OBJECTIVE This pragmatic, randomized, non-inferiority trial compared the effectiveness and cost of group-based parent management training with mastery-based individual coaching parent management training in a low-income, predominantly African American sample. METHOD Parents seeking treatment for their 2- to 5-year-old children's behavior problems in an urban fee-for-service child mental health clinic were randomized to the Chicago Parent Program (CPP; n = 81) or Parent-Child Interaction Therapy (PCIT; n = 80). Consent followed clinic intake and diagnostic assessment and parent management training was delivered by clinicians employed at the clinic. Primary outcome measures were externalizing child behavior problems, assessed at baseline and postintervention follow-up, using the Child Behavior Checklist (CBCL) and average per-participant treatment cost. RESULTS Data from 158 parents were analyzed. Most were mothers (75.9%), African American (70.3%), and economically disadvantaged (98.7% Medicaid insured). Of children, 58.2% were boys, and mean age was 3.6 years (SD 1.03). Based on CBCL scores, behavior problems improved in the 2 conditions (Cohen d = 0.57 for CPP and 0.50 for PCIT). CPP was not inferior to PCIT (90% CI -1.58 to 4.22) at follow-up, even after controlling for differences in treatment length (90% CI -1.63 to 4.87). Average per-participant treatment cost was higher for PCIT (mean $2,151) than for CPP (mean $1,413, 95% CI -1,304 to -170). CONCLUSION For parents of young children living in urban poverty, CPP is not inferior to PCIT for decreasing child behavior problems. CPP requires less time to complete and costs a third less than PCIT. CLINICAL TRIAL REGISTRATION INFORMATION Early Parenting Intervention Comparison (EPIC); https://clinicaltrials.gov/; NCT01517867.

中文翻译：

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减少城市心理健康诊所的学龄前行为问题：一项务实的、非自卑的试验。

目的 这项务实的、随机的、非劣效性试验在低收入、主要是非裔美国人的样本中比较了基于小组的家长管理培训与基于掌握的个人辅导家长管理培训的有效性和成本。方法 为 2 至 5 岁儿童的行为问题在城市收费服务儿童心理健康诊所寻求治疗的父母被随机分配到芝加哥家长计划 (CPP; n = 81) 或亲子互动疗法 ( PCIT；n = 80)。诊所聘用的临床医生在诊所接受和诊断评估后获得同意，并提供家长管理培训。主要结果测量是外化儿童行为问题，在基线和干预后随访时进行评估，使用儿童行为检查表 (CBCL) 和每位参与者的平均治疗费用。结果 分析了来自 158 名父母的数据。大多数是母亲（75.9%）、非裔美国人（70.3%）和经济上处于不利地位的人（98.7% 的医疗补助被保险人）。在儿童中，58.2% 是男孩，平均年龄为 3.6 岁 (SD 1.03)。根据 CBCL 评分，两种情况下的行为问题得到改善（CPP 的 Cohen d = 0.57，PCIT 的 Cohen d = 0.50）。即使在控制了治疗时间的差异（90% CI -1.63 至 4.87）后，CPP 在随访中也不逊于 PCIT（90% CI -1.58 至 4.22）。PCIT 的平均每位参与者治疗费用（平均 2,151 美元）高于 CPP（平均 1,413 美元，95% CI -1,304 至 -170）。结论 对于生活在城市贫困中的幼儿的父母，CPP 在减少儿童行为问题方面并不逊于 PCIT。CPP 需要更少的时间来完成，成本比 PCIT 低三分之一。临床试验注册信息早期育儿干预比较（EPIC）；https://clinicaltrials.gov/；NCT01517867。