Efficacy of Family Programs for Improving Child and Family Health and Development.

项目摘要 预防性干预，包括视频反馈计划，以促进育儿(VIPP；Juffer等人，2008年) 已被证明在改善产妇敏感性和母婴依恋安全方面取得了成功 (Bakermann-Kranenberg等人，2008年)。然而，如果范围更广，干预措施可能会更有效 还讨论了家庭制度的要素，包括父子关系和父母之间的关系， 尤其是考虑到越来越多的证据突显了父亲参与和 积极参与儿童的社会情感发展。婴儿期是一种特别敏感和 不仅对孩子，而且对经常经历日常压力增加的父母都是脆弱时期， 与家庭变化相关的育儿需求、工作-家庭角色压力以及父母间的不和 (Feeney等人，2001)。拟议的纵向研究通过测试 旨在促进婴儿健康发育和功能的全家庭预防性干预措施， 母亲和父亲，包括低收入家庭。这项分三个阶段的研究包括严格的随机 这是一项临床试验(RCT)方法，将涉及400个家庭的人口统计学多样性样本。第一阶段 包括实验室和家庭预测试(6个月大的婴儿)和8周的干预期；第二阶段(12 第三阶段(16-18个月)包括第二次后测。家庭将会是 随机分配到四种情况之一：敏感性干预(SI)、夫妻干预(CI)、两者(SI+ CI)或控制。本研究的具体目标包括：(1)对SI、CI和SI+CI的有效性进行评估 改善父母敏感度、父母效能、父母压力、父母间冲突、婴儿的干预措施 情感发展、依恋安全感、行为问题和社会情绪能力； 行为发生变化的机制。例如，SI参与之间的关系 第一阶段和第三阶段的儿童依恋可能是通过第二阶段增强的父母敏感性来调节的。 CI参与和儿童结局之间的关系可能通过父母间的功能和 更有效的沟通技巧；(3)对影响沟通效率的因素的考察 干预措施，确定哪些家庭受益最大。潜在的主持人包括人口统计学 特征、家庭(离异)组织、父母自身照顾史、父母抑郁和焦虑 制度与婴儿负性气质；(4)直接影响的母父比较，中介作用 机制和缓和过程。这项研究建立在过去研究的基础上，旨在增加儿童的 通过测试预防性干预的新方向在多个家庭关系中的情绪安全 婴儿期，涉及母子关系、父子关系和母父关系。我们的目标是促进 通过在婴儿期进行成本效益高的家庭干预，促进儿童的社会情绪发展和安全 促进敏感的亲子互动和改善父母之间的沟通。

Project Summary Preventative interventions involving video-feedback programs to promote parenting (VIPP; Juffer et al., 2008) have been shown to be successful in improving maternal sensitivity and infant-mother attachment security (Bakermans-Kranenberg et al., 2008). However, interventions might be substantially more effective if broader elements of family systems were also addressed, including father-child and inter-parental relationships, particularly given the growing body of evidence that highlights the importance of father involvement and positive engagement in children's socio-emotional development. Infancy is a particularly sensitive and vulnerable period not only for the child but also for the parents who often experience heightened daily stress, parenting demands, work-family role strain, and inter-parental discord associated with changes in the family (Feeney et al., 2001).The proposed longitudinal study addresses major gaps by testing the effectiveness of family-wide preventative interventions designed to promote healthy development and functioning in infants, mothers, and fathers, including low-income families. This three-phase study involves a rigorous randomized clinical trial (RCT) approach and will involve a demographically diverse sample of 400 families. Phase I involves a lab and home pre-test (infants 6 months of age) and 8-week intervention period; Phase II (12 months) includes an initial post-test, and Phase III (16-18 months) involves a second post-test. Families will be randomly assigned to one of four conditions: sensitivity intervention (SI), couples intervention (CI), both (SI + CI) or control. Specific aims of the study include: (1) An evaluation of the effectiveness of the SI, CI, and SI+CI interventions at improving parental sensitivity, parental efficacy, parenting stress, inter-parental conflict, infant affective development, attachment security, behavior problems, and socio-emotional competence; (2) A test of the mechanisms through which change in behavior occurs. For example, relations between SI participation in Phase I and child attachment in Phase III may be mediated by enhanced parent sensitivity in Phase II. Relations between CI participation and child outcomes may be mediated by inter-parental functioning and more effective communication skills; (3) An examination of factors that moderate the effectiveness of the interventions, determining which families benefit the most. Potential moderators include demographic characteristics, family (dis)organization, parents' own caregiving history, parents' depressive and anxious systems, and infant negative temperament; (4) Mother-father comparisons on direct effects, mediating mechanisms and moderating processes. This study builds upon past research towards increasing children's emotional security in multiple family relationships by testing new directions in preventative interventions in infancy, addressing the mother-child, father-child, and mother-father relationships. The goal is to foster children's socio-emotional development and security through cost-effective family-wide interventions in infancy that promote sensitive parent-infant interactions and improved inter-parental communication.