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、小组提供、循证的、人性化的干预措施，针对转诊到公共资助诊所的最常见原因：青少年对立违抗和品行障碍。MFGs针对一直与儿童行为障碍的发生和维持有关的家庭因素，并整合现有循证做法(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，目的是解决与EBP推广相关的严重挑战：家庭参与率低；提供商接受情况不佳；诊所和提供商在保持保真度方面存在障碍；以及减弱对儿童结局的影响。这项拟议的研究是对RFA 15-320《测试治疗、预防和服务干预的有效性的临床试验》的回应，将采用第二类有效性-实施混合方法的混合研究设计。与纽约精神卫生办公室(OMH)合作，这项纵向研究将在纽约市OMH许可的儿童行为健康诊所系统(n=134)中进行。我们将使用混合方法，涉及268名青年提供者和2688名成年照顾者(7至11岁)。这项研究的具体目标如下：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调节因素(如父母养育、家庭过程)；3)诊所(准备采用创新、领导力支持和环境)和提供者层面的MFG实施和整合调节变量(准备、动机和忠诚度)；4)CITs对MFG实施和整合的诊所和提供者层面调节因子的影响。在这项随机对照研究中，诊所将按行政区(曼哈顿、皇后区、布朗克斯、布鲁克林、斯塔顿岛)分层，并在行政区内随机分配到3种研究条件：1)MFG+CITS；2)MFG(提供标准研究培训和咨询)或3)标准护理。分别于基线、8周、16周和6个月收集数据。在第一阶段(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。McKay和Hoagwood是纽约临床技术援助中心、NIMH资助的州系统儿童循证实践实施高级中心(IDEAS；P30 MH09032)和城市儿童精神卫生服务合作研究中心(CCCR；P20 MH085983)的联席主任。来自IDEAS/CCCR中心顾问的先进方法专业知识(Jaccard，Palinkas)和政策(Hogan，Bradbury，Goldman)咨询将研究定位为最大限度地影响公共健康。这个团队做好了独一无二的准备，在州公共精神卫生系统内的现有研究和服务基础设施上进行这项研究。由于国家重点中心和与NYSOMH的合作伙伴关系，这项研究的结果立即可付诸实施。