ABSTRACT

Objective

Developing an effective population-level system of evidence-based parenting support capable of shifting (at a population level) rates of child maltreatment and social, emotional, and behavioral problems in children requires an integrated theory of change. This paper presents a systems-contextual model of change and identifies modifiable mechanisms that can potentially explain population-level changes in parenting and child outcomes.

Method

Using the Triple P-Positive Parenting Program as an exemplar of a tiered, multi-level system of evidence-based parenting interventions, we discuss the putative mechanisms of change necessary to produce change in child behavior, parenting, practitioner behavior, and organizational changes to support the sustained implementation of an intervention.

Results

A model of change is proposed that blends theoretical perspectives derived from social learning theory, self-regulation theory, applied behavior analysis, cognitive behavior principles, developmental theory, and principles derived from the fields of public health, implementation science, and economics to explain change in the behavior at the community wide level. Different types of interventions targeting different populations and mechanisms are used to illustrate how sustainable change in child and parent outcomes can be achieved.

Conclusions

Evidence supporting specific mechanisms and moderators of intervention effects are discussed as well as directions for future research on mechanisms.

中文翻译：

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基于人口的儿童和青少年育儿干预的变化机制

摘要

客观的

开发一个有效的人口水平的循证育儿支持系统，能够（在人口水平）改变儿童虐待和社会、情感和行为问题的发生率，需要一个综合的变革理论。本文提出了一个系统情境的变化模型，并确定了可修改的机制，这些机制可以潜在地解释人口层面的养育和孩子结果的变化。

方法

使用三 P 积极育儿计划作为分层、多层次的循证育儿干预系统的范例，我们讨论了改变儿童行为、育儿、从业者行为和组织变革所必需的假定机制支持干预措施的持续实施。

结果

提出了一个变革模型，融合了源自社会学习理论、自我调节理论、应用行为分析、认知行为原理、发展理论以及源自公共卫生、实施科学和经济学领域的原理的理论观点来解释变革在社区范围内的行为。针对不同人群和机制的不同类型干预措施用于说明如何实现儿童和父母结果的可持续变化。

结论

讨论了支持干预效果的具体机制和调节剂的证据，以及未来机制研究的方向。