[Implementation and evaluation of a program of prevention against abuse in at risk infants].
Teams of pediatricians and psychiatrists led a joint action-research in public health institutions for infants which intended to evaluate original modes of prevention of abuse concerning infants with medico-psychosocial high risk factors. The framework of this study was a randomized controlled trial on the modes of prevention. The sample, consisting of children selected according to risk indicators appearing on their health certificate of the 8th day, was divided into two groups: the treated group who benefited from specific prevention interventions and a control group who benefited from classic surveillance. The research was longitudinal and was centered on the study of mother-infant interactions at 3 months, 1 year, 2 years and 3 years of age. The dynamics of early interactions was studied very precisely on the occasion of each examination. The first results concern the 161 children (72 in the "intervention" group, 89 in the control group) who were evaluated at 1 year of age. Although a real change in practice could be observed (the treated group profited by a mean number of 7.5 actions, while the control group on the average profited by only 1 action), the efficacy of those actions could not be demonstrated. No significant differences were observed between both groups with respect to height and weight growth and psychomotor development, their somatic status and the quality of early interactions, except with respect to a better quality of interactions in the action mode for the treated group. The difficulties inherent in such a type or research are analysed (children lost to follow-up, contamination of the control group by actions intended only to the treated group, difficulty in disposing of reliable criteria of estimation).
Dubois
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S
l'Unité de recherche INSERM U292, Hôpital de Bicêtre.
Job-Spira
N
N
Lamour
M
M
Ferron
C
C
Leboube
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F
Lebovici
S
S
D000704:Analysis of Variance; D002649:Child Abuse / Q000517:prevention & control*; D002662:Child Health Services / Q000458:organization & administration; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009034:Mother-Child Relations; D011314:Preventive Health Services / Q000458:organization & administration; D012307:Risk Factors
Mise en oeuvre et évaluation d'un programme de prévention de la maltraitance chez le nourrisson à risque.