Intervention Development and Pilot for Foster Care Youth

描述（由申请人提供）：这项R21申请为期3年的干预研究探索/发展补助金，旨在为9-11岁的寄养儿童开发，标准化和提供新干预措施的初步测试。有虐待史并随后被安置在寄养家庭的儿童和青少年有可能出现重大的心理健康和行为问题，这些问题具有重大的公共卫生意义。在我们以前的纵向工作与寄养儿童，我们已经描述了人口，研究儿童福利制度的影响，并确定了可修改的心理社会风险和保护因素。这些干预前活动，由首席研究员的职业发展奖的支持，使我们能够解决重要的方法问题，阻碍了针对这一高风险人群的干预工作的发展。基于此干预前的研究，焦点小组参与者的反馈，并审查其他有效的方案，为高风险的青年，我们建议设计一个干预前青春期青年寄养包括三个主要组成部分：评估，辅导/宣传，和治疗技能组。 拟议的R21活动包括制定评估组合和干预方案，使治疗手册化，估计招募率和自然减员率，并进行小规模的随机对照干预试点研究。干预的目标是改善心理健康功能和学业成绩，减少青年人开始和参与问题行为。我们将对这些近端结果是否受基线特征的调节和/或受干预目标过程变量的介导进行初步检查。将使用效应量估计值确定进行全规模随机对照试验所需的样本量，以获得足够的把握度。试点研究还将关注可行性、项目吸收和可复制性问题，我们将在试点阶段之后和申请R 01之前修改评估组合、方案和手册，以进行大规模疗效试验。

DESCRIPTION (provided by applicant): This R21 application for a 3-year exploratory/development grant for intervention research is designed to develop, standardize and provide a preliminary test of a novel intervention for children, ages 9-11, placed in foster care. Children and adolescents with a history of maltreatment and subsequent placement in foster care are at risk for substantial mental health and behavioral problems of great public health significance. In our prior longitudinal work with children in foster care, we have described the population, examined child welfare system impact, and identified modifiable psychosocial risk and protective factors. These preintervention activities, supported by the Principal Investigator's Career Development Award, have enabled us to address important methodological issues that have hampered the development of intervention efforts targeting this high-risk population. Based on this pre-intervention research, feedback from focus group participants, and a review of other efficacious programs for high-risk youth, we propose to design an intervention for preadolescent youth in foster care consisting of three primary components: assessment, mentoring/advocacy, and therapeutic skills groups. The proposed R21 activities include developing the assessment battery and intervention protocol, manualizing the treatment, estimating recruitment and attrition rates, and conducting a small-scale randomized-controlled pilot study of the intervention. The goals of the intervention will be to improve mental health functioning and academic achievement and to reduce youths' initiation of, and participation in, problem behaviors. We will conduct a preliminary examination of whether these proximal outcomes are moderated by baseline characteristics and/or mediated by the process variables targeted by the intervention. Estimates of effect size will be used to determine the sample size needed for adequate power to conduct a full-scale randomized controlled trial. The pilot study will also focus on issues of feasibility, program uptake, and replicability, and we will modify the assessment battery, protocol, and manuals following the pilot phase and prior to our application for an R01 to conduct a large-scale efficacy trial.