Preventing Conduct Disorder Among Children in the Child Welfare System

描述（由申请人提供）：儿童福利系统中的儿童面临严重破坏性行为问题的高风险，包括行为障碍。因此，预防或减少早期行为问题对于改善儿童福利系统中弱势儿童群体的长期结果至关重要。我们的项目的目的是：（a）确定在儿童福利系统中，对于非裔美国人和欧洲裔美国人儿童，路径Triple P是否比常规治疗（TAU）产生更好的行为和安全性结局;（B）评估路径Triple P与TAU相比的成本效益。具体而言，本研究的目的是：（1）在圣路易斯大都会儿童福利系统（其儿童在研究进入时由他们照顾）的140名父母中进行纵向随机对照试验，以测试与TAU相比，Pathways Triple P在改善5至10岁儿童破坏性行为方面的有效性。(2)测试路径三P在防止虐待累犯的有效性;（3）衡量和评估与路径三P和TAU相关的成本和效益。将采用混合方法设计来检验假设，并回答与每个目标相关的研究问题。研究设计是纵向的，有两种治疗条件和四个数据收集点：试验前、试验后、随访1（F1，试验后6个月）和随访2（F2，F1后12个月）。将使用多种评估方法：（1）向家长管理的计算机化标准化工具，（2）与家长的半结构化访谈，（3）向教师管理的纸质标准化工具，以及（4）将研究数据与多部门国家管理数据集联系起来。这项研究的结果将确定路径三重P是否会导致最佳的儿童行为结果，并防止弱势儿童福利人群中的虐待累犯，将确定路径三重P对谁以及在什么条件下对目标人群的父母最有益，并将有助于将稀缺的联邦资金用于儿童福利系统中的儿童。 公共卫生相关性：儿童福利系统为大量受虐待儿童提供服务，这些儿童患有或有可能发展出严重的破坏性行为问题，这些问题可能带来终身后果，并使社会面临暴力犯罪的风险。有效的父母调解干预措施可用于预防和治疗这些问题，但迄今为止，只有零星的儿童福利机构内实施和测试。这项研究的结果将为儿童福利机构提供心理健康干预措施的最佳实践和政策提供信息。

DESCRIPTION (provided by applicant): Children in the child welfare system are at high risk for serious disruptive behavior problems, including conduct disorder. Therefore, the prevention or reduction of early behavior problems is critical to improving long term outcomes for the vulnerable population of children in the child welfare system. The purpose of our project is to: (a) determine if Pathways Triple P results in better behavioral and safety outcomes than treatment as usual (TAU) for African American and European American children in the child welfare system and (b) evaluate how the cost-effectiveness of Pathways Triple P compares to TAU. Specifically, the aims of this study are to: (1) conduct a longitudinal, randomized control trial with 140 parents in the metro-St. Louis child welfare system (whose children are in their care at the time of study entry) to test the effectiveness of Pathways Triple P at improving child disruptive behavior among children between the ages of 5 and 10 compared to TAU. (2) Test the effectiveness of Pathways Triple P at preventing maltreatment recidivism; and (3) Measure and evaluate the costs and benefits associated with Pathways Triple P and TAU. A mixed method design will be used to test the hypotheses and answer the research questions associated with each aim. The study design is longitudinal with two treatment conditions and four data collection points: pre-test, post-test, follow-up 1 (F1, 6 months after post-test) and follow-up 2 (F2, 12 months after F1). Multiple assessment methods will be used: (1) computerized standardized instruments administered to parents, (2) semi-structured interviews with parents, (3) paper-based standardized instrument administered to teachers and (4) linking study data with a multi-sector state administrative dataset. Findings from this study will determine if Pathways Triple P results in optimal child behavior outcomes and prevents maltreatment recidivism among the vulnerable child welfare population, will identify for whom and under what conditions Pathways Triple P is most beneficial to parents to the target population, and will help target scarce federal dollars to serve children in the child welfare system. PUBLIC HEALTH RELEVANCE: The child welfare system serves large numbers of maltreated children with or who are at risk of developing serious disruptive behavior problems that can carry lifelong consequences, and put society at risk of violent crime. Efficacious parent-mediated interventions are available for preventing and treating these problems; however, to date, have only been implemented and tested sporadically within child welfare settings. Findings from this study will inform best practice and policy related to providing mental health interventions within child welfare settings.