Strengthening Child Social-Emotional Functioning and Healthy Lifestyle Behaviors Through Parent-Based Prevention in Families Experiencing Major Stressors

儿童的社交情感困难和不健康的生活方式行为在美国都很普遍，往往是共同发生的，并且有共同的潜在风险和保护因素。任何一个领域的困难都与一系列不利的短期和长期健康结果有关，例如精神健康障碍、物质使用障碍、学业问题和慢性健康状况。主要的家庭压力源，如父母的创伤史和精神健康困难、父母的艾滋病毒、父母的药物滥用、经济压力和种族歧视，可能加剧儿童的社会情感困难和不健康的生活方式行为。家庭压力源可能通过加剧父母的压力，阻碍父母的自我调节，阻碍他们的育儿努力，间接地促进儿童的幸福。有几项预防性干预措施在提高为人父母技能和促进儿童福祉方面是有效的。然而，处理重大压力源的家庭在获得和获得这些预防性干预措施的好处方面面临重大障碍，部分原因是对父母自身压力和应对策略的关注有限。此外，这些干预措施通常针对儿童在社会情感或健康生活方式领域的结果，但不是同时进行的。本研究的目的是评估以父母自我调节、减压和积极育儿为目标的以父母为基础的预防干预的可行性、可接受性和初步效果，以促进3-9岁儿童的社会情感和生活方式健康，这些父母的孩子正经历着主要的压力源，如创伤史、精神健康困难、艾滋病毒、种族歧视、药物滥用和/或经济压力。这项试点可行性研究是在n = 60个家庭的样本中进行的，这些家庭随机分为以家庭压力为导向的预防干预组或候补组。目的包括考察：(1)以家长为基础的混合预防干预的可行性、可接受性和实施过程；(2)预防干预在儿童幸福感（情绪、社会能力、睡眠、屏幕时间、身体活动）、积极育儿、育儿压力和自我调节方面的初步效果。这个项目的创新之处在于，它试图同时促进对儿童不健康生活方式行为和社会情感困难的双重预防，强调在父母支持方案的背景下父母的自我调节和减轻压力。这条研究路线的最终目标是通过解决父母的压力、促进父母的自我调节和增强父母的效能，减少儿童社会情感和健康行为困难的患病率。

Social-emotional difficulties and unhealthy lifestyle behaviors in children are both prevalent in the US, tend to co-occur, and share underlying risk and protective factors. Difficulties in either domain are associated with a range of adverse short- and long-term health outcomes, such as mental health disorders, substance use disorders, academic problems, and chronic health conditions. Child social-emotional difficulties and unhealthy lifestyle behaviors may be exacerbated by major family stressors, such as parental trauma history and mental health difficulties, parental HIV, parental substance misuse, economic strain, and racial discrimination. Family stressors may contribute to children’s well-being indirectly by exacerbating parenting stress, impeding parents’ self-regulation, and hampering their parenting efforts. Several preventive interventions are effective in improving parenting skills and promoting children’s well-being. However, families dealing with major stressors face significant barriers to accessing and reaping the benefits of these preventive interventions, in part because of a limited focus on parents’ own stress and coping strategies. Further, these interventions typically target child outcomes in either social-emotional or healthy lifestyle domains, but not both concurrently. The purpose of this study is to assess the feasibility, acceptability, and preliminary efficacy of a parent-based preventive intervention targeting parental self-regulation, stress reduction, and positive parenting, to promote child social-emotional and lifestyle health, among parents who have a child aged 3-9 and who are experiencing major stressors, such as history of trauma, mental health difficulties, HIV, racial discrimination, substance misuse, and/or financial strain. This pilot feasibility study is being conducted with a sample of n = 60 families randomized to a family stress-oriented preventive intervention or waitlist control. Aims include examination of: (1) feasibility, acceptability, and implementation processes of the parent-based preventive intervention via mixed methods, and (2) preliminary efficacy of the preventive intervention regarding child well-being (mood, social competence, sleep, screen time, physical activity), positive parenting, and parenting stress and self-regulation. This project is innovative in that it seeks to concurrently promote the dual prevention of children’s unhealthy lifestyle behaviors and social-emotional difficulties, emphasizing parental self-regulation and stress reduction in the context of a parenting support program. This line of research ultimately targets prevalence reduction for children’s social-emotional and health-behavior difficulties by addressing parent stress, promoting parental self-regulation, and bolstering parenting efficacy.