Análise crítica de artigo

Critical analysis

Iles, J. E., Rosan, C., Wilkinson, E., & Ramchandani, P. G. (2017). Adapting and developing a video-feedback intervention for co-parents of infants at risk of externalising behaviour problems (VIPP-Co): A feasibility study. Clinical child psychology and psychiatry, 22(3), 483-499.

Introduction: The article begins with explanations and information’s about externalizing child behavior, a variable that could be impacted by the proposed intervention. Then, the authors cite researches in sensitive parenting and child-mother or child-father relationship and attachment, because interventions focusing in these variables could decrease the externalizing behavior of the child. After, the authors highlight the growing interest in studying triadic interactions like co-parenting. Poor co-parenting (high conflict and disagreement between parents) its important because could entails less adjustment for the child. Finally, they describe theories that are useful to understand the relationships discussed in the context of VIPP-SD: social learning and attachment theories. Making an analysis about the introduction, it seems that it was well constructed, and that relevant background literature was reviewed. On the other hand, it’s not clear what are the effectiveness and or efficacy of any interventions described. So, this information could be useful for the purpose of the study.

Objective: The main objective of the study was to test the feasibility of a video-feedback intervention for co-parents of infants at risk of externalizing behavior problems (VIPP-Co). The authors make it clear that they also want to describe the evidence-base and theory behind the defined intervention components. That is, they are focusing in the initial stages of the adaptation and validation of the intervention, specifically in recruitment and retention, acceptability and preliminary outcomes. It seems that the purpose of the study was stated clearly. The authors also address research questions to better situate the research and the readers.

Method: Families who reported to be struggling with their infant’s behavior were recruited via poster advertisements across community health and social care settings. In total, 30 families contacted the research team interested in taking part. Of these, 11 agreed to take part, and 6 met the study’s inclusion criteria. In total, five families (mothers with a mean age of 35 years and fathers with a mean age of 36 years) with infants between 10 and 24 months (mean age of 16 months) finalized the intervention. The procedure was characterized by the content and themes described in the VIPP-SD manual; however, it was made a modification to reflect its delivery with co-parents. So, two additional messages were included in the feedback delivered in VIPP-Co. The first one was “working together as a couple and supporting each other”, and the second message was “having fun together as a family”. An initial 1 hour home-based were received by the families and it was described as the pre intervention. After, during the visit, the parents and infants completed the baseline questionnaire measures and several filmed tasks. Following this, the intervention was delivered by a clinical psychologist across 4–6 home-based intervention. The authors also used psychometric questionnaires (for parental well-being, externalizing behavior and parental couple relationship) and observational measures (for quality of parent–infant interactions and parental discipline). About this part of the section, the authors described appropriately the intervention and with details. Besides, they use several different instruments and techniques to measure the variables. By citing the psychometric measures, they even present some internal consistency evidence validity. So, it was very informative. To assess the acceptability of VIPP-Co, the authors also asked parents to provide detailed feedback about the intervention. This was obtained using self-report questionnaires and interviews. About data analysis, it was adequately described. For qualitative data, they conducted a thematic analysis detailed by Braun and Clarke. They also control for bias using methods to address inter coder reliability. Although feasibility was the primary objective, clinical improvement data were considered a useful secondary outcome in the study. Descriptive statistics were reported for each of the measures to compare any change across the intervention. Finally, its worth to say that the ethical aspects were presented, including that informed consent was obtained. However, this aspect was poorly described, they did not provide numbers of ethical approval’s or extensive information about procedures.

Results: About the results, the authors presented it in a sequential order according to the aims of the study, which are useful to readers. About recruitment and retention, they say it was challenging because, besides all the information and multi methods, only 30 parents contact the research team. Regarding intervention acceptability, the intervention was viewed generally as positive. So, all fathers and mothers reported that it positively impacted their understanding of their child’s thoughts and feelings, and their approach to individual parenting and co-parenting. About the preliminary outcomes, a global trend improvement across the measures and in the observational coding of parent-infant interaction was perceived. Regarding this section of the article, although the results were objectively described, the tables and figures (a graph) were detailed, clear and a good source of information. For example, intervention themes based on participant feedback were accompanied by quotations that characterized the theme. Another example: parent reported experience of changes were

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