Family Mediation Program for At-Risk Youth

描述（由申请人提供）：这项试点随机分组试验的结果将通过提供关于亲子调解改善高危青少年问题行为和相关态度的疗效的初步证据，为科学知识和临床实践提供信息，并阐明发生这种情况的过程。调解是一种解决争端的方法，通过中立的第三方协助冲突各方达成解决办法。目前在全国各地都提供了亲子调解方案，但尚未就其对家庭功能和青少年问题行为（如药物使用）的影响进行严格评估。此外，在评估调解进程的基本组成部分和调查这些组成部分中的每一个如何与积极的家庭和青年成果相关联方面，很少有人关注调解进程本身。本研究旨在对一项针对高危中学生及其家长/监护人的亲子调解计划进行试点评估。八所参与学校的学校辅导员将根据明确的标准确定哪些青少年正在经历重大的行为问题。在四所干预学校确定的青少年将由学校辅导员转介到亲子调解计划。在四所控制学校被确定的青少年将被分配到一个等待名单控制条件。所有参与的青少年和家长将完成三个简短的调查（基线，6周随访，12周随访），以获得亲子调解对家庭功能指标的短期影响的初步证据，以及关键的青少年问题行为和相关态度。参与亲子调解的家庭也将提供关于调解过程的反馈，以研究其与这些结果的联系。我们将利用这次试点评估的数据来解决以下三个目标：1）调查接受亲子调解的家庭是否150名父母/监护人和150名青年人）在12周内的家庭功能比150个家庭的等待名单对照样本有更大的改善（家长/监护人及青少年）不接受亲子调解; 2）调查接受亲子调解的家庭中的青少年是否在物质使用意图和行为、学校相关行为和态度方面有更大的改善，3）通过以下方法更好地理解干预效果：（1）探讨家庭功能的改善是否可以解释参与亲子调解的家庭与对照组相比，青少年问题行为和相关态度的变化;及B）找出参与调解的家庭在亲子调解过程中与家庭功能、青少年问题行为及相关态度的正面成果最相关的范畴。如果该初步评估的结果有希望，我们将提交R 01申请，以进行一项随机试验，该试验的样本量更大，随访时间更长。

DESCRIPTION (provided by applicant): Results from this pilot cluster-randomized trial will inform both scientific knowledge and clinical practice by providing preliminary evidence on the efficacy of parent-child mediation for improving problem behaviors and related attitudes among at-risk youth, as well as elucidating the process through which this occurs. Mediation is a method of dispute resolution in which the parties in conflict are assisted in reaching a settlement through a neutral third party. Parent-child mediation programs are currently offered throughout the country, but have not been rigorously evaluated in terms of their impact on family functioning and youth problem behaviors such as substance use. Further, little attention has focused on the mediation process itself in terms of assessing its fundamental components and investigating how each of these components is related to positive family and youth outcomes. The proposed study involves a pilot evaluation of a parent-child mediation program for at- risk middle and high school students and their parents/guardians. School counselors at eight participating schools will identify youth who are experiencing significant behavioral problems based on well-defined criteria. Identified youth at the four intervention schools will be referred by school counselors to the parent-child mediation program. Identified youth at the four control schools will be assigned to a wait-list control condition. All participating youth and parents will complete three brief surveys (baseline, 6-week follow-up, 12-week follow-up) to obtain preliminary evidence of the short-term impact of parent-child mediation on indicators of family functioning, as well as key youth problem behaviors and related attitudes. Families who participate in parent-child mediation will also provide feedback on the mediation process in order to examine its associations with these outcomes. We will use data from this pilot evaluation to address the following three aims: 1) To investigate whether families who receive parent-child mediation (150 parents/guardians and 150 youth) show greater improvement in family functioning over a 12-week period compared to a wait-list control sample of 150 families (parent/guardian and youth) not receiving parent-child mediation; 2) To investigate whether youth in families who receive parent-child mediation show greater improvement in substance use intentions and behavior, school-related behavior and attitudes, sexual activity intentions and behavior, and delinquency over a 12-week period compared to a wait-list control sample; and 3) to gain a better understanding of intervention effects by: a) exploring whether improvements in family functioning serve as an explanatory mechanism for changes in youth problem behaviors and related attitudes among families who participate in parent-child mediation versus controls; and b) identifying aspects of the parent-child mediation process that are most related to positive outcomes in family functioning and youth problem behaviors and related attitudes among families who participate in mediation. If results from this pilot evaluation are promising, we will submit an R01 application to conduct a randomized trial with a larger sample size and significantly longer follow-up period.