Primary Care Triple P for parents of NICU graduates with behavioral problems: a randomized, clinical trial using observations of parent–child interaction

BMC Pediatrics

Marian Jongmans¹  Ingeborg van der Tweel⁴  Susanne Mulder-De Tollenaer⁶  Corine Koopman-Esseboom¹  Ravian Veenstra²  Barbara Wijnberg-Williams²  Monica Uniken Venema³  Lex Wijnroks⁵  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 Child, Family and Education Studies, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands;Department of Neonatology, Isala Clinics, Zwolle, The Netherlands

关键词: Positive parenting skills;    Parent–child interaction;    RCT;    Perinatal asphyxia;    Preterm birth;    Parenting intervention;    Primary Care Triple P;   

Others  :  1090520
DOI  :  10.1186/s12887-014-0305-4

 received in 2014-08-22, accepted in 2014-12-02,  发布年份 2014

【 摘 要 】

Background

Preterm-born or asphyxiated term-born children show more emotional and behavioral problems at preschool age than term-born children without a medical condition. It is uncertain whether parenting intervention programs aimed at the general population, are effective in this specific group. In earlier findings from the present trial, Primary Care Triple P was not effective in reducing parent-reported child behavioral problems. However, parenting programs claim to positively change child behavior through enhancement of the parent–child interaction. Therefore, we investigated whether Primary Care Triple P is effective in improving the quality of parent–child interaction and increasing the application of trained parenting skills in parents of preterm-born or asphyxiated term-born preschoolers with behavioral problems.

Methods

For this pragmatic, open randomized clinical trial, participants were recruited from a cohort of infants admitted to the neonatal intensive care units of two Dutch hospitals. Children aged 2–5 years, with a gestational age <32 weeks and/or birth weight <1500 g and children with a gestational age 37–42 weeks and perinatal asphyxia were included. After screening for a t-score ≥60 on the Child Behavior Checklist, children were randomly assigned to Primary Care Triple P (n = 34) or a wait-list control group (n = 33). Trial outcomes were the quality of parent–child interaction and the application of trained parenting skills, both scored from structured observation tasks.

Results

There was no effect of the intervention on either of the observational outcome measures at the 6-month trial endpoint.

Conclusions

Primary Care Triple P, is not effective in improving the quality of parent–child interaction nor does it increase the application of trained parenting skills in parents of preterm-born or asphyxiated term-born children with behavioral problems. Further research should focus on personalized care for these parents, with an emphasis on psychological support to reduce stress and promote self-regulation.

Trial registration

Netherlands National Trial Register NTR2179 webcite. Registered 26 January 2010.

