Intervention Development and Pilot for Foster Care Youth

描述(由申请人提供)：本R21申请为期3年的探索/发展基金，用于干预研究，旨在开发、标准化和提供一种新的干预措施的初步测试，该干预措施适用于寄养的9-11岁儿童。有虐待史并随后被安置在寄养中心的儿童和青少年面临严重的精神健康和行为问题的风险，这些问题对公共卫生具有重大意义。在我们之前关于寄养儿童的纵向工作中，我们描述了人口，检查了儿童福利系统的影响，并确定了可改变的心理社会风险和保护因素。这些干预前活动得到首席调查员职业发展奖的支持，使我们能够解决阻碍针对这一高危人群开展干预工作的重要方法问题。基于这项干预前的研究，来自焦点小组参与者的反馈，以及对其他针对高危青少年的有效计划的回顾，我们建议设计一种针对青春期前青少年寄养的干预措施，包括三个主要组成部分：评估、指导/宣传和治疗技能小组。 拟议的R21活动包括制定评估小组和干预方案，使治疗过程自动化，估计招募和流失率，并对干预进行小规模随机对照试点研究。干预的目标将是改善心理健康功能和学习成绩，减少青少年发起和参与问题行为。我们将对这些近期结果是否受到基线特征和/或干预目标过程变量的影响进行初步检查。效应大小的估计将被用来确定进行全面随机对照试验所需的足够能量所需的样本量。试点研究还将集中在可行性、计划采用率和可复制性等问题上，我们将在试点阶段之后和申请R01之前修改评估单元、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.