Objective

To determine whether an internet-based and telephone-assisted parent training intervention, which used whole population screening and which comprehensively targeted symptomatic 4-year-old children, was effective 24 months after the start of treatment. No long-term follow-up studies using a randomized controlled trial (RCT) existed on this subject.

Method

Of the 4,656 children 4 years old who were screened in Southwest Finland, 730 met the criteria for high-level disruptive behavioral problems, and 464 parents agreed to be randomized to the 11-week Strongest Families Smart Website (SFSW) intervention (n = 232) or an educational control (EC) (n = 232). After 24 months, 163 SFSW parents (70%) and 165 EC parents (71%) were still participating.

Results

When we compared the results at baseline and 24 months, the primary outcome of the Child Behavior Checklist (CBCL) externalizing score showed significantly higher improvements in the SFSW group (effect size 0.22; p < 0.001). This group also showed greater improvements in the secondary outcomes: the CBCL total and internalizing scales, 5 of the 7 CBCL symptom domains, 3 of the 5 DSM subscores, and self-reported parenting skills. Fewer SFSW children (17.5%) than EC children (28.0%) had been referred to child mental health services between baseline and 24 months (odds ratio = 1.8; 95% confidence interval = 1.1−3.1).

Conclusion

The SFSW internet-based and telephone-assisted parental training program was effective 24 months after initiation, underlining the value of identifying children at risk in the community early and providing evidence-based parent training for a large number of families.

Clinical trial registration information: Strongest Families Finland Canada

Family-based Prevention and Treatment Program of Early Childhood Disruptive Behavior (Fin-Can). http://www.clinicaltrials.gov; NCT01750996.

中文翻译：

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互联网和电话辅助家长培训针对4岁时的破坏行为的两年随访

客观的

为了确定基于互联网和电话协助的父母培训干预措施是否有效，该干预措施在开始治疗后24个月有效，该干预措施采用了整体人群筛查，并全面针对有症状的4岁儿童。没有关于该主题的使用随机对照试验（RCT）的长期随访研究。

方法

在芬兰西南部筛查的4656名4岁儿童中，有730名符合严重破坏性行为问题的标准，并且464名父母同意随机接受为期11周的“最强家庭智能网站”（SFSW）干预（n = 232） ）或教育控制（EC）（n = 232）。24个月后，仍有163名SFSW父母（占70％）和165名EC父母（占71％）。

结果

当我们比较基线和24个月的结果时，儿童行为清单（CBCL）外在化评分的主要结果显示SFSW组的改善显着更高（影响大小0.22；p  <0.001）。该组在次要结局方面也显示出更大的改善：CBCL总体和内化量表，7个CBCL症状域中的5个，5个DSM子评分中的3个以及自我报告的育儿技能。在基线至24个月之间接受儿童心理健康服务的SFSW儿童（17.5％）少于EC儿童（28.0％）（优势比= 1.8； 95％置信区间= 1.1-3.1）。

结论

SFSW基于互联网和电话协助的父母培训计划在启动后24个月生效，突显了早期识别社区中处于危险中的儿童的价值，并为大量家庭提供了基于证据的父母培训。

临床试验注册信息：最坚强的家庭芬兰加拿大

以家庭为基础的幼儿破坏行为的预防和治疗计划（Fin-Can）。http://www.clinicaltrials.gov; NCT01750996。