Brief parenting intervention for parents of NICU graduates: a randomized, clinical trial of Primary Care Triple P

BMC Pediatrics

Marian Jongmans¹  Ingeborg van der Tweel⁴  Susanne Mulder-De Tollenaer⁵  Corine Koopman-Esseboom¹  Ravian Veenstra²  Barbara Wijnberg-Williams²  Monica Uniken Venema³  Lex Wijnroks⁶  Renske Schappin³ 

[1] Department of Neonatology, Wilhelmina Children’s Hospital, UMC Utrecht, Utrecht, The Netherlands;Department of Medical Psychology, Isala Clinics, Zwolle, The Netherlands;Department of Medical Psychology and Social Work, Wilhelmina Children’s Hospital, UMC Utrecht, Utrecht, The Netherlands;Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands;Department of Neonatology, Isala Clinics, Zwolle, The Netherlands;Department of Special Education, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands

关键词: RCT;    Perinatal asphyxia;    Preterm birth;    Parenting intervention;    Primary Care Triple P;   

Others  :  1144899
DOI  :  10.1186/1471-2431-13-69

 received in 2013-04-25, accepted in 2013-04-26,  发布年份 2013

【 摘 要 】

Background

Preterm-born or asphyxiated term-born children who received neonatal intensive care show more emotional and behavioral problems than term-born children without a medical condition. It is uncertain whether regular parenting intervention programs to which the parents of these children are usually referred, are effective in reducing child problem behavior in this specific population. Our objective was to investigate whether a regular, brief parenting intervention, Primary Care Triple P, is effective in decreasing emotional and behavioral problems in preterm-born or asphyxiated term-born preschoolers.

Methods

For this pragmatic, open randomized clinical trial, participants were recruited from a cohort of infants admitted to the neonatal intensive care units (NICU) of two Dutch hospitals. Children born with a gestational age <32 weeks or birth weight <1500 g and children born at a gestational age 37–42 weeks with perinatal asphyxia were included. After screening for a t-score ≥60 on the Child Behavior Checklist (CBCL), children were randomly assigned to Primary Care Triple P (n = 34) or a wait-list control group (n = 33). The primary outcome was child emotional and behavioral problems reported by parents on the CBCL, 6 months after the start of the trial.

Results

There was no effect of the intervention on the CBCL at the trial endpoint (t₆₄ = 0.54, P = .30). On secondary measurements of child problem behavior, parenting style, parenting stress, and parent perceived child vulnerability, groups either did not differ significantly or the intervention group showed more problems. In both the intervention and control group there was a significant decrease in emotional and behavioral problems during the trial.

Conclusions

Primary Care Triple P, a brief parenting intervention, is not effective in reducing child emotional and behavioral problems in preterm-born children or term-born children with perinatal asphyxia.

