为儿童发展提供初级保健育儿计划的混合交付:一项随机临床试验
Susan M Chang1, Joanne A Smith1, Amika S Wright1
1Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica.
JAMA network open
|February 3, 2026
概括
这项研究表明,通过初级医疗保健提供的育儿计划改善了儿童的发展和育儿技能. 结合面对面和远程交付,为早期学习支持提供了一个可扩展的方法.
科学领域:
- 儿童发展 儿童发展
- 公共卫生干预措施 公共卫生干预措施
- 育儿支持计划 育儿支持计划
背景情况:
- 育儿计划增强早期学习和儿童的发展.
- 在政府服务中扩展这些计划需要有效的整合策略.
- 对于育儿干预措施的混合交付模式需要证据.
研究的目的:
- 评估通过政府初级医疗保健提供的育儿计划.
- 评估该计划对儿童发展,育儿态度和行为的影响.
- 为了确定结合面对面和远程交付模式的有效性.
主要方法:
- 在牙买加初级医疗保健中心进行单盲随机临床试验.
- 干预组接受了为期8个月的育儿计划,并得到社区卫生工作者的支持 (家庭访问和电话).
- 使用格里菲斯精神发展尺度评估儿童发育;用环境测量家庭观察 (HOME) 测量家长行为.
主要成果:
- 育儿计划显著改善了儿童的整体发育系数 (ES,0.17 SD) 和精细运动技能 (ES,0.19 SD).
- 育儿行为,包括参与和使用学习材料,也显示出显著的改善 (HOME分数ES,0.25 SD).
- 干预组和对照组之间没有随访率或参与者特征的显著差异.
结论:
- 通过初级医疗保健提供的育儿计划对儿童的发展和育儿产生了积极的影响.
- 混合 (面对面和远程) 交付是扩大育儿干预措施的可行策略.
- 将育儿支持纳入初级医疗保健可以有效地接触到家庭并促进幼儿发展.
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