Technology-Enhanced Program for Child Disruptive Behavior Disorders: Development and Pilot Randomized Control Trial
Technology-Enhanced Program for Child Disruptive Behavior Disorders: Development and Pilot Randomized Control Trial
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DOI：
10.1080/15374416.2013.822308
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发表时间：
2014-01-02
影响因子：
4.2
通讯作者：
Newey, Greg A.
中科院分区：
文献类型：
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作者：
Jones, Deborah J.;Forehand, Rex;Newey, Greg A.
早发性破坏性行为障碍在低收入家庭中所占比例过高；然而，与其他群体相比，这些家庭不太可能参加行为家长培训（BPT）。该项目旨在开发并试点测试基于证据的 BPT 计划“帮助不合规儿童”(HNC) 的技术增强版本。其目的是提高低收入家庭的参与度，进而提高儿童的行为结果，并通过提高治疗效率来节省潜在的成本。具有临床显着破坏性行为的 3 至 8 岁儿童的低收入家庭被随机分配并完成标准 HNC (n=8) 或技术增强型 HNC (TE-HNC；n=7)。护理人员的平均年龄为 37 岁； 87% 是女性，80% 至少从事兼职工作。超过一半（53%）的青少年是男孩；样本的平均年龄为5.67岁。所有家庭均接受标准 HNC 计划；然而，TE-HNC 还包括以下智能手机增强功能：(a) 技能视频系列、(b) 简短的每日调查、(c) 短信提醒、(d) 视频录制家庭练习和 (e) 周中视频通话。对于所有参与结果，TE-HNC 产生的效应规模都比 HNC 更大。两组的破坏性行为均取得了临床上显着的改善；然而，研究结果表明，与 TE-HNC 相关的更多计划参与可提高儿童治疗结果。家庭对评估后访谈的反应揭示了该技术所带来的推动作用的进一步证据。最后，成本分析表明，TE-HNC 家庭完成该计划所需的疗程也比 HNC 家庭少，这种效率并没有影响家庭满意度。 TE-HNC 作为一种让低收入家庭参与 BPT 的创新方法有望节省成本，因此值得进行更大规模的进一步研究。
Early onset disruptive behavior disorders are overrepresented in low-income families; yet these families are less likely to engage in behavioral parent training (BPT) than other groups. This project aimed to develop and pilot test a technology-enhanced version of one evidence-based BPT program, Helping the Noncompliant Child (HNC). The aim was to increase engagement of low-income families and, in turn, child behavior outcomes, with potential cost-savings associated with greater treatment efficiency. Low-income families of 3- to 8-year-old children with clinically significant disruptive behaviors were randomized to and completed standard HNC (n=8) or Technology-Enhanced HNC (TE-HNC; n=7). On average, caregivers were 37 years old; 87% were female, and 80% worked at least part-time. More than half (53%) of the youth were boys; the average age of the sample was 5.67 years. All families received the standard HNC program; however, TE-HNC also included the following smartphone enhancements: (a) skills video series, (b) brief daily surveys, (c) text message reminders, (d) video recording home practice, and (e) midweek video calls. TE-HNC yielded larger effect sizes than HNC for all engagement outcomes. Both groups yielded clinically significant improvements in disruptive behavior; however, findings suggest that the greater program engagement associated with TE-HNC boosted child treatment outcome. Further evidence for the boost afforded by the technology is revealed in family responses to postassessment interviews. Finally, cost analysis suggests that TE-HNC families also required fewer sessions than HNC families to complete the program, an efficiency that did not compromise family satisfaction. TE-HNC shows promise as an innovative approach to engaging low-income families in BPT with potential cost-savings and, therefore, merits further investigation on a larger scale.