Effectiveness of an Empirically Supported Family Intervention: Mental Health Outcomes, Mechanisms of Effect, and Organizational Factors

经验支持的家庭干预的有效性：心理健康结果、影响机制和组织因素

• 批准号: 10320476
• 负责人: JOHN G BORKOWSKI
• 金额: $ 76.29万
• 依托单位: UNIVERSITY OF NOTRE DAME
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-01 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10320476
• 关键词: Address; Adolescent; Age; Back; Basic Science; Child; Church; Cities; Clinical Trials Design; Communication; Communities; Conflict (Psychology); Development; Educational Curriculum; Effectiveness; Emotional; Environment; Ethnic Origin; Evidence based program; Expressed Sequence Tags; Family; Feasibility Studies; Fostering; Gender; Goals; Indiana; Intervention; Link; Literature; Longevity; Mediating; Mediator of activation protein; Mental Health; Mission; Modeling; National Institute of Mental Health; Outcome; Parents; Participant; Pattern; Personal Satisfaction; Predisposition; Prevention; Process; Program Effectiveness; Program Evaluation; Public Health; Race; Randomized; Research; Research Assistant; Research Design; Resources; Risk; Sampling; Security; Site; Social Work; Source; Students; System; Testing; Theoretical model; Time; Training; Work; Youth; base; brief intervention; community center; community setting; cost effective; cost effective intervention; design; effectiveness evaluation; effectiveness testing; effectiveness trial; efficacy research; efficacy trial; evidence base; experience; family support; improved; indexing; innovation; member; organizational structure; programs; psychoeducation; psychoeducational; recruit; response; satisfaction; service providers; social media; socioeconomics; substance use; success; theories; undergraduate student

Project Summary/Abstract Cost-effective, brief programs to support family communication and improve mental health in youth are a pressing need; yet few evidence-based programs exist. Our group has developed and rigorously tested an empirically-supported family-systems approach to improving communication and conflict in families, thereby improving mental health in youth. Beneficial effects for youth mental health and other indices of adjustment associated with the Happy Families Curriculum have been supported in several efficacy trials with families from a variety risk contexts. However, the value of efficacy research is limited unless it is subsequently tested in the context of an effectiveness trial. Given the potential large-scale benefits of broad implementation of the Happy Families Curriculum, a critical need exists for an effectiveness trial to evaluate the program when it is implemented in community settings by facilitators who would provide the program in “real world” settings. Our objective in this proposal is to test the effectiveness for a large sample, in different contexts of risk, of the brief (i.e. 4 session) psycho-educational and communication training approach used in our efficacy trials, and to examine the mechanisms associated with change processes that occur as a result of the program, including emotional security as a mediator of program effects and moderators of effects associated with participants’ socioeconomic and contextual risks as well as organizational factors that may impact program effectiveness. Our central hypothesis is that participation in the program will improve patterns of communication and conflict in families, thereby improving youth mental health. This hypothesis is supported by extensive efficacy research on the Happy Families Curriculum and conclusions based on a recently conducted feasibility study of the proposed effectiveness trial. Our rationale is that providing a family-systems approach to improving the family environment will support youth mental health over time. The specific aims are: (1) evaluating program effectiveness for improving communication, reducing destructive conflict in families and enhancing mental health in youth, (2) testing process models, guided by the Emotional Security Theory (EST; Davies & Cummings, 1994), to explain how, why, for whom and when, changes occur as a result of the program, and (3) evaluating organizational factors associated with program effectiveness, including the impact of organization structure and facilitator type, and organizations’ subjective evaluation of the program. This approach is innovative because it utilizes an RCT design to test the effectiveness of a proven family-systems approach that represents a brief, inexpensive and readily scalable approach to foster change in families’ communication patterns and improve mental health. The program is based on a well-established theoretical model for “mechanisms of effect” and backed by evidence for program efficacy. This research is significant because it will result in an inexpensive model program for family-system-level interventions that is sustainable in the organizations it is tested in, and readily adjusted to other contexts.

项目摘要/摘要 支持青少年家庭沟通和改善心理健康的具有成本效益的简短计划是 迫切需要；然而，现有的循证项目很少。我们的团队已经开发并严格测试了一个 经验支持的家庭系统方法，以改善家庭中的沟通和冲突，从而 改善青年心理健康状况。对青少年心理健康和其他适应指数的有益影响 与幸福家庭课程相关的课程在几个家庭的疗效试验中得到了支持 各种风险背景。然而，功效研究的价值是有限的，除非它随后在 有效性试验的背景。鉴于广泛实施Happy的潜在大规模好处 家庭课程，迫切需要一项有效性试验来评估该计划 由推动者在社区环境中实施，这些推动者将在“真实世界”环境中提供该程序。我们的 本提案的目的是测试在不同风险背景下，对大样本的有效性 (即4节)在我们的疗效试验中使用的心理教育和沟通训练方法，以及 检查与作为计划结果而发生的变化过程相关联的机制，包括 情绪安全感作为项目效果的中介者和与参与者相关的效果的调节者 可能影响计划有效性的社会经济和背景风险以及组织因素。 我们的中心假设是，参与该计划将改善沟通和冲突的模式 在家庭中，从而改善青年的心理健康。这一假设得到了广泛的疗效研究的支持。 关于幸福家庭课程和根据最近进行的可行性研究得出的结论 拟议的有效性试验。我们的理由是提供一种家庭系统的方法来改善家庭 随着时间的推移，环境将支持青少年的心理健康。具体目标是：(1)评估方案 改善沟通、减少家庭中的破坏性冲突和增强心理的有效性 青年健康，(2)情绪安全理论指导下的测试过程模型(EST；Davies& Cummings，1994)，以解释该计划如何、为什么、对谁以及何时发生变化，以及(3) 评估与计划有效性相关的组织因素，包括组织的影响 结构和促进者类型，以及组织对计划的主观评价。这种方法是 创新，因为它利用RCT设计来测试经过验证的家庭系统方法的有效性，该方法 代表了一种简短、廉价且可随时扩展的方法，以促进家庭沟通的变化 模式和改善心理健康。该计划是基于一种成熟的理论模型 “效果机制”，并有项目有效性的证据支持。这项研究具有重要意义，因为它 将产生一个可持续的家庭系统一级干预的廉价模式方案 它在组织中进行测试，并随时调整以适应其他环境。