Family Groups to Reduce Youth Behavioral Difficulties

家庭团体减少青少年行为困难

• 批准号: 7103005
• 负责人: Mary McKernan McKay
• 金额: $ 70.8万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7103005
• 关键词: African American; Hispanic Americans; behavioral /social science research tag; caregivers; child behavior disorders; child mental health service; child rearing; clinical research; clinical trials; conduct disorder; family structure /dynamics; group counseling; health care service evaluation; health services research tag; human subject; human therapy evaluation; low socioeconomic status; mental disorder prevention; middle childhood (6-11); oppositional defiant disorder; parent offspring interaction; stress management; urban poverty area

DESCRIPTION (provided by applicant): The primary goal of the proposed study is to examine a multiple family group (MFG) service delivery strategy on service use and outcome for urban, low-income children of color. The study will involve school-age, inner-city children (7 to 11 years) meeting diagnostic criteria for ODD or CD, and their families, in a 16-week series of group meetings with 6 to 8 families in each group. The MFG service delivery strategy has been designed in collaboration with urban parents to strengthen specific aspects of parenting skills and family relationship processes (child management skills, family communication, within family support and parent/child interaction). Sessions also have been designed to target factors (e.g. parental stress, use of emotional and parenting support, family involvement with the child in context and stigma associated with mental health care) which potentially affect inner-city service use and outcomes. The study will include 372 youth and their families (including adult caregivers and siblings between the age of 6 and 18 years) nested within 10 child outpatient clinics. Youth and their families will be randomly assigned to one of 2 conditions: 1) MFG or; 2) standard of care (traditionally offered outpatient services). A 5-wave experimental research design with assessments at baseline, 8 weeks (midway through MFG), posttest (16 weeks), 6, and 18 month follow-up will be used to test the following hypotheses: 1) youth in a MFG will evidence significantly reduced externalizing behavioral difficulties and increased functional capacities relative to youth receiving standard services over time; 2) youth and their family members involved in a MFG will display significantly higher levels of attendance and will report significantly enhanced relationships with providers and motivation to address mental health goals in comparison to those receiving standard outpatient care longitudinally; 3) involvement in a MFG will be associated with significant improvements in parenting skills, family communication, within family support and parent/child interaction relative to participation in standard outpatient care over time and; 4) participation in a MFG will be associated with significant decreases in parenting stress and stigma associated with service use and increases in use of parenting/emotional support resources, parental involvement at school, supervision of youth and with enhanced youth and family-level outcomes relative to participation in standard services. The proposed study responds to calls for effectiveness studies that examine "engaging" service delivery models set within urban child mental health centers that struggle with serious services capacity issues.

描述（由申请人提供）：拟议的研究的主要目标是检查多个家庭组（MFG）服务使用策略，涉及城市，低收入有色人种的服务和结果。这项研究将涉及在16周的小组会议上，每组中有6至8个家庭，将涉及奇数或CD及其家人的诊断标准及其家人的诊断标准。 MFG服务提供策略是与城市父母合作设计的，以增强育儿技能和家庭关系过程的特定方面（儿童管理技能，家庭沟通，家庭支持和父母/子女互动）。会议也被设计为目标因素（例如父母的压力，情感和育儿支持，在上下文中与儿童的家庭参与以及与心理保健相关的污名），这可能会影响城市内部服务的使用和结果。这项研究将包括372名青年及其家人（包括成人照顾者和6岁至18岁之间的兄弟姐妹），嵌套在10个儿童门诊诊所中。青年及其家人将被随机分配到两个条件之一：1）MFG或； 2）护理标准（传统上提供门诊服务）。在基线时进行评估，8周（MFG的中途），后测（16周），6周和18个月的随访将用于测试以下假设：1）MFG中的青年将大大降低行为上的外在化和增加与青少年接收标准服务的功能性的功能，将对青少年大大降低，这将对基线，第16周和第18个月的随访进行了5波实验研究设计。 2）青年及其家庭成员参与MFG的出勤水平将显着提高，并将报告与提供者的关系大大增强，并与纵向接受标准门诊护理的人相比，以解决心理健康目标的动力； 3）参与MFG将与育儿技能，家庭沟通，家庭支持和父母/子女互动相对于参与标准的门诊护理的显着提高与； 4）参与MFG将与育儿压力和服务使用相关的育儿压力和污名显着减少，并增加了育儿/情感支持资源的使用，父母参与学校的监督，青年的监督以及与参与标准服务相比的青年和家庭水平增强的结果。拟议的研究回应了对有效性研究的呼吁，该研究研究了在城市儿童精神卫生中心内设定的“吸引”服务交付模型，这些模型与严重的服务能力问题斗争。