Efficacy Trial of Equine Assisted Intervention on Child Stress and Competence

描述（由申请人提供）：尽管有证据表明，提高儿童的行为和社会情感能力是预防成年后精神、情感和行为障碍的有效策略，但确定以证据为基础的干预措施，以提高儿童的能力，构成了一个挑战。根据轶事证据，马辅助咨询显示出了希望，但不幸的是，很少有实验研究来确定其因果关系。虽然重要，但先前对马辅助干预的研究受到案例研究、小样本量和相关设计的限制。因此，我们无法对马辅助干预的有效性作出因果推论。此外，我们对马辅助干预影响的因果途径的了解非常有限。没有这些知识，我们无法确定马的辅助干预是否以及如何提供一种有效的方法来增强个体儿童的社会情感和行为优势，从而促进预防或解决精神、情感和行为问题。本研究的目的是进行一项随机实验试验，以确定PATH -一种现有的马辅助干预-在改善小学和中学年龄儿童的行为和社会情感能力方面的有效性。除了测量其对社会情绪和行为能力的影响外，本研究还将测量儿童压力系统活动的生理标志——唾液皮质醇水平——以确定马辅助干预的效果是否可以用下丘脑垂体肾上腺轴（HPA）活动的变化来解释，HPA轴是调节身体对心理压力的生理和行为反应的主要系统之一。我们将根据他们的社会和行为能力和转诊情况选择128名5年级到8年级的儿童，并随机将他们分配到治疗组或候补组。教师、家长、儿童和训练有素的观察员将在多个时间点对儿童在各个领域的能力进行评估，在此期间将收集儿童唾液中的皮质醇。这项研究将首先确定PATH to Success是否能提高儿童的社会情感和行为能力。其次，它将确定对儿童压力生理指标的影响，以及它们在多大程度上解释了社会情绪和行为能力的提高。最后，我们将获得关于剂量效应和可能的长期效应的知识，这方面我们几乎一无所知。这项研究的结果有望对我们理解马辅助干预对儿童社会情绪和行为能力和压力的影响产生重要的积极影响，并对有兴趣扩展创新的、基于证据的方法的精神卫生专业人员产生更广泛的影响。

DESCRIPTION (provided by applicant): Although evidence suggests that promotion of children's behavioral and socioemotional competence is an effective strategy to prevent mental, emotional and behavioral disorders in adulthood, identifying evidence-based interventions that promote child competencies, constitutes a challenge. Based on anecdotal evidence, equine assisted counseling has shown promise, but unfortunately, little experimental research has been done to determine its causal effects. Although important, prior studies on equine assisted interventions are limited by their focus on case studies, small sample sizes and correlational designs. We are thus unable to make causal inferences about the efficacy of equine assisted interventions. Moreover, our knowledge of the causal pathways underlying the effects of equine assisted interventions is extremely limited. Without this knowledge, we cannot ascertain whether - and how- equine assisted intervention provides an effective approach to enhance socioemotional and behavioral strengths of individual children to facilitate the prevention or resolution of mental, emotional and behavioral problems. The objective of this study is to conduct a randomized experimental trial to determine the efficacy of PATH to success - an existing equine assisted intervention - in improving the behavioral and socioemotional competence of elementary and middle-school age children. In addition to measuring its effects on socioemotional and behavioral competence, this study will measure children's physiological markers of stress-system activity - salivary cortisol levels - to determine whether effects of equine assisted intervention can be explained by changes in activity of the Hypothalamic Pituitary Adrenal (HPA) Axis, one of the bodies' main systems regulating physiological and behavioral responses to psychological stress. We will select 128 5th through 8th grade children based on their social and behavioral competence and referral, and randomly assign them to a treatment or waitlisted condition. Teachers, parents, children and trained observers will rate child competence in various domains at multiple time-points, during which child salivary cortisol will be collected. This study will first determine whether PATH to Success improves children's socioemotional and behavioral competence. Second, it will determine effects on physiological indicators of child stress, and the extent to which they explain improvements in socioemotional and behavioral competence. Last, we will gain knowledge about the dosage effects and possible longer-term effects, about which virtually nothing is known. The results of the proposed study are expected to have an important positive impact on our understanding of the effects of equine assisted intervention on child socioemotional and behavioral competence and stress, and on the broader field of mental health professionals interested in expanding innovative, evidence- based approaches. PUBLIC HEALTH RELEVANCE: This proposed research increases our knowledge about the effects of equine assisted intervention on children's behavioral and socioemotional competence, and the physiological pathways underlying these effects. The proposed study focuses on an important yet under-investigated area of human animal interaction and child development that has potential applicability to the prevention or resolution of social, emotional, academic and behavioral problems of children and youth.