Conventional vs Mindfulness Intervention in Parents of Children With Disabilities

描述(由申请人提供)：本申请涉及比较有效性研究的广泛挑战领域(05)，05-AT-102*补充和替代医学的比较有效性研究。这项申请的标题是：残疾儿童父母的常规VS正念干预。在美国，每5名儿童中就有1名患有发育障碍，自闭症谱系障碍(ASD)的患病率尤其高(每150名儿童中就有1名)。多达20%的美国家庭正在抚养有发育障碍的孩子，这些父母比正常发育的孩子的父母承受着更多的压力，以及更多的抑郁、焦虑以及健康和心理健康问题。残疾儿童家庭面临的经济困难增加，使负面结果更加复杂。尽管父母的压力在许多类型的残疾中都会增加，但患有自闭症儿童的父母尤其容易产生负面的心理和经济后果。该应用程序比较了在患有自闭症和其他残疾儿童的父母中，传统家长小组干预和改进的基于正念的压力减轻(MBSR)计划的有效性。家长团体被广泛用于提供信息、支持和宣传。MBSR对于有医疗、精神或其他问题的人是有效的，并通过正念训练和练习来教授减轻压力。与传统的父母群体相比，我们的研究表明，基于正念的干预可能在减轻压力、改善残疾儿童父母的健康和心理健康方面特别有效。我们将400名患有自闭症或其他残疾儿童的父母随机分配到父母组和改良的MBSR计划组，为期6周，并收集父母健康、积极和消极心理状态以及压力的生物标记物指数的数据。来自干预前、干预中和干预后4个时间点的数据将用于分层线性建模，分析还将评估母亲、父亲、少数族裔父母或儿童诊断的干预效果是否不同。残疾儿童的失业父母将被聘为研究助理，并接受培训，以实施家长小组或修改后的MBSR计划干预措施。同伴导师是倡导和支持的有效提供者。雇用残疾儿童的失业父母符合ARRA的直接任务，并表明在未来旨在减轻压力和改善20%抚养残疾儿童的美国家庭的大规模公共卫生努力中雇用父母的可行性。 公共卫生相关性：每5名儿童中就有1名患有发育障碍，残疾儿童的父母比一般发育不良儿童的父母有更高的压力、健康和心理健康问题。这项研究测试了两种不同干预措施的有效性，两种干预措施都旨在减轻患有自闭症谱系障碍或其他残疾儿童的父母的压力(父母小组模式与修改后的基于正念的压力减轻计划)。这项研究将为如何最好地减轻压力，提高高达20%的美国家庭的健康和幸福感提供新的线索，这些家庭正在抚养发育障碍儿童。

DESCRIPTION (provided by applicant): This application addresses the Broad Challenge area of Comparative Effectiveness Research (05), 05-AT-102* Comparative Effectiveness Studies of Complementary and Alternative Medicine. This application is entitled: Conventional vs Mindfulness Intervention in Parents of Children with Disabilities. A full 1 in 5 children in the US has a developmental disability, and the prevalence rate for autism spectrum disorders (ASD) is especially high (1 in 150 children). As many as 20% of US families are raising children with developmental disabilities, and these parents experience more stress than parents of typically- developing children, as well as more depression, anxiety, and health and mental health problems. Negative outcomes are complicated by increased economic hardships faced by families of children with disabilities. Although parental stress is elevated in many types of disabilities, parents of children with ASD are especially prone to negative psychological and economic outcomes. This application compares the effectiveness of a conventional Parent Group intervention to a modified Mindfulness- Based Stress Reduction (MBSR) program in parents of children with ASD and other disabilities. Parent groups are widely-used to provide information, support, and advocacy. MBSR is efficacious for people with medical, psychiatric or other concerns, and teaches stress reduction through mindfulness training and practice. In contrast to conventional parent groups, our studies suggest that mindfulness-based interventions may be particularly effective in reducing stress and improving the health and mental health of parents of children with disabilities. We will randomly assign 400 parents of children with ASD or other disabilities to 6 weeks of a Parent Group versus a modified MBSR program group, and collect data on parental health, positive and negative psychological states, and biomarker indices of stress. Data from pre, mid, and 4 post intervention time points will be used in hierarchical linear modeling, and analyses will also assess if intervention effects differ across mothers, fathers, minority parents, or child diagnoses. Unemployed parents of children with disabilities will be hired as research assistants and trained to conduct either the Parent Group or modified MBSR program interventions. Peer-mentors are effective providers of advocacy and support. Hiring unemployed parents of children with disabilities meets the immediate ARRA mandate and demonstrates the feasibility of hiring parents in future large-scale public health efforts aimed at reducing stress and improving healthy outcomes in the 20% of US families who are raising children with disabilities. PUBLIC HEALTH RELEVANCE: A full 1 in 5 children has a developmental disability, and parents of children with disabilities have significantly high rates of stress, and health and mental health problems than parents of typically- developing children. This study tests the effectiveness of two different interventions, both aimed at reducing stress in parents of children with autism spectrum disorders or other disabilities (a Parent Group model versus a modified Mindfulness-Based Stress Reduction program). This study will shed new light on how to best reduce stress and increase health and well-being in up to 20% of US families who are raising children with developmental disabilities.