫生组织预防精神疾病的报告中确定的内化问题。如果有效和具有成本效益，这种干预措施很容易在人口一级应用。各国政府将精神健康视为优先事项，从而提高了澳大利亚和国际上采用有效的早期预防方案的可能性。
Background: The World Health Organization predicts that by 2030 internalising problems (e. g. depression and anxiety) will be second only to HIV/AIDS in international burden of disease. Internalising problems affect 1 in 7 school aged children, impacting on peer relations, school engagement, and later mental health, relationships and employment. The development of early childhood prevention for internalising problems is in its infancy. The current study follows two successful 'efficacy' trials of a parenting group intervention to reduce internalising disorders in temperamentally inhibited preschool children. Cool Little Kids is a population-level randomised trial to determine the impacts of systematically screening preschoolers for inhibition then offering a parenting group intervention, on child internalising problems and economic costs at school entry.Methods/Design: This randomised trial will be conducted within the preschool service system, attended by more than 95% of Australian children in the year before starting school. In early 2011, preschool services in four local government areas in Melbourne, Australia, will distribute the screening tool. The approximate to 16% (n approximate to 500) with temperamental inhibition will enter the trial. Intervention parents will be offered Cool Little Kids, a 6-session group program in the local community, focusing on ways to develop their child's bravery skills by reducing overprotective parenting interactions. Outcomes one and two years post-baseline will comprise child internalising diagnoses and symptoms, parenting interactions, and parent wellbeing. An economic evaluation (cost-consequences framework) will compare incremental differences in costs of the intervention versus control children to incremental differences in outcomes, from a societal perspective. Analyses will use the intention-to-treat principle, using logistic and linear regression models (binary and continuous outcomes respectively) to compare outcomes between the trial arms.Discussion: This trial addresses gaps for internalising problems identified in the 2004 World Health Organization Prevention of Mental Disorders report. If effective and cost-effective, the intervention could readily be applied at a population level. Governments consider mental health to be a priority, enhancing the likelihood that an effective early prevention program would be adopted in Australia and internationally.