Evaluation of APA?s ACT Program: Engaging Fathers to Prevent Adverse Childhood Experiences

项目摘要 本拟定研究涉及RFA-CE-21-004的目标#3，“评价主要 预防战略，其中包括照顾者及其子女的双代办法， 暴力和逆境的循环”。虐待儿童是最常见的一种暴力形式， 由看护人犯下的，是一个严重的公共卫生问题，导致整个生命周期的健康不平等， 使青少年容易犯下暴力行为。越来越多的证据表明，早期干预措施的目标是 通过家长培训方案防止虐待儿童。然而，这项研究的主要局限性包括： 结果评价中包括的男性照顾者很少， 暴力的结果。特别是，暴露于成人亲密伴侣暴力（IPV），这往往同时发生， 在CM家庭中，对青少年有同样的不良行为和健康后果，包括青少年暴力 （YV）。鉴于CM、IPV和YV之间存在大量共同的风险和保护因素， 有理由怀疑有效的CM预防计划将防止这些多种形式的暴力。的 这项研究的目的是探索这种潜力，在一个以证据为基础的，家长培训计划， CM预防，ACT提高安全的孩子。该项目建立在对首都地区的国内和国际评价的基础上 通过对男性照顾者实施严格的准实验设计来实施计划。对于拟议的项目， 将从提供全套服务的4个服务提供者地点招募500名男性护理人员 家庭，包括ACT计划。将使用治疗权重的逆概率来平衡 干预组和对照组的潜在混杂协变量。评估将于 基线，10周（即，干预后即刻）、干预后6个月和干预后12个月 干预结果测量包括CM犯罪风险，IPV和青少年攻击（一个风险因素， 在青春期更严重的YV形式）。此外，我们将评估一些中介变量 包括养育行为、父母压力、家庭冲突和愤怒调节。对于最终的主要目的， 我们还将从ACT参与者、辅导员和管理员那里收集成本日记数据，以便我们可以- 效用分析数据收集将通过护理人员报告进行。据推测，男性照顾者在 随着时间推移，ACT条件将报告较少CM风险、IPV和YV风险。这项研究是创新的，因为它 有可能证明单一方案有能力消除多种形式暴力的风险， 不仅由不同的项目解决，而且在科学文献的不同筒仓中解决。这些发现可能 具有重大的公共卫生影响，为整合资源提供证据， 传播单一的跨领域预防方案。鉴于此，ACT目前在13个国家实施， 美国80个社区，公共卫生影响将是巨大的。

Project Summary This proposed study addresses Objective #3 of RFA-CE-21-004, “Effectiveness research to evaluate primary prevention strategies that incorporate a dual-generation approach for caregivers and their children that breaks the cycle of violence and adversity”. Child maltreatment (CM), a form of violence exposure most often perpetrated by caretakers, is a serious public health issue that results in health inequity across the lifespan and predisposes youth to violence perpetration. There is increasing evidence for early intervention efforts targeting child maltreatment prevention via parent training programs. However, major limitations of this research involve the paucity of male caregivers included in outcome evaluations and the failure to look at other associated violence outcomes. In particular, exposure to adult intimate partner violence (IPV), which frequently co-occurs in families with CM, has the same adverse behavioral and health outcomes for youth including youth violence (YV). Given the significant number of shared risk and protective factors among CM, IPV, and YV, there are reasons to suspect that efficacious CM prevention programs will prevent these multiple forms of violence. The purpose of this proposed study is to explore this potential in an evidence-based, parent training program for CM prevention, ACT Raising Safe Kids. This project builds on domestic on international evaluations of the ACT program by implementing a rigorous quasi-experimental design with male caregivers. For the proposed project, 500 male caregivers will be recruited from 4 service provider sites that provide an armamentarium of services to families, including the ACT program. Inverse probability of treatment weighting will be used to balance the intervention group and the control group on potential confounding covariates. Assessments will be collected at baseline, 10 weeks (i.e., immediately post-intervention), 6 months post-intervention, and 12 months post- intervention. Outcome measures include CM perpetration risk, IPV, and youth aggression (a risk factor for more severe forms of YV in adolescence). Additionally, we will assess a number of mediating variables including parenting behaviors, parental stress, family conflict, and anger regulation. For the final primary AIM, we will also collect cost diary data from ACT participants, facilitators, and administrators so we may a cost- utility analysis. Data collection will be web-based via caregiver report. It is hypothesized that male caregivers in the ACT condition will report less CM risk, IPV, and YV risk over time. This research is innovative as it has potential to demonstrate the ability of a single program to eliminate risk for multiple forms of violence typically addressed not only by different programs, but in different silos of the scientific literature. Such findings could have substantial public health impact providing evidence for the consolidation of resources to, and broad dissemination of, single cross-cutting prevention programs. Given that, ACT is currently implemented in 13 countries and 80 U.S. communities, the public health impact would be substantial.