Multi-Court Trial of NBP to Prevent Substance Abuse and Mental Health Disorder

说明(由申请人提供)：拟议的项目要求提供资金，以评估通过新开端方案的家庭法院实施的系统，这是对脱离离婚家庭的青年进行有效的预防性干预。NBP是一个为期10节的育儿小组，已经在两个基于大学的随机实验中进行了评估，并在六年的时间里证明了在减少多重问题结果方面的积极计划效果：减少了大麻、药物和酒精的使用，将被诊断为精神疾病的患病率降低了37%；减少了外在问题，减少了高风险的性行为；以及提高了平均成绩和自尊(Wolchik等人，2008年)。中介分析表明，这些影响大部分是由亲子关系质量的改善、有效的管教或两者兼而有之。对于许多结果，计划的好处对那些当他们进入计划时风险最高的年轻人来说是最大的。在过去的三年里，主要调查人员与家庭法院的人员和服务营销研究人员合作，开发并试验了通过家庭法院交付NBP的系统的测试组件。这项拟议的研究测试了在亚利桑那州五个法院实施的NBP的有效性。这项申请有四个具体目标：1.检查随机分配到NBP的家庭是否比那些分配到关于积极育儿措施、青少年药物使用和心理健康问题的简短研讨会的家庭有更大的改善。评估将在测试前、测试后和6个月后进行；分析将测试项目对6个月后青少年结果的影响是否通过测试后项目对父母养育的影响而起到中介作用。2.测试NBP的影响是否受到项目开始时的儿童风险水平、父母的性别、父母的种族(即墨西哥裔美国人与非西班牙裔高加索人)或儿童年龄的缓解。3.审查实施的可变性是否解释了正面育儿和青年结果的可变性。分析还将测试执行层面和结果之间的关系是否因父母的性别和族裔而不同。4.实验测试，与参加NBP的父母的标准信息联系相比，简短的电话预约面谈是否增加了入门机会(即至少参加一次会议)(即表示愿意参加)。参与访谈的效果将在整个样本中进行测试，并分别针对父亲和母亲、墨西哥裔美国人和非西语裔白人进行测试。这一项目为以后的研究奠定了科学基础，这些研究涉及在大量法院传播《国家保护公约》的问题。这项拟议的研究对预防药物使用和心理健康问题具有重要的公共卫生意义，这些问题在每年150万父母离婚的美国儿童中造成了巨大的个人和社会成本。

DESCRIPTION (provided by applicant): The proposed project requests funding to evaluate a system for implementation through the family courts of the New Beginnings Program, an efficacious preventive intervention for youth from divorcing families. The NBP is a 10- session, parenting group that has been evaluated in two university-based randomized experimental trials and has demonstrated positive program effects to reduce multiple problem outcomes at six-years: reduced marijuana, drug and alcohol use, 37% reduction in prevalence of diagnosed mental disorder; reduced externalizing problems, and reduced high risk sexual behavior; and improved grade point average and self-esteem (Wolchik et al., 2008). Mediational analyses indicated that most of these effects were accounted for by improvements in parent-child relationship quality, effective discipline or both. For many outcomes, program benefits were strongest for youth who were at highest risk when they entered the program. Over the past three years, the primary investigators have collaborated with personnel from family courts and service marketing researchers to develop and pilot test components of a system for delivering NBP through the family courts. The proposed research tests the effectiveness of the NBP as delivered in five courts in Arizona. There are four specific aims of this application: 1. Examine whether families randomly assigned to the NBP show greater improvement than those assigned to a brief workshop on measures of positive parenting, youth substance use and mental health problems. Assessments will occur at pre-test, post-test and 6-month follow-up; analyses will test whether program effects on youth outcomes at 6-months are mediated by program-induced effects on parenting at post-test. 2. Test whether the effects of the NBP are moderated by level of child risk at program entry, gender of parent, ethnicity of parent (i.e., Mexican American vs. non-Hispanic Caucasians) or age of child. 3. Examine whether variability in implementation accounts for variability in positive parenting and youth outcomes. Analyses will also test whether relations between dimensions of implementation and outcomes differ across gender of parent and ethnicity. 4. Experimentally test whether a brief telephone engagement interview increases initiation (i.e. attendance at least one session) relative to a standard informational contact for parents who enroll in the NBP (i.e. express intent to attend). The effect of the engagement interview will be tested for the overall sample, and separately for fathers and mothers, and Mexican Americans and non-Hispanic Caucasians. This project lays the scientific foundation for later studies that address the dissemination of the NBP in a large number of courts. The proposed research has important public health implications for preventing substance use and mental health problems that have substantial individual and societal costs in the 1.5 million U.S. children whose parents divorce each year.