【 授权许可】

   
2014 Schappin et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]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.
• [2]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.
• [3]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.
• [4]Miles MS, Holditch-Davis D: Parenting the prematurely born child: pathways of influence. Semin Perinatol 1997, 21:254-266.
• [5]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.
• [6]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.
• [7]Campbell SB: Behavior Problems in Preschool Children: Clinical and Developmental Issues. 2nd edition. The Guilford Press, New York, NY; 2006.
• [8]Clark CAC, Woodward LJ, Horwood LJ, Moor S: Development of emotional and behavioral regulation in children born extremely preterm and very preterm: biological and social influences. Child Dev 2008, 79:1444-1462.
• [9]Evans T, Whittingham K, Sanders MR, Colditz P, Boyd RN: Are parenting interventions effective in improving the relationship between mothers and their preterm infants? Infant Behav Dev 2014, 37:131-154.
• [10]Benzies KM, Magill-Evans JE, Hayden KA, Ballantyne M: Key components of early intervention programs for preterm infants and their parents: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2013, 13:S10. BioMed Central Full Text
• [11]Koldewijn K, Wolf MJ, Van Wassenaer A, Meijssen D, Van Sonderen L, Van Baar A, Beelen A, Nollet F, Kok J: The infant behavioral assessment and intervention program for very low birth weight infants at 6 months corrected age. J Pediatr 2009, 154:33-38.
• [12]Kaaresen PI, Rønning JA, Ulvund SE, Dahl LB: A randomized, controlled trial of the effectiveness of an early-intervention program in reducing parenting stress after preterm birth. Pediatrics 2006, 118:e9-e19.
• [13]Van Hus JW, Jeukens-Visser M, Koldewijn K, Geldof CJ, Kok JH, Nollet F, Van Wassenaer-Leemhuis AG: Sustained developmental effects of the infant behavioral assessment and intervention program in very low birth weight infants at 5.5 years corrected age. J Pediatr 2013, 162:1112-1119.
• [14]Kaaresen PI, Rønning JA, Tunby J, Nordhov SM, Ulvund SE, Dahl LB: A randomized controlled trial of an early intervention program in low birth weight children: outcome at 2 years. Early Hum Dev 2008, 84:201-209.
• [15]Newnham CA, Milgrom J, Skouteris H: Effectiveness of a modified mother-infant transaction program on outcomes for preterm infants from 3 to 24 months of age. Infant Behav Dev 2009, 32:17-26.
• [16]Verkerk G, Jeukens-Visser M, Houtzager B, Koldewijn K, Van Wassenaer A, Nollet F, Kok J: The infant behavioral assessment and intervention program in very low birth weight infants; outcome on executive functioning, behaviour and cognition at preschool age. Early Hum Dev 2012, 88:699-705.
• [17]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.
• [18]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. Parent Res Pract Monogr 2003, 1:1-21.
• [19]Schappin R, Wijnroks L, Uniken Venema M, Wijnberg-Williams B, Veenstra R, Koopman-Esseboom C, Mulder-De Tollenaer S, Van der Tweel I, Jongmans M: Brief parenting intervention for parents of NICU graduates: a randomized, clinical trial of Primary Care Triple P. BMC Pediatr 2013, 13:69. BioMed Central Full Text
• [20]Crisante L: Training in parent consultation skills for primary care practitioners in early intervention in the pre-school context. Aust e-J Adv Ment Health 2003, 2:1-10.
• [21]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.
• [22]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
• [23]Sanders MR, Kirby JN, Tellegen CL, Day JJ: The triple P-positive parenting program: a systematic review and meta-analysis of a multi-level system of parenting support. Clin Psychol Rev 2014, 34:337-357.
• [24]Sanders MR, Waugh L, Tully L, Hynes K: The Revised Family Observation Schedule. 3rd edition. Parenting and Family Support Centre, Brisbane, Australia; 1996.
• [25]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.
• [26]Achenbach TM, Rescorla LA: Manual for the ASEBA School-Age Forms & Profiles. University of Vermont, Research Center for Children, Youth, & Families, Burlington, VT; 2000.
• [27]Turner KMT, Sanders MR, Markie-Dadds C: Practitioner’s Manual for Primary Care Triple P. Australian Academic Press, Brisbane, Australia; 2007.
• [28]National Institute of Child Health and Human Development Early Child Care Research Network: Child care and mother-child interaction in the first three years of life Dev Psychol 1999, 35:1399-1413.
• [29]Institute of Child Health and Human Development Early Child Care Research Network: Coding Manual, 36-Month Mother-Child Structured Interaction Qualitative Rating Scales. National Institute of Child Health and Human Development, Bethesda, MD; 1993.
• [30]Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics 1977, 33:159-174.
• [31]Dallal GE: Randomization.com [http://www.randomization.com]
• [32]Corp IBM: IBM SPSS Statistics for Windows, Volume Version 20. Armonk, NY, IBM Corp; 2011.
• [33]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.
• [34]Schappin R, Wijnroks L, Uniken Venema MMAT, Jongmans MJ: Rethinking stress in parents of preterm infants: a meta-analysis. PLoS One 2013, 8:e54992.
• [35]Wijnroks L: Maternal recollected anxiety and mother-infant interaction in preterm infants. Infant Ment Health J 1999, 20:393-409.
• [36]Huhtala M, Korja R, Lehtonen L, Haataja L, Lapinleimu H, Rautava R, Group PS: Parental psychological well-being and behavioral outcome of very low birth weight infants at 3 years. Pediatrics 2012, 129:e937-e944.
• [37]Poehlmann J, Schwichtenberg AJM, Shlafer RJ, Hahn E, Bianchi JP, Warner R: Emerging self-regulation in toddlers born preterm or low birth weight: differential susceptibility to parenting? Dev Psychopathol 2011, 23:177-193.
• [38]Westrupp EM, Mensah FK, Giallo R, Cooklin A, Nicholson JM: Mental health in low-to-moderate risk preterm, low birth weight, and small for gestational age children at 4 to 5 years: the role of early maternal parenting. J Am Acad Child Adolesc Psychiatry 2012, 51:313-323.
• [39]Finch BK: Socioeconomic gradients and low birth-weight: empiciral and policy considerations. Health Serv Res 2003, 38:1819-1841.