Publikationen
Wie viele Familien in Deutschland sind in welchem Ausmaß psychosozial belastet?
Wie viele Familien in Deutschland sind in welchem Ausmaß psychosozial belastet? Ein Vergleich verschiedener Klassifizierungsverfahren zur Einschätzung des frühen Hilfebedarfs.
In: Kindheit und Entwicklung
Jahrg.: 29, H. 3, S. 128-137
Zusammenfassung: Die Kumulation von Risikofaktoren ist ein gängiges Kriterium zur Indikation eines frühen Hilfebedarfs. Über die Anzahl und das Ausmaß der psychosozial belasteten Familien in Deutschland ist bislang nur wenig bekannt. Mit Daten von N=7 549 Familien der Studie Kinder in Deutschland – KiD 0–3 und einem Inventar aus 25 Risikofaktoren wurde die Klassifizierung der Familien in Risikogruppen anhand einfacher Summenindizes mit den Ergebnissen einer Latenten Klassenanalyse (LCA) verglichen. Während einfache Summenindizes 24–30%der Familien als belastet identifizierten, erzeugte die inhaltlich überlegene LCA eine Vier-Klassen-Lösung mit 59% unbelasteten und 5% hochbelasteten Familien. Im mittleren Belastungsbereich unterscheidet sich die Gruppe der sozioökonomisch belasteten Familien (19%) von Familienmit hohem elterlichem Stress und Konfliktpotenzial (17%). Die Ergebnisse liefern wichtige Hinweise für die Versorgungsforschung zu Frühen Hilfen. Abstract: Early childhood intervention is a support and educational program in Germany promoting relationship and parenting competence in mothers and fathers of infants and toddlers to promote the healthy development and well-being of children. We do not know much about the distribution and proportion of families with high psychosocial adversity. To reach families at risk and to plan intervention, we need to estimate rates of psychosocial adversities and the proportion of (highly) burdened families with infants and toddlers. A cumulative risk model stresses the impact of an accumulation of psychosocial risk factors, which may cause difficulties in parenting and developmental outcomes in children. The accumulation of risk factors is a common reason for early childhood intervention programs; however, it does not give any information about the constellation and clusters of risk factors. In order to classify the families into risk groups, we compared simple sum indices with a latent class analysis (LCA). The KiD 0–3 study was rolled out in a random sample of German pediatric practices. The data referred to families with children aged up to 48 months (male: 50%, ø age = 14.0; female: 50%, ø age = 14.6). A representative sample of 7,549 mothers (91%, ø age: 31.6) and fathers (7%, ø age =35.0) answered a written questionnaire during a pediatric child development examination (well-child visits). The questionnaire contained a risk inventory of 25 factors, based on international systematic reviews and meta-analyses. The simple additive sum score with a range of 0 to 25 points identified 30%families with three ormore risk factors. Themultidimensional additive index counts the number of dimensions that contain at least one risk factor. The dimensions are defined as life situation, personality, mental health, behavior during pregnancy, child’s special needs, and problematic care behavior. By using the multidimensional index, 24%of families were classified as burdened with ≥3 dimensions. The LCA yielded a proportion of 59% unburdened and 5% multiple-burdened families within a four-class solution. The main advantage of the LCA is the possibility to distinguish families at an intermediate risk level: socioeconomically burdened families (19%) and those with high parenting stress and family conflict (17%). The classes from LCA seem to be a better solution compared with the cumulative risk models by providing exhaustive information on risk factors. However, predictive validity has not been tested. The classes may serve as target groups of further examinations and program implementation to create an evidence base of early childhood intervention in Germany.