Personalizing Parent Training Interventions for Culturally Diverse Families

 描述（由申请人提供）：行为父母培训（BPT）干预措施已被证明对有外化行为问题的幼儿有效。然而，并非所有家庭都受益，少数民族家庭尤其不太可能入学，参与， 改善BPT。拟议的研究的总体目标是开发和试点测试的个性化工具，在，可用于增加适合不同文化的家庭在亲子互动疗法（PCIT），基于证据的BPT干预幼儿。个性化有可能对公共卫生产生重大影响，因为这种方法对个别家庭特有的特征做出了反应，因此可以在包括非西班牙裔白人在内的一系列种族群体中使用。我们建议通过个性化父母解释模型（PEM）参数来最大限度地提高治疗的影响，这些参数在不同种族群体中存在差异，并已被经验证明会影响治疗参与和/或结果。在研究的第一阶段，我们将建立在我们以前的经验，文化适应BPT和调查治疗师-客户解释模型匹配，以开发BPT。首先，我们将编制一套可靠的，简短的，易于使用的评估工具，临床医生可以用来确定父母的立场上的每一个确定的PEM个性化参数。其次，我们将确定一组初始的干预适应，以应对这些个性化参数中的每一个的极端分数。第三，我们将征求一个专家小组的反馈意见，为三个少数民族群体（拉丁裔，亚裔和非裔美国人）的BPT文化适应，并根据他们的输入修改BPT。第四，我们将与具有PCIT专业知识的临床医生进行关键的知情人访谈，以评估他们对每种适应措施的可能有效性、吸引力和可行性的看法，我们将根据这些反馈来完善“适应”。最后，PCIT的创建者Sheila Eyberg博士将提供最终的保真度检查，以确保Patient In适应性与干预的基本理论模型一致，Patient In将被编程用于平板电脑。在第二阶段，我们将进行一个试点测试的预激治疗+ PCIT的样本（N=28）的家庭与来自广泛的种族背景，以确定是否预激治疗可以实现保真度，可以显著增加PEM治疗匹配，以及PEM治疗匹配与参与和结果PCIT。将对来自先前试验的BELLING + PCIT和标准PCIT的治疗元素进行比较，以确定两种治疗条件是否可以可靠地彼此区分。初步试验的结果将用作更大规模R 01应用的基础，以比较PCIT + TBI与标准版本的PCIT和多元文化人群中的常规治疗。

 DESCRIPTION (provided by applicant): Behavioral Parent Training (BPT) Interventions have proven efficacy for young children with externalizing behavior problems. However, not all families benefit, and ethnic minority families in particular are less likely to enroll, engage, and improve in BPT. The overarching goal of the proposed study is to develop and pilot test a personalization instrument, PersIn, that can be used to increase fit for culturally diverse familie in Parent Child Interaction Therapy (PCIT), an evidence based BPT intervention for young children. Personalization has the potential for significant public health impact because the approach is responsive to characteristics specific to individual families, and therefore can be used across a range of ethnic groups, including non-Hispanic Whites. We propose to maximize the impact of PersIn by personalizing on Parent Explanatory Model (PEM) parameters that have been found to vary across ethnic groups and which have been empirically demonstrated to impact treatment engagement and/or outcomes. In the first phase of the study, we will build on our previous experience culturally adapting BPTs and investigating therapist-client explanatory model match to develop PersIn. First, we will compile a proposed set of reliable, brief, and easy to use assessment instruments that clinicians could use to determine the parents' standing on each of the identified PEM personalization parameters. Second, we will identify an initial set of intervention adaptations that respond to extreme scores on each of these personalization parameters. Third, we will solicit feedback from a panel of experts in the cultural adaptation of BPT for each of three ethnic minority groups (Latino-, Asian-, and African-American) and modify PersIn according to their input. Fourth, we will conduct key informant interviews with clinicians with expertise with PCIT with diverse families to assess their perception of the likely effectiveness, appeal, and feasibility of each of the adaptations, and we will refine PersIn based on this feedback. Finally, Dr. Sheila Eyberg, creator of PCIT, will provide a final fidelity check o ensure that PersIn adaptations are consistent with the underlying theoretical model of the intervention and PersIn will be programmed for use on a tablet computer. In the second phase, we will conduct a pilot test of PersIn + PCIT with a sample of (N=28) families with a preschooler with externalizing programs from a wide range of ethnic backgrounds to determine if PersIn can be implemented with fidelity, can measurably increase PEM-treatment match, and that PEM-treatment match is related to engagement and outcomes in PCIT. A comparison between treatment elements of PersIn + PCIT and standard PCIT from a previous trial will be conducted to determine whether the two treatment conditions can be reliably differentiated from one another. Results from the pilot trial will be used as the basis of a larger R01 application to compare PCIT + PersIn to the standard version of PCIT and treatment as usual among a multicultural population.