An Evaluation of an Integrated Approach to Prevention and Early Intervention

对预防和早期干预综合方法的评估

• 批准号: 9906869
• 负责人: NICHOLAS S IALONGO
• 金额: $ 74.29万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9906869
• 关键词: Adolescence; Behavior; Characteristics; Child; Coercion; Drug abuse; Early Intervention; Evaluation; Frequencies; Generations; Goals; Instruction; Intervention; Intervention Studies; Mediating; Modeling; Occupational; Outcome; Parents; Perception; Play; Prevention approach; Preventive Intervention; Preventive treatment; Problem Solving; Randomized; Randomized Controlled Trials; Schools; Self Efficacy; Self Management; Social Problems; Students; Testing; Thinking; Time; Universities; antisocial behavior; base; burnout; cohort; design; elementary school; emotion regulation; evidence base; falls; follow-up; improved; public health relevance; recruit; skills; social learning; teacher; universal prevention; young adult

 DESCRIPTION (provided by applicant): Aggressive/disruptive behavior in the elementary school years is a strong indicator of antisocial behavior, drug abuse and low educational and occupational attainment in adolescence and young adulthood. The Good Behavior Game (GBG) and Promoting Alternative Thinking Strategies (PATHS) represent two of a handful of universal, elementary school, preventive interventions which have been shown in large scale, randomized controlled trials to have an immediate and beneficial impact on aggressive/disruptive behavior. PATHS seeks to accomplish reductions in such behavior via teacher led instruction aimed at facilitating emotion regulation and social problem-solving, whereas the GBG provides teachers with an efficient means of reducing aggressive/disruptive behavior using social learning principles within a game-like context. Importantly, however, the effects of the GBG on aggressive/disruptive behavior proved modest in our 1st and 2nd generation Johns Hopkins University Preventive Intervention Research Center (JHU PIRC) field trials. This has been the case for PATHS as well. We recently completed a 27-school, randomized controlled trial examining whether the combination of these interventions, which we refer to as PATHS to PAX, would yield significantly greater impact on aggressive/disruptive behavior than the GBG alone. Our rationale for expecting greater impact was that the use of the GBG should result in reductions in aggressive/disruptive behavior, which should then facilitate the acquisition of the emotion regulation and social problem-solving skills taught in PATHS. PATHS to PAX did result in a modestly greater reduction in aggressive/disruptive behavior than the GBG alone at 1-year post-test. Yet, the most aggressive/disruptive students still failed to sufficiently benefit from te PATHS to PAX intervention. Accordingly, in this application, we propose to examine whether the addition of the Incredible Years (IY), an evidence-based preventive and treatment intervention aimed at reducing aggressive/disruptive behavior, would yield greater impact on these behaviors than the PATHS to PAX intervention alone. We also propose to examine whether the combination of the PATHS to PAX + IY results in increased frequency of implementation of the PATHS to PAX intervention. We hypothesize that relative to teachers in the PATHS to PAX alone condition, teachers in the PATHS to PAX+IY condition will perceive PATHS to PAX as more efficacious and will therefore be more likely to implement it. Four cohorts of 12 schools each will be recruited with schools randomly assigned to 1 of 3 intervention conditions: 1) Control; 2) PATHS to PAX Alone; or 3) PATHS to PAX+IY. Assessments of student outcomes will be carried out at pre-test and post-test in the fall and spring of the initial school year foreach cohort and at a 6-month and one year follow-up.

 描述（由申请人提供）：小学阶段的攻击性/破坏性行为是青少年和青年时期反社会行为、药物滥用和教育和职业成就低的一个强有力的指标。良好行为游戏（GBG）和促进替代性思维策略（PATHS）是少数几种普遍的小学预防性干预措施中的两种，这些干预措施已在大规模随机对照试验中显示对攻击性/破坏性行为有直接和有益的影响。PATHS旨在通过教师主导的教学来减少这种行为，旨在促进情绪调节和社会问题解决，而GBG为教师提供了一种有效的手段，在类似游戏的环境中使用社会学习原则来减少攻击性/破坏性行为。然而，重要的是，在我们的第一代和第二代约翰霍普金斯大学预防干预研究中心（JHU PIRC）现场试验中，GBG对攻击性/破坏性行为的影响被证明是适度的。Paths也是如此。我们最近完成了一项27所学校的随机对照试验，研究这些干预措施的组合（我们称之为PATHS to PAX）是否会比单独使用GBG对攻击/破坏行为产生更大的影响。我们期待更大影响的理由是，GBG的使用应该会导致攻击性/破坏性行为的减少，这应该有助于获得PATHS中教授的情绪调节和解决社会问题的技能。在测试后1年，PATHS至PAX确实导致攻击/破坏性行为比单独GBG略微更大的减少。然而，最具攻击性/破坏性的学生仍然未能充分受益于te PATHS到PAX干预。因此，在本申请中，我们建议研究增加难以置信的岁月（IY），一种以证据为基础的预防和治疗干预措施，旨在减少攻击性/破坏性行为，是否会对这些行为产生比PATHS更大的影响单独PAX干预。我们还建议研究将《新途径》与PAX + IY相结合是否会增加《新途径》与PAX干预措施的实施频率。我们假设，相对于教师在PATHS到PAX单独的条件下，教师在PATHS到PAX+IY条件下会认为PATHS到PAX更有效，因此更有可能实施它。四个队列的12所学校将被招募与学校随机分配到3个干预条件之一：1）控制; 2）PATHS到PAX单独;或3）PATHS到PAX+IY。学生成绩的评估将在每个队列的第一学年秋季和春季的前测和后测以及6个月和1年的随访中进行。