Maximizing the Impact of Preventive Interventions: Identifying Responders and Non-Responders of an Evidence-Based Intervention for Low-Income Families Using a Person-Centered Approach

最大限度地发挥预防性干预措施的影响：使用以人为本的方法识别低收入家庭循证干预措施的反应者和非反应者

• 批准号: 10664705
• 负责人: Daniel Kabat Cooper
• 金额: $ 8.89万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-15 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10664705
• 关键词: Address; Adolescent; Child; Child Rearing; Conflict (Psychology); Couples; Data; Depressed mood; Disadvantaged; Distal; Economics; Education; Educational Intervention; Effectiveness; Effectiveness of Interventions; Elements; Employment; Ensure; Evidence based intervention; Evidence based program; Exposure to; Family; Family Process; Family Relationship; Fathers; Functional disorder; Goals; Health; Health Promotion; Income; Individual; Intervention; Literature; Low income; Marital Relationships; Marriage; Mental Depression; Mental Health; Mental disorders; Methods; Modeling; Mothers; National Institute of Mental Health; Occupations; Outcome; Parents; Participant; Pattern; Personal Satisfaction; Persons; Population; Poverty; Prevention; Prevention program; Process; Program Effectiveness; Public Health; Randomized; Recommendation; Reporting; Research; Risk; Risk Factors; Strategic Planning; Stress; Testing; Time; Victimization; behavioral outcome; coping; cost effectiveness; economic disparity; economic need; experience; fatherhood; follow up assessment; gender difference; improved; interest; intervention effect; lower income families; novel strategies; patient engagement; person centered; physical conditioning; prevent; preventive intervention; programs; promote resilience; racial difference; racial disparity; resilience; responders and non-responders; response; skills; sociodemographics; stress management; stressor; substance use; therapy design

Project Summary/Abstract The literature is inconclusive about who does and does not benefit from preventive interventions. Even less is known about the unique combinations of participant risk factors that impact program effectiveness for low-income families. These are crucial gaps to address, given that economically disadvantaged families vary in the level and pattern of adversities they experience; and, these adversities may influence their response to intervention. One of the few preventive interventions designed specifically to meet the needs of economically disadvantaged families is Fatherhood, Relationship, and Marriage Education (FRAME), which combines the core elements of two evidence-based programs: Premarital Relationship Education Program and Families Coping with Economic Strain. On average, families benefitted from FRAME, but a portion of them did not experience the expected gains. This project will examine whether certain types or combinations of pre-existing risk factors, such as economic strain and parental depression, impacted response to FRAME. This information is critical for identifying program responders and non-responders to inform tailored intervention approaches and maximize the efficacy and cost-effectiveness of prevention programs for underserved families experiencing various types of adversity. Using existing data from the FRAME study with low-income families (N = 301 mother-father-child triads), the long-term goal of this study is to improve the effectiveness of family-based interventions to promote resilience to adversity and address the Healthy People 2030’s initiative to strengthen the health and well-being of all people. As a preliminary analysis, we conducted baseline latent class analysis (LCA) and identified four family risk classes: Job Instability Only (low on all risk factors except job instability; 14%), Economic Stress, Depressed Parents (high on economic stressors and parental depression; 41%), Extreme Family Dysfunction (high on all risk factors; 33%), and Mothers At Risk (high mother victimization; 12%). Therefore, the overall objective of this two-year R03 is to test the effects of these family risk classes on family mental health outcomes and intervention effectiveness (i.e., families’ response to the FRAME intervention). The specific aims are to: (a) model the effects of family risk classes on longitudinal family outcomes, (b) identify the effects of family risk classes on families’ engagement and response to intervention, and (c) examine racial and gender differences in family risk classes and families’ response to intervention. This study will use a novel approach (i.e., latent class analysis and the BCH method) to understand risk processes and test differential intervention effects. These contributions are significant because they can inform efforts to maximize the cost-effectiveness of prevention programs for economically disadvantaged families by ensuring that the most people benefit from the intervention.

项目总结/摘要 关于谁能从预防性干预措施中受益，谁不能受益，文献尚无定论。更不是 了解影响低收入者计划有效性的参与者风险因素的独特组合 家庭这些都是需要解决的关键差距，因为经济上处于不利地位的家庭在水平和 他们经历的逆境模式;这些逆境可能会影响他们对干预的反应。一 为满足经济弱势群体的需要而专门设计的为数不多的预防性干预措施 家庭是父亲，关系和婚姻教育（框架），它结合了核心要素， 两个循证方案：婚前关系教育方案和家庭应对经济危机方案 株平均而言，家庭从框架中受益，但其中一部分家庭没有经历预期的 收益.本项目将审查某些类型或组合的预先存在的风险因素，如 经济压力和父母抑郁，影响对FRAME的反应。这些信息对于识别 规划反应者和无反应者，以告知量身定制的干预方法，并最大限度地提高疗效 以及为经历各种逆境的得不到充分服务的家庭提供预防方案的成本效益。 使用FRAME研究中低收入家庭（N = 301个母亲-父亲-孩子三联体）的现有数据， 这项研究的长期目标是提高以家庭为基础的干预措施的有效性，以促进对 应对逆境，并应对“健康人2030”倡议，以加强所有人的健康和福祉。 作为初步分析，我们进行了基线潜在类别分析（LCA），并确定了四个家庭风险 类别：仅工作不稳定（除工作不稳定外的所有风险因素均较低; 14%），经济压力，抑郁 父母（高经济压力和父母抑郁症; 41%），极端家庭功能障碍（高所有 风险因素; 33%），和母亲的风险（高母亲受害; 12%）。因此，这一总体目标 为期两年的R 03是为了测试这些家庭风险类别对家庭心理健康结果和干预的影响 有效性（即，家庭对框架干预的反应）。具体目标是：（a）建立影响模型 （B）确定家庭风险等级对家庭纵向结果的影响， （c）审查家庭风险类别中的种族和性别差异 和家庭对干预的反应。本研究将使用一种新方法（即，潜在阶级分析和 BCH方法），以了解风险过程和测试差异干预效果。这些捐款 重要的是，它们可以为最大限度地提高预防方案的成本效益提供信息， 通过确保大多数人受益于干预措施，帮助经济上处于不利地位的家庭。