连接家庭：为接受初级保健的幼儿家庭提供贫困筛查和经济支持导航：随机对照试验。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics Pub Date : 2025-03-24 DOI:10.1016/j.acap.2025.102820

Imaan Bayoumi MD , Patricia C. Parkin MD , Mary Martin MSc , Charles D.G. Keown-Stoneman PhD , Catherine S. Birken MD, MSc , Jonathon L. Maguire MD, MSc , Cornelia M. Borkhoff PhD

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引用次数: 0

摘要

目的：确定随机对照试验（RCT）的可行性：确定一项随机对照试验（RCT）的可行性，以评估社区支持工作者（CSW）支持下的财务支持和社会系统导航结构化审查的影响：方法：在加拿大安大略省金斯顿市的初级保健机构开展了一项针对亲子二人组（父母一方和 2-5 岁的孩子）的试验性随机对照试验，该二人组对 "您是否曾在月底入不敷出？干预措施包括 CSW 支持的社会系统导航或对照组；两组都收到了关于可用资源的书面总结。主要结果是可行性，包括招募率、完成率和保留率，以及干预的坚持性和忠实性。次要结果是儿童的社会、情感和行为健康（优势和困难量表 SDQ）以及养育压力（养育压力指数-IV PSI）：在 74 个符合条件的家庭中，37 个家庭（50%）参加了该项目，平均（标清）儿童年龄为 35.4（11.1）个月，57% 为女性。29 名参与者（78%）在 6 个月时接受了结果评估，22 名参与者（60%）在 12 个月时接受了结果评估。被随机分配到干预组的参与者与儿童保健工作者会面的平均次数为 1.71 次（标准差为 1.68 次），会面次数范围为 0-5 次，其中有 35.7% 的参与者未与儿童保健工作者进行任何会面。通过方差分析，基线调整后的 SDQ 困难总分在 6 个月时的组间平均差异为 -1.21 (95% CI -3.82, 1.40)，在 12 个月时的组间平均差异为 1.10 (95% CI -3.13, 5.34)；基线调整后的 PSI 总分在 6 个月时的组间平均差异为 -12.88 (95% CI -21.63, -4.12)，在 12 个月时的组间平均差异为 7.79 (95% CI -4.42, 20.00)：对经济拮据的幼儿家庭进行试验是可行的。目前正在进行一项经过修改的最终试验。

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Connecting Families: Poverty Screening and Financial Support Navigation for Families of Young Children in Primary Care: A Pilot Randomized Controlled Trial

Objective

To determine the feasibility of a randomized controlled trial (RCT) evaluating the impact of community support worker (CSW) supported, structured review of financial supports and social system navigation.

Methods

A pilot RCT of parent-child dyads (1 parent and child aged 2–5 years old) endorsing the question “Do you ever have difficulty making ends meet at the end of the month?” was conducted in primary care in Kingston, Ontario, Canada. Interventions included CSW-supported social system navigation or control; both groups received a written summary of available resources. The primary outcome was feasibility, including recruitment, completion, and retention rates and intervention adherence and fidelity. Secondary outcomes were child social, emotional, and behavioral health (Strengths and Difficulties Scale [SDQ]) and parenting stress (Parenting Stress Index-IV [PSI]).

Results

Of 74 eligible dyads, 37 (50%) were enrolled, mean (standard deviation [SD]) child age 35.4 (11.1) months and 57% were female. Outcomes were assessed on 29 participants (78%) at 6 months and 22 participants (60%) at 12 months. Participants randomized to the intervention arm met with the CSW a mean of 1.71 (SD 1.68) times, with a range of 0 to 5 meetings, including 35.7% who did not attend any meetings with the CSW. Using analysis of covariance, the mean between-group difference in the baseline adjusted SDQ Total Difficulties Score at 6 months was −1.21 (95% confidence interval [CI] −3.82, 1.40) and at 12 months was 1.10 (95% CI −3.13, 5.34), and in the baseline adjusted PSI Total Score at 6 months was −12.88 (95% CI −21.63, −4.12) and at 12 months was 7.79 (95% CI −4.42, 20.00).

Conclusions

Conducting a trial enrolling families of young children experiencing financial strain is feasible. A definitive trial with modifications is warranted and is underway.

Clinical Trials Registration

clinicaltrials.gov NCT05667675.

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来源期刊

Academic Pediatrics PEDIATRICS-

CiteScore

4.60

自引率

12.90%

发文量

300

审稿时长

60 days

期刊介绍： Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.