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

总结 有寄养史的青少年（FCI）有200-400%的机会 报告一生或过去一年的心理健康（MH）问题（Havlicek，Garcia和Smith，2013）， 并且自杀的可能性高3.5倍（Katz等人，2011年），比同行。有 很少有专门为这些青年设计的预防性干预措施，现有的预防性干预措施 一般研究对不太具体的，直接的“问题”行为的影响，而不是 长期特定的MH障碍。目前的建议使用综合数据分析（IDA）， 协调7项双焦点青少年随机对照试验的数据， 专门为FCI青年设计的干预措施， （产生了一个多族裔的综合样本，基线时有1 925名青年， 按时间对每个人进行评估，涵盖从5岁开始的多个青年发展时期， 基线时15年）。本研究解决了有关交叉和长期的关键问题 干预对FCI青少年多个MH结局的影响， 过去或可以单独回答。干预措施对症状和诊断的有效性 五类MH结果（抑郁和焦虑，自杀，思维问题和 精神病、创伤后应激障碍、攻击性和暴力）将被检查。 增加抽样规模也将有助于检查干预措施对低基数的影响 评定MH结果（例如，自杀倾向、精神病）。使用IDA来利用多个数据集， 目前的建议可以积极影响FCI青年的生活，使我们能够了解， 以及在生命早期实施的预防性干预措施（目标1） 对FCI青年MH的积极影响，以及通过哪些机制（即， 改善养育子女的技能，减少青少年情绪和行为失调;目标2） 以及对于哪些亚群这些干预可能是最有效的（即，为 女性与男性，在发育期，其中MH结果通常表现为 [e.g.,儿童期暴力和攻击，以及青春期早期至晚期所有其他MH 结果]，对于经历了更多安置变化并获得更多 干预剂量和种族亚组;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).