Improving Access to Early Parent Education and Support

描述(申请人提供)：在最初的3年里，儿童的长期发展轨迹已经确立，孩子每天接受的父母教育的质量深刻地影响着这些轨迹。然而，对许多父母来说，过渡到为人父母是一个困难的过程，可能会导致父母压力和社会孤立，以及缺乏育儿能力和信心。这些困难可能会干扰儿童最佳的社交、情感和认知发展，并增加虐待儿童的风险。针对幼儿家庭的家访和小组育儿计划成本高、覆盖范围有限，这意味着大多数新家庭根本得不到任何服务。自我管理的育儿计划为普通家庭提供了一个有吸引力的选择，包括那些中等风险的家庭。它们通常成本较低，克服了参加育儿小组的障碍，在增加父母的知识、信心和技能以及减轻压力方面表现出了良好的效果。然而，人们很少注意到低成本、自我管理、互动的多媒体方法对幼儿父母的潜在价值。该项目建议开发和评估一个基于互联网的互动项目，该项目整合了自动电子邮件、视频流和互动网站技术，为婴幼儿的父母提供频繁、持续的家长教育和支持服务。第一个三年在线(F3Y在线)系列将包括三个节目：为婴儿的父母提供的不可思议的婴儿在线，为一岁孩子的父母提供的精彩在线节目，以及为两岁孩子的父母提供的精彩的在线两个项目。每个项目将包括一系列有吸引力的电子邮件，提供教育内容以及到互动网站的链接，其中包括(A)针对每个主题示范目标技能的视频片段，(B)练习技能的互动练习，(C)可打印的小贴士和工作表，以及(D)家长可以相互互动的讨论论坛。在第一阶段，开发了一个令人难以置信的婴儿在线计划的原型，并在对65名婴儿母亲进行的随机对照试验中评估了其可行性。在父母养育知识、自我效能感、父母教养快乐、社会支持等方面取得了积极的效果。这个第二阶段的项目将完善不可思议的婴儿在线项目，开发精彩的在线项目和精彩的两个在线项目，并在300名头胎婴儿和蹒跚学步的母亲的随机对照试验中评估这三个项目的效果。母亲们将被随机分为立即接受适合年龄的F3Y在线计划或等待6个月。F3Y在线在提高母亲的育儿知识、技能、社会支持、自我效能感、压力和育儿乐趣，以及幼儿的社会情绪适应方面的有效性，将在测试后和3个月的随访中与等待名单控制条件进行比较。这些影响的潜在调节因素，如孩子的气质、母亲的抑郁和收入，将被探索。母亲使用该程序的程度以及对其吸引力、有用性、相关性和可用性的满意程度也将被审查。与公共卫生相关：前三年在线系列节目的创新、低成本、互动和电子邮件驱动的方法有可能为广大有年幼子女的父母带来循证的父母教育和支持，否则他们将得不到父母支持服务。因此，如果证明有效，这项计划可能有助于增加有能力和自信的父母的流行率，并在幼儿中进行积极的社会情绪调整。

DESCRIPTION (provided by applicant): During the first 3 years, children's long-term developmental trajectories are established, and the quality of parenting the child receives on a daily basis profoundly influences these trajectories. The transition to parenthood is a difficult one for many parents, however, and can lead to parental stress and social isolation and a lack of parenting competence and confidence. These difficulties can then interfere with optimal social, emotional, and cognitive development in the child and increase the risk for child maltreatment. The high cost and limited reach of home visiting and group-based parenting programs for families of young children mean that most new families receive no services at all. Self-administered parenting programs offer an attractive alternative for the general population of families, including those at moderate risk. They are typically low in cost, overcome barriers to attendance at parenting groups, and have shown promising effects in increasing parents' knowledge, confidence, and skill, and in reducing stress. Little attention has been paid, however, to the potential value of low-cost, self-administered, interactive multimedia approaches for parents of young children. This project proposes to develop and evaluate an interactive internet-based program that integrates automated email, video streaming, and interactive website technologies to deliver frequent, ongoing parent education and support services to parents of infants and toddlers. The First 3 Years Online (F3Y Online) series will be comprised of three programs: Incredible Infants Online for parents of infants, Wonderful Ones Online for parents of one-year-olds, and Terrific Twos Online for parents of two-year-olds. Each program will involve a series of attractive email messages that provide educational content as well as links to an interactive website with (a) video vignettes that model targeted skills for each topic, (b) interactive exercises for practicing skills, (c) printable tip sheets and worksheets, and (d) a discussion forum where parents can interact with each other. In Phase I, a prototype for the Incredible Infants Online program was developed and its feasibility evaluated in a randomized controlled trial with 65 mothers of infants. It was well-received and achieved positive effects on parenting knowledge, self-efficacy, pleasure in parenting, and social support. This Phase II project will refine the Incredible Infants Online program, develop the Wonderful Ones Online and Terrific Twos Online programs, and evaluate the efficacy of all three in a randomized controlled trial with 300 mothers of first-born infants and toddlers. Mothers will be randomized to receive the age-appropriate F3Y Online program immediately or to wait 6 months. The efficacy of F3Y Online in improving mothers' parenting knowledge, skills, social support, self-efficacy, stress, and pleasure in parenting, and toddlers' socio-emotional adjustment, will be examined relative to the waitlist control condition at post-test and at 3-month follow-up. Potential moderators of these effects, such as child temperament, maternal depression, and income, will be explored. The degree to which mothers use the program and are satisfied with its appeal, usefulness, relevance, and usability will also be examined. PUBLIC HEALTH RELEVANCE: The innovative, low-cost, interactive, and email-driven approach of the First 3 Years Online series has the potential to bring evidence-based parent education and support to a broad population of parents of young children who would otherwise receive no parent support services. Therefore, if proven effective, this program could contribute to an increased prevalence of competent and confident parents and positive social-emotional adjustment among young children.