Intervening in the Lives of Foster Care Youth: Using Integrative Data Analysis to Examine Crossover and Long-Term Mental Health Benefits of Dual-Focused Caregiver–Youth Preventative Interventions

摘要 有寄养参与史(FCI)的年轻人有200-400%的机会 报告一生或过去一年的精神健康(MH)问题(Havlicek，Garcia&Smith，2013)， 自杀的可能性是同龄人的3.5倍(Katz等人，2011年)。确实有 很少有专门为这些青年和现有青年设计的预防干预措施 一般考察了对不太具体、直接的“问题”行为的影响，而不是 长期的特定MH疾病。目前的提案使用综合数据分析(IDA)来 协调7个双焦点照顾者-青年随机对照试验的数据 专门为FCI青年设计的干预措施，分享潜在的变革理论 (得出种族多样化的组合样本，基线为1925名青年，超过6500名 个人时间评估，涵盖从5岁到5岁的多个青少年发展阶段- 按基线计算为15年)。这项研究解决了交叉和长期的关键问题 干预对FCI青少年多种MH结局的影响没有一项研究在 过去还是可以独自回答的。症状与诊断并重的干预效果分析 MH结果的五类(抑郁和焦虑、自杀、思维问题和 精神病，创伤后应激障碍，以及攻击和暴力)将被审查。 增加样本量还将审查干预措施对低基数的影响。 对MH结果进行评分(例如，自杀、精神质)。使用IDA来利用多个数据集， 当前的提案可以通过使我们了解如果 以及在生命早期实施的预防性干预(目标1)可能有多长时间 对FCI青年MH的积极影响，以及通过哪些机制(即， 改善育儿技能，减少青少年情绪和行为失调；目标2) 以及这些干预对哪些亚群可能是最有效的(即 女性与男性，在MH结局典型表现的发育期 [例如，暴力和攻击性的儿童期，以及所有其他MH的青春期早期至晚期 结果]，对于经历了更多安置变化和获得更多帮助的FCI青年来说 干预剂量，按种族分组；目标3)。

Summary Youth with a history of foster care involvement (FCI) have a 200–400% greater chance of reporting a lifetime or past year mental health (MH) problem (Havlicek, Garcia, & Smith, 2013), and are 3.5 times more likely to commit suicide (Katz et al., 2011), than their peers. There are few preventive interventions specifically designed for these youth, and those that exist have generally examined effects on less specific, immediate “problem” behaviors rather than long-term specific MH disorders. The current proposal uses integrative data analysis (IDA) to harmonize data across seven dual-focused caregiver–youth randomized control trials of interventions designed specifically for FCI youth that shared underlying theories of change (yielding an ethnically diverse combined sample of 1,925 youth at baseline and over 6,500 person-by-time assessments that cover multiple periods of youth development from ages 5– 15 years at baseline). This study addresses key questions about both crossover and long-term intervention effects on multiple MH outcomes in FCI youth that no one study has examined in the past or could answer alone. Efficacy of the interventions on both symptoms and diagnoses of five classes of MH outcomes (depression and anxiety, suicidality, thought problems and psychosis, posttraumatic stress disorder, and aggression and violence) will be examined. Increased sample size will also allow for examination of the impact of interventions on low base rate MH outcomes (e.g., suicidality, psychoticism). Using IDA to leverage multiple datasets, the current proposal could positively impact the lives of FCI youth by enabling us to understand if and for how long (Aim 1) preventative interventions implemented early in life may have positive impacts on FCI youth MH, as well as the mechanisms through which (i.e., improved parenting skills and decreased youth emotional and behavioral dysregulation; Aim 2) and for which subpopulations those interventions might be most efficacious (i.e., for females versus males, in the developmental period in which the MH outcome typically manifests [e.g., childhood for violence and aggression, and early to late adolescence for all other MH outcomes], for FCI youth who have experienced more placement changes and received greater intervention dosage, and by ethnic subgroups; Aim 3).