Family Groups for Urban Youth with Disruptive Behavior

有破坏性行为的城市青少年家庭团体

• 批准号: 8874649
• 负责人: Mary McKernan McKay
• 金额: $ 78.79万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8874649
• 关键词: Address; Adopted; Adult; Attenuated; Behavior; Behavior Disorders; Behavioral; Caregivers; Caring; Child; Child Behavior; Child Mental Health; Child Rearing; Childhood; Climate; Clinic; Clinical Trials; Collaborations; Communities; Consultations; Data; Disease; Disruptive Behavior Disorder; Effectiveness; Evidence based practice; Family; Family Process; Funding; Future; Health Services Research; Health system; Hybrids; Impairment; Intervention; Island; Knowledge; Leadership; Licensing; Life; Longitudinal Studies; Low income; Maintenance; Mediator of activation protein; Mental Health; Methods; Modeling; Motivation; National Institute of Mental Health; Outcome; Parents; Phase; Policies; Policy Maker; Policy Research; Positioning Attribute; Poverty; Process; Provider; Public Health; Public Policy; Randomized; Readiness; Relative (related person); Research; Research Design; Research Infrastructure; Research Training; Resources; Services; Site; System; Testing; Treatment Effectiveness; Youth; base; behavioral health; child mental health service; conduct problem; evidence base; follow-up; innovation; public health relevance; ranpirnase; response; service intervention; social; standard care; theories; therapy design; uptake

 DESCRIPTION (provided by applicant): A multiple family group (MFG) is a family-centered, group delivered, evidence-informed, manualized intervention that targets the most common reason for referral to publicly funded clinics: youth oppositional defiant and conduct disorders. MFGs target family factors which have been consistently implicated in the onset and maintenance of childhood behavioral disorders and integrate components of existing evidence-based practices (EBPs). The MFG service delivery model was developed in collaboration with urban parents and service providers to address the serious challenges associated with EBP roll-outs: low rates of family involvement; poor uptake by providers; clinic and provider impediments to maintaining fidelity; and attenuated child outcome effects. The proposed study, in response to RFA 15-320, Clinical Trials to Test the Effectiveness of Treatment, Preventative, and Services Interventions, will employ a mixed methods Type II effectiveness-implementation hybrid research design. In collaboration with the NYS Office of Mental Health (OMH), this longitudinal study will be conducted across the NYC OMH licensed child behavioral health clinic system (n=134). We will use mixed methods, and involve 268 providers and 2,688 adult caregivers of youth (7 to 11 years). The following Specific Aims guide this study: To examine 1) short-term and longitudinal impact of MFGs on urban youth with ODD and CD (replication); 2) family-level mediators (e.g. parenting, family process) of child outcomes; 3) clinic (readiness to adopt an innovation, leadership support and climate) and provider level moderators (preparedness, motivation and fidelity) of MFG implementation and integration and; 4) the impact of CITs on clinic and provider level moderators of MFG implementation and integration. In this RCT, clinics will be stratified by borough (Manhattan, Queens, Bronx, Brooklyn, Staten Island) and randomly assigned within borough to 3 study conditions: 1) MFG+CITs; 2) MFG (with standard research training and consultation) or; 3) Standard Care. Data will be collected baseline, 8 and 16 weeks and 6 mo. follow-up) in Phase 1 (focus on implementation) and Phase II (integration). Our team includes the highest level of NYSOMH research and policy leadership. McKay and Hoagwood are the co-Directors of the NYS Clinic Technical Assistance Center, the NIMH-funded Advanced Center on Implementation of Evidence-based Practice for Children in State Systems (IDEAS; P30 MH09032) and the Center for Collaborative Urban Child Mental Health Services Research (CCCR; P20 MH085983). Advanced methodological expertise (Jaccard, Palinkas) and policy (Hogan, Bradbury, Goldman) consultation from IDEAS/CCCR Center advisors position the study for maximum public health impact. This team is uniquely prepared to build on an existing research and service infrastructure within a state public mental health system to conduct this study. Because of the nationally- focused centers and the partnerships with NYSOMH, the findings from this study are immediately actionable.

 描述（由申请人提供）：多家庭小组 (MFG) 是一种以家庭为中心、以小组为中心、以证据为依据的手动干预措施，针对转诊至公共资助诊所的最常见原因：青少年逆反行为和品行障碍。 MFG 针对一直与儿童行为障碍的发生和维持有关的家庭因素，并整合了现有循证实践 (EBP) 的组成部分。 MFG 服务提供模式是与城市家长和服务提供商合作开发的，旨在解决与 EBP 推出相关的严峻挑战：家庭参与率低；提供商的接受度低；诊所和提供者维持忠诚度的障碍；和减弱的儿童结局影响。拟议的研究响应 RFA 15-320“测试治疗、预防和服务干预有效性的临床试验”，将采用混合方法 II 型有效性实施混合研究设计。这项纵向研究将与纽约州心理健康办公室 (OMH) 合作，在纽约市 OMH 许可的儿童行为健康诊所系统 (n=134) 中进行。我们将采用混合方法，涉及 268 名提供者和 2,688 名青少年（7 至 11 岁）的成年护理人员。以下具体目标指导本研究： 检验 1) MFG 对患有 ODD 和 CD 的城市青年的短期和纵向影响（复制）； 2）家庭层面的儿童结果中介因素（例如养育子女、家庭过程）； 3) MFG 实施和整合的诊所（采用创新的准备程度、领导力支持和氛围）和提供商级别的调节者（准备程度、动机和忠诚度）； 4) CIT 对 MFG 实施和整合的诊所和提供者层面调节因素的影响。在此 RCT 中，诊所将按行政区（曼哈顿、皇后区、布朗克斯、布鲁克林、史泰登岛）进行分层，并在行政区内随机分配至 3 个研究条件：1) MFG+CIT； 2) MFG（提供标准研究培训和咨询）或； 3) 标准护理。将在基线、第 8 周、第 16 周以及第 6 个月收集数据。后续）第一阶段（重点是实施）和第二阶段（整合）。我们的团队包括 NYSOMH 最高水平的研究和政策领导。麦凯和霍格伍德是纽约州诊所技术援助中心、NIMH 资助的国家系统中儿童循证实践实施高级中心 (IDEAS; P30 MH09032) 和城市儿童心理健康服务合作研究中心 (CCCR; P20 MH085983) 的联合主任。 IDEAS/CCCR 中心顾问提供的先进方法学专业知识（Jaccard、Palinkas）和政策（Hogan、Bradbury、Goldman）咨询使该研究能够最大限度地发挥公共卫生影响。该团队专门准备在州公共心理健康系统内现有的研究和服务基础设施的基础上开展这项研究。由于中心以全国为重点以及与 NYSOMH 的合作伙伴关系，本研究的结果可立即付诸实践。