Engaging Low-Income Parents in Prevention Programs

描述(由申请人提供)：我们请求继续支持NINR资助的一项关于创新家长培训计划(芝加哥家长计划；CPP)有效性的研究，该计划是与家长咨询委员会合作开发的，用于服务于低收入有色人种家庭的托儿中心。目前的研究受到了预防试验中常见问题的影响：登记和出席率较低，以及无法纳入讲西班牙语的拉丁裔父母。从历史上看，科学家们通过排除不会说英语的拉丁裔人，制定昂贵且不切实际的主题激励措施来应对这些挑战，这些激励措施阻碍了针对有色人种的预防科学的发展，并将其转化为医疗保健政策。拟议研究的主要目标是在现有赠款的基础上，测试提高拉美裔参与率的两项战略的有效性，并使用可在研究范围之外推广的方法，最大限度地发挥对低收入有色人种家庭的预防性父母培训的效果。使用随机实验设计(n=450)，我们将测试(1)西班牙语版本的CPP和(2)根据出勤率贴现父母的育儿自付费用的有效性。八个日托中心将被配对并随机分配到控制和实验条件：(1)12周的干预条件，其中出席门槛降低，但不提供出席的经济激励(标准)；(2)折扣共付激励条件，其中参与门槛降低，父母每周的托儿共付账单根据出勤情况获得折扣(折扣共付)，以及(3)不干预控制条件。参与度将根据参与率、出勤率和家长对干预的参与度来定义。CPP的有效性将使用干预后1年内评估的多个父母和孩子的结果进行检查。还将审查使用折扣自付策略与标准条件相比的成本效益。相关性：这项研究的目标是使用现实世界的方法来提高预防干预的参与率，旨在促进2-4岁儿童的低收入少数民族家庭的积极育儿和心理健康。这项研究的数据将改善父母和孩子在生命的前5年的结果。

DESCRIPTION (provided by applicant): We request continued support for a NINR-funded study on the effectiveness of an innovative parent training program (The Chicago Parent Program; CPP) developed in collaboration with a parent advisory council and used in childcare centers serving low-income families of color. The current study has been affected by issues common in prevention trials: low enrollment and attendance rates and the inability to include Spanish- speaking Latino parents. Historically, scientists have addressed these challenges by excluding non-English- speaking Latinos and instituting costly and unrealistic subject incentives, strategies that hinder the growth of prevention science for people of color and its translation to health care policy. The primary goal of the proposed study is to build upon the current grant by testing the effectiveness of two strategies for increasing participation rates among Latinos and maximizing the effects of preventive parent training for low-income families of color using methods that can be generalized beyond the research context. Using a randomized experimental design (n=450), we will test the effectiveness of (1) a Spanish-language version of the CPP and (2) discounting parents' childcare co-pay costs contingent upon attendance. Eight day care centers will be matched and randomly assigned to control and experimental conditions: (1) a 12-week intervention condition in which barriers to attendance are reduced but no financial incentives for attendance are offered (Standard), (2) a discount co-pay incentive condition in which barriers to participation are reduced and parents receive a discount on their weekly childcare co-pay bill contingent upon attendance (Discount Co- pay), and (3) a no-intervention control condition. Participation will be defined by enrollment rate, attendance, and parent engagement in the intervention. CPP effectiveness will be examined using multiple parent and child outcomes assessed up to 1 year post-intervention. The cost-effectiveness of using a discount co-pay strategy compared to the standard condition will also be examined. Relevance: The goals of this study are to use a real world approach to increase participation rates in a prevention intervention designed to promote positive parenting and mental health among low-income ethnic minority families of 2-4 year old children. Data from this study would lead to improved outcomes for parents and children during the first 5 years of life.