Online vs Staff Delivery: Child & Family Outcomes, Value Analysis, Satisfaction

在线与员工交付：儿童

• 批准号: 9135511
• 负责人: RONALD J PRINZ
• 金额: $ 66.26万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-05 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9135511
• 关键词: 7 year old; Accounting; Address; Adherence; Adolescence; Adult; Age; Attention; Behavioral; Caregivers; Characteristics; Child; Child Mental Health; Child Rearing; Childhood; Communities; Computers; Consumer Satisfaction; Cost Analysis; Databases; Development; Disadvantaged; Documentation; Effectiveness; Emotional; Family; Family Sizes; Fathers; Goals; Growth; High Prevalence; Home environment; Household and Family; Human Resources; Inferior; Internet; Intervention; Left; Light; Measures; Mental Health; Modality; Modeling; Mothers; Outcome; Outcome Assessment; Parent-Child Relations; Parents; Participant; Patient Self-Report; Phase; Population; Prevalence; Problem behavior; Process; Provider; Public Health; Randomized; Records; Reporting; Resources; Risk; Sampling; Schedule; Self-Administered; Services; Source; Staging; Stress; Technology; Testing; Time; Training; Transportation; Variant; Work; base; conduct problem; cost; cost effective; design; early onset; empowered; evidence base; experience; flexibility; follow-up; improved; indicated prevention; informant; innovation; meetings; post intervention; preference; primary outcome; programs; satisfaction; secondary outcome; service intervention; staff intervention; teacher; treatment program; trial design; web site

High-prevalence mental health problems require innovative strategies to broaden reach of evidence-based services. Disruptive behavior problems (DBPs), or conduct problems, in young children represent a major public health challenge that is not only highly prevalent but also, left untreated, heighten risk for adverse mental health and developmental outcomes in adolescence and adulthood. New, efficacious intervention strategies that can be delivered with sufficient reach in a resource effective manner are needed. Internet and online technology has considerable potential to help achieve such a goal. Building on parenting interventions that have demonstrated impact on childhood DBPs, this project compares an Online-Delivered Intervention to a well-validated Staff-Delivered Intervention, holding program content constant. The sample includes families with a 3-7 year old child who has a pronounced level of DBPs. Both interventions encourage fathers as well as mothers (and other key caregivers in the home) to participate. This innovative study makes use of a non-inferiority trial design that builds on methodological strengths: stratified random assignment, adequate statistical power, attention to fidelity of intervention, multi-informant and multi-source assessment of outcomes (including direct observation of parent-child interaction), and documentation of participant adherence. The aims of the project are: (1) to test whether the online intervention is as good as the more established staff-delivered intervention with respect to impact on childhood DBPs, parenting, and parent/family stress; (2) to conduct a rigorous value analysis comparing the two interventions, accounting for provider and participant expenses as well as pre-implementation and implementation phases; (3) to assess consumer satisfaction for the online intervention in comparison to the other intervention, as well as detailed consumer appraisal of the online intervention experience, and to explore how logistical factors, participant characteristics, and personal preferences are related to degree of consumer satisfaction; and, (4) to document participant adherence to the online intervention in comparison to the other intervention, and explore correlates of participant adherence for each intervention. The Online-Delivered Intervention provides an interactive website designed to engage and activate the participant through sequenced, personalized, interactive, and video-based content. The conceptualization that guides the intervention emphasizes a self-regulatory process, parent specification of goals, practical and straightforward parenting strategies, modeling, and action activation. Beyond shedding light on the impact and benefits of a viable online parenting intervention for childhood disruptive behavior problems, the results from this project will help the mental health field to better understand more generally the potential advantages and disadvantages of online interventions over traditionally delivered interventions, particularly in light of resource minimization/effectiveness analysis.

高发病率的心理健康问题需要创新策略来扩大循证服务的范围。幼儿中的破坏性行为问题（DBP）或品行问题是一项重大的公共卫生挑战，不仅非常普遍，而且如果不加以治疗，会增加青春期和成年期不良心理健康和发育结果的风险。需要能够以资源有效的方式在足够的范围内提供新的、有效的干预策略。互联网和在线技术具有巨大的潜力来帮助实现这一目标。该项目以已证明对儿童 DBP 产生影响的育儿干预措施为基础，将在线提供的干预措施与经过充分验证的工作人员提供的干预措施进行比较，保持计划内容不变。样本包括有 3-7 岁儿童的家庭，该儿童的 DBP 水平较高。这两种干预措施都鼓励父亲和母亲（以及家庭中的其他主要护理人员）参与。这项创新研究利用了建立在方法论优势之上的非劣效性试验设计：分层随机分配、足够的统计功效、对干预保真度的关注、对结果的多信息者和多来源评估（包括对亲子互动的直接观察）以及参与者依从性的记录。该项目的目的是：（1）测试在线干预在对儿童 DBP、养育和父母/家庭压力的影响方面是否与更成熟的工作人员提供的干预一样好； (2) 对两种干预措施进行严格的价值分析，考虑提供者和参与者的费用以及实施前和实施阶段； （3）与其他干预相比，评估消费者对在线干预的满意度，以及消费者对在线干预体验的详细评价，并探讨后勤因素、参与者特征和个人偏好与消费者满意度的关系； (4) 与其他干预措施相比，记录参与者对在线干预的依从性，并探索参与者对每种干预措施依从性的相关性。在线干预提供了一个交互式网站，旨在通过有序的、个性化的、交互式的和基于视频的内容来吸引和激活参与者。指导干预的概念化强调自我调节过程、家长明确的目标、实用且直接的育儿策略、建模和行动激活。除了阐明可行的在线育儿干预措施对儿童破坏性行为问题的影响和益处之外，该项目的结果还将帮助心理健康领域更好地更广泛地了解在线干预措施相对于传统干预措施的潜在优点和缺点，特别是考虑到资源最小化/有效性分析。