Online parenting interventions hold promise for increasing access to behavioral support for families with low income and who reside in rural areas. The current study evaluates the efficacy of a mobile app-based parenting support program, the Family Check-Up Online (FCU-O) with telehealth coaching support, for parents of children 1.5-5 years old at risk of experiencing parenting challenges. We tested effects of the FCU-O on parent wellbeing (parenting self-efficacy and symptoms of depression and anxiety) and parent-reported parenting skills (support for positive behavior, limit-setting, and proactive parenting) at the 3-month follow-up in a randomized controlled trial (FCU-O versus control). We also tested relationships between parents’ baseline characteristics and their engagement with the app and telehealth coaching. Eligibility criteria included endorsing depressive symptoms or current or past substance misuse. Participants (N = 356) were predominantly White (72%) and low-income, with 43% of families residing in a rural area. Approximately one-third-of participants reported clinically significant symptoms of anxiety or depression and one-third-endorsed a lifetime history of opioid misuse. Intent to treat analyses tested effects of the FCU-O on parent wellbeing and parenting skills. The FCU-O was associated with improvements to parents’ support for positive behavior, limit-setting, and proactive parenting skills, as well as parenting self-efficacy and depressive symptoms. Parents’ initial symptoms of depression and anxiety significantly predicted greater telehealth coach engagement; low levels of initial self-reported skills positive behavior support and limit-setting significantly predicted greater app engagement. Results provide support for the FCU-O as a preventive parenting intervention for parents experiencing mental health challenges, with implications for reducing barriers to accessing parenting support for underserved families.

中文翻译：

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在线家庭检查对幼儿至学龄前儿童家庭的育儿和父母健康的影响


在线育儿干预有望增加低收入和居住在农村地区的家庭获得行为支持的机会。目前的研究评估了基于移动应用程序的育儿支持计划，即具有远程医疗指导支持的在线家庭检查 （FCU-O），对 1.5-5 岁有可能遇到育儿挑战的儿童的父母的有效性。在一项随机对照试验 （FCU-O 与对照组相比），我们在 3 个月的随访中测试了 FCU-O 对父母幸福感 （养育自我效能感和抑郁和焦虑症状） 和父母报告的养育技能 （支持积极行为、设定限制和主动养育） 的影响。我们还测试了父母的基线特征与他们与应用程序和远程医疗指导的参与度之间的关系。资格标准包括认可抑郁症状或当前或过去的药物滥用。参与者 （N = 356） 主要是白人 （72%） 和低收入者，其中 43% 的家庭居住在农村地区。大约三分之一的参与者报告了具有临床意义的焦虑或抑郁症状，三分之一的参与者认可有终生阿片类药物滥用史。意向治疗分析测试了 FCU-O 对父母健康和育儿技能的影响。FCU-O 与父母对积极行为、限制设定和主动育儿技能的支持以及育儿自我效能感和抑郁症状的改善有关。父母最初的抑郁和焦虑症状显着预测了远程医疗教练的参与度更高;初始自我报告的技能水平较低、积极行为支持和限制设置显著预测了更高的应用参与度。 结果为 FCU-O 作为对面临心理健康挑战的父母的预防性育儿干预措施提供支持，并有助于减少服务不足家庭获得育儿支持的障碍。