Project 1

摘要研究项目1 研究项目1被整合到转型中心，以促进下一代的研究， 将研究结果转化为临床和预防干预措施，并传播 研究和最佳做法，以不同的利益攸关方。根据发展精神病理学的研究， 在生命周期框架内纳入多个层次的分析。提高对最佳方法的认识 提供母亲和儿童双重预防干预在预防艾滋病毒/艾滋病方面具有重要的公共卫生意义， 虐待儿童。项目1包括一项随机对照试验，以评估是否扩大社区 卫生工作者（CHW）外展模式，增加了儿童-父母心理治疗（CPP），一种强化干预措施 重点关注有虐待儿童风险的家庭的亲子关系， 改善母子关系，更敏感的养育，更健康的儿童发展，虐待 预防CPP的疗效已在虐待和其他高危人群中得到证实。 通过使用四个干预组，评价将评估更密集的干预是否更好， 与单独提供CHW支持相比，保护儿童免受虐待，并将确定最佳时机 在这些干预中（即，产前或产后开始），最佳服务持续时间（即，6对12 月），影响机制（中介分析），以及哪种干预策略最适合母亲 不同的风险因素（主持人分析）。孕妇（N = 300）及其出生后的婴儿将 参加纵向评估将发生在怀孕的第三个三个月，婴儿的年龄为3岁 9个月，并在12个月时进行干预后随访。每次获得的测量结果- 这一点构成了一个丰富的多层次的角度来看，随着时间的推移，孕产妇和儿童的运作，以应对 干预措施。母亲养育行为、表征模式、认知和生理反应， 并对婴儿的健康和发育进行纵向评估。假设CPP组可以改善 相对于CHW单独家访而言，敏感和响应式养育和安全依恋，从而 减少虐待儿童的风险。改善母亲依恋表现，养育子女 认知和应激反应被假设为介导治疗结果。主持人，包括 母亲的创伤史、精神病理学和亲密伴侣暴力，将有助于确定 对CHW和CPP的不同反应性（什么对谁有效，为什么？）并允许量身定制 预防战略。确定服务提供的时间、剂量和强度，以及结果沿着 调解人和主持人的工作具有创新性，将促进制定有针对性的预防和干预措施 为这一弱势群体制定支持养育子女和减少虐待儿童的战略。

ABSTRACT RESEARCH PROJECT 1 Research Project 1 is integrated into the TRANSFORM Center to promote the next generation of research on child maltreatment, translate research findings into clinical and preventive interventions, and disseminate research and best practice to varied stakeholders. Informed by developmental psychopathology, the research incorporates multiple levels of analysis within a lifespan framework. Increasing knowledge of optimal methods for delivering dual mother and child preventive intervention has crucial public health significance in preventing child maltreatment. Project 1 involves a randomized control trial to evaluate whether expanding a Community Health Worker (CHW) outreach model, by adding Child-Parent Psychotherapy (CPP), an intensive intervention that focuses on parent-infant relationships for families at risk for child maltreatment, increases efficacy for improved mother-child relationships, more sensitive parenting, healthier child development, and maltreatment prevention. The efficacy of CPP has been demonstrated with maltreated and other high-risk populations. Through the use of four intervention arms, the evaluation will assess whether more intensive intervention better protects against child maltreatment compared with CHW support alone, and will determine the optimal timing of these interventions (i.e., beginning prenatally or postnatally), the optimal duration of services (i.e., 6 vs. 12 months), mechanisms of effect (mediator analyses), and which intervention strategy works best for mothers with varying risk factors (moderator analyses). Pregnant women (N = 300) and their infants after birth will participate. Longitudinal assessments will occur during the third trimester of pregnancy, at infant's ages of 3 and 9 months, and a post-intervention follow-up at 12 months old. The measurements obtained at each time- point constitute a rich multi-level perspective of maternal and child functioning over time in response to the interventions. Maternal parenting behaviors, representational models, cognitions, and physiological reactivity, and infants' health and development will be assessed longitudinally. CPP groups are hypothesized to improve sensitive and responsive parenting and secure attachment, relative to CHW home visitation alone, thereby reducing risks for child maltreatment. Improvements in maternal attachment representations, parenting cognitions, and stress reactivity are hypothesized to mediate treatment outcomes. Moderators, including maternal histories of trauma, psychopathology, and intimate partner violence, will advance determination of differential responsiveness to CHW and CPP (what works for whom and why?) and allow for tailored preventive strategies. Identification of timing, dosage, and intensity of service delivery, along with outcome mediators and moderators is innovative and will facilitate development of targeted prevention and intervention strategies that support parenting and decrease child maltreatment for this vulnerable population.