Trial registration

Netherlands National Trial Register (NTR): NTR2179

【 授权许可】

   
2013 Schappin et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Delobel-Ayoub M, Arnaud C, White-Koning M, Casper C, Pierrat V, Garel M, Burguet A, Roze JC, Matis J, Picaud JC: Behavioral problems and cognitive performance at 5 years of age after very preterm birth: the EPIPAGE study. Pediatrics 2009, 123:1485-1492.
• [2]Gray RF, Indurkhya A, McCormick MC: Prevalence, stability, and predictors of clinically significant behavior problems in low birth weight children at 3, 5, and 8 years of age. Pediatrics 2004, 114:736-743.
• [3]Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJS: Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis. JAMA 2002, 288:728-737.
• [4]Van Handel M, Swaab H, De Vries LS, Jongmans MJ: Long-term cognitive and behavioral consequences of neonatal encephalopathy following perinatal asphyxia: a review. Eur J Pediatr 2007, 166:645-654.
• [5]Van Handel M, Swaab H, De Vries LS, Jongmans MJ: Behavioral outcome in children with a history of neonatal encephalopathy following perinatal asphyxia. J Pediatr Psychol 2012, 35:286-295.
• [6]Singer LT, Salvator A, Guo S, Collin M, Lilien L, Baley J: Maternal psychological distress and parenting stress after the birth of a very low-birth-weight infant. JAMA 1999, 281:799-805.
• [7]Miles MS, Holditch-Davis D: Parenting the prematurely born child: Pathways of influence. Semin Perinatol 1997, 21:254-266.
• [8]Estroff DB, Yando R, Burke K, Synder D: Perceptions of preschoolers' vulnerability by mothers who had delivered preterm. J Pediatr Psychol 1994, 19:709-721.
• [9]De Ocampo AC, Macias MM, Saylor CF, Katikaneni LD: Caretaker perception of child vulnerability predicts behavior problems in NICU graduates. Child Psychiatry Hum Dev 2003, 34:83-96.
• [10]Miles MS, Holditch-Davis D: Compensatory parenting: how mothers describe parenting their 3-year-old, prematurely born children. J Pediatr Nurs 1995, 10:243-253.
• [11]Campbell SB: Behavior Problems in Preschool Children: Clinical and Developmental Issues. 2nd edn. New York: The Guilford Press; 2006.
• [12]Johnson S, Ring W, Marlow N: Randomised trial of parental support for families with very preterm children: outcome at 5 years. Arch Dis Child 2005, 90:909-915.
• [13]Koldewijn K, Van Wassenaer A, Wolf MJ, Meijssen D, Houtzager B, Beelen A, Kok J, Nollet F: A neurobehavioral intervention and assessment program in very low birth weight infants: outcome at 24 months. J Pediatr 2010, 156:359-365.
• [14]Spittle AJ, Treyvaud K, Doyle LW, Roberts G, Lee KJ, Inder TE, Cheong JLY, Hunt RW, Newnham CA, Anderson PJ: Early emergence of behavior and social-emotional problems in very preterm infants. J Am Acad Child Adolesc Psychiatry 2009, 48:909-918.
• [15]Sanders MR, Markie-Dadds C, Turner KMT: Theoretical, scientific and clinical foundations of the Triple P-Positive Parenting Program: a population approach to the promotion of parenting competence. Parenting Res Pract Monogr 2003, 1:1-21.
• [16]Turner KMT, Sanders MR: Help when it's needed first: a controlled evaluation of a brief, preventive behavioral family intervention in a primary care setting. Behav Ther 2006, 37:131-142.
• [17]Crisante L: Training in parent consultation skills for primary care practitioners in early intervention in the pre-school context. Aust e-J Adv Mental Health 2003, 2:1-10.
• [18]Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH: Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol 2008, 50:744-750.
• [19]Achenbach TM, Rescorla LA: Manual for the ASEBA School-Age Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families; 2000.
• [20]De Brock AJLL, Vermulst AA, Gerris JRM, Abidin RR: NOSI - Nijmeegse Ouderlijke Stress Index: handleiding experimentele versie [NOSI - Nijmegen Parenting Stress Index: manual for the experimental version]. Lisse: Swets en Zeitlinger; 1992.
• [21]Schappin R, Wijnroks L, Uniken Venema MMAT, Jongmans MJ: Rethinking stress in parents of preterm infants: a meta-analysis. PLoS One 2013, 8:e54992.
• [22]Dallal GEhttp://www.randomization.com webcite. Updated July 16, 2008. Accessed June 11, 2009
• [23]Turner KMT, Sanders MR, Markie-Dadds C: Practitioner's Manual for Primary Care Triple P. Brisbane: Australian Academic Press; 2007.
• [24]Eyberg S, Pincus D: Eyberg Child Behavior Inventory & Sutter-Eyberg Student Behavior Inventory - Revised. Odessa, FL: Psychological Assessment Resources; 1999.
• [25]Decović M, Janssens JMAM, Gerris JRM: Factor structure and construct validity of the Block Child Rearing Practices Report (CRPR). Psychol Assess 1991, 3:182-187.
• [26]Perrin EC, West PD, Culley BS: Is my child normal yet? Correlates of vulnerability. Pediatrics 1989, 83:355-363.
• [27]Feaster DJ, Mikulich-Gilbertson S, Brincks A: Modeling site effects in the design and analysis of multi-site trials. Am J Drug Alcohol Abuse 2011, 37:383-391.
• [28]SPSS Statistics [computer program]. Version 20.0. : IBM Corporation; 2011.
• [29]McConnell D, Breitkreuz R, Savage A: Independent evaluation of the Triple P Positive Parenting Program in family support service settings. Child Fam Social Work 2012, 17:43-54.
• [30]De Graaf I, Onrust S, Haverman M, Janssens J: Helping families improve: an evaluation of two primary care approaches to parenting support in the Netherlands. Inf Child Dev 2009, 18:481-501.
• [31]Boyle CL, Sanders MR, Lutzker JR, Prinz RJ, Shapiro C, Whitaker DJ: An analysis of training, generalization, and maintenance effects of Primary Care Triple P for parents of preschool-aged children with disruptive behavior. Child Psychiatry Hum Dev 2010, 41:114-131.
• [32]Wilson P, Rush R, Hussey S, Puckering C, Sim F, Allely CS, Doku P, McConnachie A, Gillberg C: How evidence-based is an 'evidence-based parenting program'? A PRISMA systematic review and meta-analysis of Triple P. BMC Med 2012, 10:130. BioMed Central Full Text
• [33]Keiley MK, Bates JE, Dodge KA, Pettit GS: A cross-domain growth analysis: externalizing and internalizing behaviors during 8 years of childhood. J Abnorm Child Psychol 2000, 28:161-179.
• [34]Owens EB, Shaw DS: Predicting growth curves of externalizing behavior across the preschool years. J Abnorm Child Psychol 2003, 31:575-590.