Preventing substance use through hybrid web and in vivo delivery of Coping Power

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DESCRIPTION (provided by applicant): This proposal will develop and test the feasibility of a hybrid internet-enhanced version of the Coping Power program for aggressive 5th grade children who are at risk for substance use. Coping Power is a preventive intervention with demonstrated efficacy and effectiveness for preadolescent children at-risk for substance abuse and delinquency. Despite its demonstrated preventive effects, the length of time required to implement Coping Power and similar evidence-based prevention programs has been identified as a barrier to providers' adoption of such programs and parents' attendance and engagement. To address this barrier, this application will develop a hybrid version of Coping Power which will permit it to be delivered more efficiently, with substantially fewer face-to-face sessions, while retaining all of the core content (Coping Power-Internet Enhanced; CP-IE). This innovative, targeted prevention approach will include 12 child sessions held every other week over a 6 month period, 7 parent sessions, and internet-delivered media components, which participants will access between in-person sessions. The use of internet-delivered media to augment the intervention is expected to further enhance children's and parents' interest in and retention of intervention- related content. This is consistent with empirical evidence that individuals pay more attention to and learn more deeply from multimedia presentations than from verbal-only messages, resulting in greater problem-solving transfer, as described in Kennedy's cognitive interaction model of multimedia interactivity research. This proposal will allow CP-IE to be developed and pilot-tested. Then, 96 at-risk, aggressive 5th grade students from 8 schools will be randomly assigned to participate in CP-IE or Care-as-Usual, using a matched pairs sampling design. CP-IE participants will access internet-delivered intervention content between in-person sessions, including animated videos that were developed to model key Coping Power topics. The primary aims of this proposal are to: 1) Develop an efficient, internet-augmented hybrid version of the Coping Power program for children who are at-risk for substance abuse and their parents; 2) Assess the feasibility of the CP-IE program in retaining participants, and in determining if children and families view a high rate of the CP-IE internet- delivered content; 3) Assess the acceptability of the CP-IE program, as indicated by child, parent and school counselor ratings, and ability to deliver CP-IE with high intervention integrity and implementation quality; 4) Assess if CP-IE promotes a high level of participant motivation in the program, comprehension and retention of intervention content, and change in children's social cognition, self-regulation, and social competence abilities and in parents' parenting practices; and 5) Use the planned feasibility study as a basis for a large-scale randomized trial of CP-IE. Preliminary outcome effects of CP-IE within the feasibility study will also be explored. If its feasibility and subsequent efficacy are documented, the hybrid CP-IE program can be disseminated much more widely, and thus have broad public health significance in substance use prevention. PUBLIC HEALTH RELEVANCE: The Coping Power program is a multi-component preventive intervention with demonstrated efficacy (Lochman & Wells, 2002a) and effectiveness (Lochman & Wells, 2002b; Lochman & Wells, 2004) for preventing substance abuse and delinquency in at-risk preadolescent children. This application will develop a hybrid version of the Coping Power intervention, which will allow for delivery of all of the core content from the full-length Coping Power program (which typically has 34 child sessions and 16 parent sessions) by providing a reduced number of in-person sessions (12 child, 7 parent sessions) that are enhanced by internet-delivered content (including video modeling, individualized feedback, and messaging features; CP-IE) between each in- person session. If its feasibility and subsequent efficacy is documented, the hybrid CP-IE program can be much more widely disseminated, and thus have broad public health significance in targeted prevention of substance use outcomes in children.