BB2: Using Baby Books to Improve Maternal and Paternal Parenting and Child Outcomes

BB2：使用婴儿书籍改善母亲和父亲的养育方式以及儿童的成果

• 批准号: 9063602
• 负责人: Natasha J Cabrera
• 金额: $ 60.79万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-05 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9063602
• 关键词: Address; Belief; Books; CD80 gene; California; Child; Child Development; Child Language; Child Rearing; Child health care; Childhood; Childhood Injury; Cognitive; Country; Data; Data Collection; Discipline; District of Columbia; Dose; Family; Fathers; Funding; Growth; Health; Home environment; ICAM1 gene; Immunization; Infant; Informal Social Control; Injury; Intervention; Interview; Knowledge; Language; Language Development; Linguistics; Link; Low income; Maternal and Child Health; Measures; Mediating; Mediation; Mediator of activation protein; Medical; Methods; Modeling; Monitor; Morbidity - disease rate; Mothers; Outcome; Parents; Perception; Physicians; Punishment; Randomized; Readiness; Reading; Safety; Schedule; Schools; Self Efficacy; Social Development; System; Testing; United States National Institutes of Health; Variant; Visit; Work; cognitive development; cost; depressive symptoms; design; dosage; evidence base; executive function; father child interaction; improved; injury prevention; innovation; insight; maternal stress; minority children; mortality; public health intervention; skills; social; social skills; stem; stress symptom; success

 DESCRIPTION (provided by applicant): The use of anticipatory guidance (AG) to educate parents about typical child development, injury prevention, and optimal parenting has had mixed effects, in part because of the way AG is delivered to parents. One notable exception is the Baby Books Project (BB1), a randomly assigned NIH-funded intervention that embedded AG into baby books, rather than the typical handouts or physician discussion, to improve maternal and child health. BB1 proved quite effective in increasing low-income, new mothers' knowledge of child development and parenting, improving maternal self-efficacy, improving parenting beliefs and practices (reading, safety, discipline), reducing maternal stress and depressive symptoms, increasing children's language skills, and reducing the number of preventable child injuries over the first 18 months (all statistically significant effect sizes, .24-.59 sd). Given te success of BB1, the proposed application (Baby Books 2 - BB2) seeks to replicate and expand on these promising findings. Although BB1 was effective in impacting mothers and their parenting behaviors, like most interventions, it did not include fathers. We aim to test whether effects are equivalent for fathers and whether the impacts of this low-cost intervention are additive or perhaps multiplicative when both mothers and fathers are targeted. Moreover, if information about co-parenting - the way parents work together to raise their children - is included in addition to the AG typically provided at well-child visits, will the books impact the quality of the co-parenting relationship and subsequently benefit parents and their children? It is reasonable to expect that a family system intervention could have more enduring effects on children's outcomes than one focused solely on mothers. Further, providing AG through 24 months and following children to 30 months enables assessment of impacts on physical, cognitive, language, and social development that BB1 could not measure. Lastly, BB1 was provided in one region and exclusively in English. Testing the intervention in two geographical regions, in English and Spanish, allows for consideration of cultural variation in the impact of th educational baby books and increases the external validity of the findings. In the proposed project we will randomly assign 240 two-parent families to one of 4 conditions: educational books provided to (1) mothers only, (2) fathers only, or (3) both parents; and (4) non-educational books provided to both parents. In-home data collection will occur at 6-9 months (baseline) and at 18, 24, and 30 months, with supplemental phone interviews when children are 12, 15, and 21 months. Using a 4-group randomized design, this project (BB2) will test the impact of educational baby books on mothers only, fathers only, and mothers and fathers together in comparison to non-educational (i.e., visually similar but lacking educational content) baby books. With 7 waves of data collection using interviews, observations, and a retrospective medical chart audit, this project is one of the first to test differential and multiplicative effecs of targeting both parents and will provide valuable insight into a low-cost and easy-to-implement intervention for low-income children.

 描述（由申请人提供）：使用预期指导（AG）来教育家长有关典型儿童发展、伤害预防和最佳养育方式的效果好坏参半，部分原因在于向家长提供预期指导的方式。一个值得注意的例外是婴儿书籍项目 (BB1)，这是一项由 NIH 资助的随机分配干预措施，将 AG 嵌入婴儿书籍中，而不是典型的讲义或医生讨论中，以改善母婴健康。事实证明，BB1 在提高低收入新妈妈对儿童发展和育儿知识、提高产妇自我效能、改善育儿信念和实践（阅读、安全、纪律）、减轻产妇压力和抑郁症状、提高儿童语言技能以及减少前 18 个月内可预防的儿童伤害数量方面非常有效（所有效应大小均具有统计显着性，0.24-0.59 标准差）。鉴于 BB1 的成功，拟议的应用程序（婴儿书籍 2 - BB2）旨在复制和扩展这些有希望的发现。尽管 BB1 与大多数干预措施一样可以有效影响母亲及其养育行为，但它并不包括父亲。我们的目的是测试对父亲的影响是否相同，以及当母亲和父亲都成为目标时，这种低成本干预措施的影响是否是相加的或可能是相乘的。此外，如果除了健康儿童访问时通常提供的 AG 之外，还包括有关共同养育（父母共同抚养孩子的方式）的信息，那么这些书籍是否会影响共同养育关系的质量，从而使父母及其孩子受益？这是 可以合理地预期，家庭系统干预可能比仅针对母亲的干预对儿童的结局产生更持久的影响。此外，在 24 个月内提供 AG 并跟踪儿童至 30 个月，可以评估 BB1 无法衡量的对身体、认知、语言和社交发展的影响。最后，BB1 仅在一个地区提供英语版本。在英语和西班牙语两个地理区域测试干预措施，可以考虑婴儿教育书籍影响的文化差异，并提高研究结果的外部有效性。在拟议的项目中，我们将随机分配 240 个双亲家庭符合 4 个条件之一：向 (1) 仅母亲、(2) 仅父亲或 (3) 父母双方提供教育书籍； (4) 向父母双方提供非教育书籍。家庭数据收集将在孩子 6-9 个月（基线）以及 18、24 和 30 个月时进行，并在孩子 12、15 和 21 个月时进行补充电话访谈。该项目 (BB2) 采用 4 组随机设计，将测试教育性婴儿书籍对仅母亲、仅父亲以及母亲和父亲一起的影响，并与非教育性（即视觉上相似但缺乏教育内容）婴儿书籍进行比较。该项目通过访谈、观察和回顾性病历审核进行了 7 轮数据收集，是第一个测试针对父母双方的差异和乘数效应的项目之一，并将为针对低收入儿童的低成本且易于实施的干预措施提供宝贵的见解。