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

描述(由申请人提供)：这项建议将开发和测试针对有物质使用风险的攻击性5年级儿童的混合互联网增强版本的应对能力计划的可行性。应对能力是一种预防性干预措施，对有药物滥用和犯罪风险的青春期前儿童证明是有效和有效的。尽管其预防效果得到了证明，但实施应对能力和类似的循证预防计划所需的时间长度已被确定为阻碍提供者采用此类计划以及家长出席和参与的障碍。为了解决这一障碍，这款应用程序将开发一个混合版本的应对能力，使其能够以更少的面对面会话更有效地提供，同时保留所有核心内容(应对能力-互联网增强；CP-IE)。这一创新的、有针对性的预防方法将包括在6个月内每隔一周举行12次儿童会议、7次家长会议以及通过互联网提供的媒体组件，参与者将在面对面的会议之间访问这些组件。利用互联网传播的媒体加强干预，预计将进一步提高儿童和家长对干预相关内容的兴趣和保留。这与肯尼迪的多媒体互动研究的认知互动模型所描述的个人对多媒体展示的关注和学习比单纯从口头信息中学习更深入的经验证据相一致，从而导致更大的问题解决迁移。这项提议将允许开发CP-IE并进行试点测试。然后，来自8所学校的96名具有攻击性的高危5年级学生将被随机分配到CP-IE或照常护理中，采用配对抽样设计。CP-IE参与者将在面对面会议之间访问互联网提供的干预内容，包括为模拟关键应对能力主题而开发的动画视频。这项提议的主要目的是：1)为有药物滥用风险的儿童及其父母开发一个有效的、互联网增强的应对能力方案的混合版本；2)评估CP-IE方案在留住参与者方面的可行性，并确定儿童和家庭是否观看了CP-IE互联网提供的高比率的内容；3)评估CP-IE方案的可接受性，如儿童、家长和学校辅导员评级所表明的那样，以及提供具有高度干预完整性和实施的CP-IE的能力 4)评估CP-IE是否在项目中促进了高水平的参与者动机，对干预内容的理解和保持，以及儿童的社会认知、自我调节和社会能力能力以及父母养育实践的变化；以及5)将计划中的可行性研究作为CP-IE大规模随机试验的基础。还将探讨CP-IE在可行性研究中的初步结果影响。如果它的可行性和 随后的疗效被记录在案，CP-IE混合方案可以更广泛地传播，因此在物质使用预防方面具有广泛的公共卫生意义。 公共卫生相关性：应对能力方案是一种多组成部分的预防性干预措施，证明了预防高危青春期前儿童滥用药物和犯罪的有效性(Lochman&Wells，2002a)和有效性(Lochman&Wells，2002b；Lochman&Wells，2004)。该应用程序将开发应对能力干预的混合版本，通过在每个面对面会议之间提供更少的面对面会话(12个孩子，7个家长会话)，并通过互联网交付的内容(包括视频建模、个性化反馈和消息传递功能；CP-IE)，允许交付来自完整应对能力计划(通常有34个子会话和16个家长会话)的所有核心内容。如果其可行性和随后的有效性被记录在案，CP-IE混合计划可以得到更广泛的传播，从而在有针对性地预防儿童药物使用结果方面具有广泛的公共卫生意义。

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.