Parent training for parents of toddlers born very premature: A factorial design to test web delivery and telephone coaching

项目总结/摘要 儿童行为问题是精神和公共卫生的首要问题。问题行为，如 侵略、反抗和不服从早在2岁时就出现，并可持续到 青少年和成年期导致长期的功能和心理适应不良。出生的儿童 极早产儿（VPT;出生时胎龄< 32周）表现出行为障碍的可能性是正常人的两倍。 问题就像他们的同伴一样。尽管VPT人群中存在行为问题的风险和发生， 干预措施往往侧重于治疗发育迟缓，父母很少有资源， 管理行为问题。行为父母培训（BPT）是一种有效的治疗儿童的家庭， 问题行为然而，很少有人知道BPT计划的使用前VPT婴儿与他们的 独特的医疗、发育和心理风险特征。此外，制度和个人障碍 影响家长对BPT的接触和参与。为了满足这些家庭的具体需要， 服务障碍，通过数字应用程序和参与战略（如电话辅导）提供BPT 可以提供方便和有针对性的方法来支持幼儿的父母。目前尚无 对曾经接受过VPT的婴儿进行有效、可获得的BPT干预。这项研究的目的是，“父母培训， 早产儿的父母：测试网络交付和电话辅导的析因设计”是为了 开发一种新的、可获得的和有效的BPT交付形式，以满足以下群体未得到满足的独特需求： VPT儿童的父母。 本研究中提出的BPT计划是对基于证据的芝加哥家长计划的改编。 程序（CPP）称为ezParent。该研究设计是一个析因设计，以测试一种混合方法， ezParent和电话辅导电话。辅导电话是为了加强家长的学习和支持 根据孩子的发展水平和需要制定策略。父母和孩子（20-30个月） 更正）将从芝加哥，IL和哥伦布内的两个中西部NICU随访诊所招募二联体， 哦父母（n=220）将被随机分配到四种条件之一：（1）ezParent+coach，（2）ezParent，（3）Active 控制+教练，或（4）主动控制。我们将测试ezParent和 辅导要求父母和孩子的结果。我们将评估ezParent剂量的差异， 有和没有辅导电话的参与。将在基线时评估父母和孩子的数据， 12-基线后月数。 提供低强度、数字化的干预措施有可能影响参与度， 解决为有较高行为问题风险的VPT儿童的父母提供服务方面的挑战， 有严重的行为问题

PROJECT SUMMARY/ABSTRACT Childhood behavior problems are a top mental and public health priority. Problem behavior such as aggression, defiance, and noncompliance emerge as early as 2 years of age and can persist through adolescence and adulthood leading to long term functional and psychological maladjustment. Children born very premature (VPT; gestational age at birth < 32 weeks) are twice as likely to demonstrate behavioral problems as their peers. Despite the risk and occurrence of behavior problems in the VPT population, early intervention tends to focus on treatment of developmental delays with very few resources for parents to manage behavior issues. Behavioral parent training (BPT) is an effective treatment for families of children with problem behaviors. However, little is known about the use of BPT programs for former VPT infants with their unique medical, developmental, and psychological risk profiles. In addition, system and individual barriers effect parent access and engagement in BPT. In an effort to address tailored needs of these families and service barriers, BPT delivery via digital applications and engagement strategies like telephone coaching calls can provide accessible and tailored approaches to support parents of young children. Currently, there is no effective, accessible BPT intervention for former VPT infants. The purpose of the study, “Parent training for parents of toddlers born very premature: A factorial design to test web delivery and telephone coaching” is to develop a new, accessible and effective form of BPT delivery to address the unmet and unique needs of parents of VPT children. The BPT program proposed in this study is an adaptation of the evidence-based based Chicago Parent Program (CPP) called the ezParent. The study design is a factorial design to test a hybrid approach of digital ezParent and telephone coaching calls. Coaching calls are meant to reinforce parent learning and support tailoring strategies to their child’s developmental level and needs. Parent and child (aged 20-30 months corrected) dyads will be recruited from two Midwest NICU follow up clinics within Chicago, IL and Columbus, OH. Parents (n=220) will be randomized to one of four conditions: (1) ezParent+coach, (2) ezParent, (3) Active Control+coach, or (4) Active Control. We will test the independent and combined effects of ezParent and coaching calls on parent and child outcomes. We will evaluate the differences in ezParent dose and engagement with and without coaching calls. Parent and child data will be assessed at baseline, and 3-, 6- and 12-months post baseline. Providing low intensity, digitally delivered interventions has the potential for influencing engagement and address challenges in service delivery for parents of VPT children at higher risk for behavioral problems and with elevated behavior problems.