Parental Reflective Functioning and Child Outcomes

描述（由申请方提供）：拟定研究是一项前瞻性纵向研究，基于一项现有随机临床试验，比较了年轻首次母亲及其婴儿的家访干预与常规初级保健。本研究的目的是评估中期（试验后1 - 3年）干预对母亲的反射功能（RF）和孩子的结果之间的关系的影响。本拟定研究包括先前从主要研究中收集的数据以及受试者完成主要研究后1 - 3年收集的随访数据。关于父母的属性如何被翻译到孩子身上，文献中存在空白。一种可能的平移机制可以是RF。本研究旨在通过调查RF、父母教养方式和儿童行为结果之间的关系，评估RF在有效父母教养中的作用。拟议研究的主要目的是：1.比较干预组和对照组之间从基线（主要研究结束）到3 - 5岁的儿童结局（包括儿童行为）的差异，以及报告的儿童虐待和忽视。2.检查主要研究结束时和儿童3 - 5岁时的RF评分; 2.a）评价两组基线（主要研究结束时）和3 - 5岁时RF评分之间的差异; 2.b）评价组、RF和儿童结局变量的相互作用。两个探索性目标包括：3。检查从基线（2岁时主要研究结束）到3 - 5岁年龄的随时间推移和组间关系，涉及与儿童行为相关的关键母亲变量，如母亲抑郁，养育能力，母亲生命历程，养育压力和母亲掌握。评估RF和儿童行为之间的关系，独立于组。将通过分析初步研究中收集的数据和干预后1 - 3年收集的数据来审查这些目标。在主要研究结束时向干预组和对照组母亲进行的许多问卷调查和一次访谈将在干预后1 - 3年重新进行，并对儿童行为进行额外的有效测量。儿童行为问题的成本支出是没有行为问题的儿童的3.5倍，这是一个非常值得关注的公共卫生问题。多项研究表明，早期养育和儿童行为之间的关系。本提案的目的是通过检查家访方案的中间效果来评估养育如何转化为儿童，家访方案旨在支持和加强养育，以防止儿童行为问题，从而降低公共卫生成本。

DESCRIPTION (provided by applicant): The proposed study is a prospective longitudinal study based on an existing randomized clinical trial comparing a home visiting intervention with routine primary care for young first time mothers and their infants. The purpose of this study is to evaluate the intermediate term (1-3 years after trial) effects of the intervention on the relationship between mothers' reflective functioning (RF) and child outcomes. This proposed study includes previously collected data from the primary study as well as follow-up data to be collected 1-3 years after subjects complete the primary study. There is a gap in the literature regarding how parental attributes are translated to the child. One possible mechanism of translation may be RF. This study proposes to evaluate the role of RF in effective parenting by investigating the relationship between RF, parenting, and child behavior outcomes. The primary aims of the proposed study are to: 1 .Compare differences between the intervention and control groups from baseline (end of primary study) to age 3-5 years with respect to child outcomes including child behavior, and reported child abuse and neglect. 2. Examine the RF scores at the end of the primary study and child age 3- 5 years; 2.a) Evaluate differences between the two groups' RF scores at baseline (end of primary study) and at age 3-5 years; 2.b) Evaluate the interaction of the group, RF, and child outcome variables. Two exploratory aims include: 3. Examine the relationship overtime and between groups from baseline (the end of the primary study at age 2 years) to age 3-5 years with respect to key maternal variables relative to child behavior such as maternal depression, parenting competence, maternal life course, parenting stress, and maternal mastery and 4. Evaluate the relationship between RF and child behavior, independent of group. These aims will be examined through analyses of data collected in the primary study and data to be collected 1-3 years post-intervention. Many of the questionnaires and one interview that were administered to the intervention group and control group mothers at the end of the primary study will be re-administered 1-3 years post-intervention as well as an additional well validated measure for child behavior. Child behavior problems were found to have 3.5 times more cost expenditure compared to children without behavioral problems, which is of great public health concern. Multiple studies have shown relation- ships between early parenting and child behavior. The purpose of this proposal is to evaluate how parenting translates to the child by examining the intermediate effects of a home-visiting program that aims to support and enhance parenting in effort to prevent child behavioral problems and therefore lower public health costs.