Theory-driven, human-centered design-based adaptation and pilot test of an intervention to reduce interparental conflict to prevent children's mental health problems after separation/divorce

以理论为驱动、以人为中心的设计为基础的干预措施的适应性和试点测试，以减少父母间冲突，预防分居/离婚后儿童的心理健康问题

• 批准号: 10609051
• 负责人: Karey O'Hara
• 金额: $ 27.48万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10609051
• 关键词: Address; Administrator; Adopted; Adoption; Age; Child; Child Mental Health; Collaborations; Conflict (Psychology); County; Data; Decision Making; Development; Diagnosis; Disease; Divorce; Evidence based intervention; Exposure to; Family; Focus Groups; Foundations; Goals; High Prevalence; Hour; Hybrids; Individual; Intervention; Intervention Trial; Interview; Investigational Therapies; Legal; Link; Longevity; Longitudinal Studies; Mediator; Mental Health; Mental disorders; Methods; National Institute of Mental Health; Outcome; Parents; Partnership Practice; Persons; Population; Process; Public Health; Questionnaires; Randomized; Randomized, Controlled Trials; Recording of previous events; Reporting; Research; Research Personnel; Resources; Risk; Services; Shorthand; Strategic Planning; Structure; Subgroup; Surveys; System; Techniques; Testing; Treatment/Psychosocial Effects; United States National Institutes of Health; court; design; digital; divorce/separation; effectiveness/implementation trial; evidence base; experience; heuristics; high risk sexual behavior; human centered design; implementation framework; implementation outcomes; improved; interest; intervention refinement; peer; pilot test; prevent; programs; prototype; psychosocial; service providers; skills; societal costs; substance use; suicidal; theories; therapy design; therapy development; usability

PROJECT SUMMARY/ABSTRACT: About half of children in the U.S. experience parental divorce prior to age 16. Parental divorce confers risk for various mental health problems and disorders throughout the lifespan that incur significant individual and societal costs. Exposure to high levels of interparental conflict (IPC) accounts for much of this increased risk. The high prevalence of parental divorce, its significant public health burden, and the strong link between IPC and children's mental health problems highlight the importance of interventions that reduce post- separation/divorce IPC. Many family courts mandate high-IPC separated/divorcing parents to attend interventions but none of the currently implemented interventions has been rigorously evaluated. Although two interventions have reduced IPC in divorced families in randomized controlled trials, neither has been adopted as a service by family courts, and thus are not reaching high-IPC parents. The current project represents a foundational step toward reducing the public health burden of parental divorce by developing and testing a scalable intervention to reduce IPC. It will use an established adaptation framework and human-centered design (HCD) methods to develop a relevant, useful, and engaging intervention for high-IPC parents that will be adopted and sustained by family courts. The project will adapt strategies from the two rigorously evaluated interventions that have reduced IPC; follow an established framework for adapting interventions; use HCD, which has been shown to improve effects and scalability of psychosocial interventions; and use state-of-the-art analytic techniques. We will analyze results from a survey of family court judges and administrators to determine the intervention format (i.e., digital, in-person, hybrid). In semi-structured interviews and focus groups, court-based service providers and high-IPC parents will provide qualitative and quantitative data about the intervention content and engagement strategies. These data will be used to develop a prototype of the intervention. Input from an advisory board, which consists of a judge, an administrator, a service provider, and four parents, and data from user testing sessions with parents and service providers will be used to refine the intervention. The randomized pilot will consist of parents mandated by judges to attend the new intervention or the existing court program. Parents will opt in or out of the research component. Qualitative and quantitative methods will be used to collect data on acceptability, feasibility, appropriateness, and usability as well as parents' use of the intervention skills. Before and after participation, parents will complete questionnaires on IPC and child mental health problems. The specific aims are to: 1) Use HCD methods to develop an intervention that fits with the family court and is contextually appropriate for high-IPC separated/divorcing parents and 2) Pilot test the intervention with high-IPC families ordered to attend by the court. This proposal advances NIMH's strategic plan (3.2, 4.2), which encourages investigators to adapt existing interventions to optimize outcomes and leverage effective research-practice partnerships with stakeholders to develop scalable interventions.

项目摘要/摘要： 在美国，大约一半的儿童在16岁之前经历过父母离婚。 一生中出现的各种心理健康问题和障碍，会导致严重的个人和 社会成本。暴露于高水平的父母间冲突(IPC)是导致这种增加的风险的主要原因。 父母离婚率高，其严重的公共卫生负担，以及IPC之间的密切联系 儿童的心理健康问题突出了干预措施的重要性，以减少后 分居/离婚IPC。许多家庭法院强制要求高IPC分居/离婚的父母出席 干预措施，但目前实施的干预措施都没有经过严格评估。虽然有两个 在随机对照试验中，干预措施减少了离婚家庭的IPC，两者都没有被采用 作为家庭法院的一项服务，因此没有接触到高IPC的父母。当前项目表示一个 为减少父母离婚的公共卫生负担迈出的基础性一步 可扩展的干预措施，以减少IPC。它将使用一个既定的适应框架并以人为中心 设计(HCD)方法，为高IPC父母制定相关、有用和参与性的干预措施， 由家庭法院予以采纳和维持。该项目将采用两个经过严格评估的战略 减少了IPC的干预措施；遵循调整干预措施的既定框架；使用HCD， 它已被证明可以改善心理社会干预的效果和可扩展性；并使用最先进的 分析技术。我们将分析对家事法院法官和管理人的调查结果，以 确定干预方式(即数字、面对面、混合式)。在半结构化访谈和焦点小组中， 基于法院的服务提供商和高IPC父母将提供有关 干预内容和参与策略。这些数据将被用来开发干预的原型。 来自顾问委员会的意见，该委员会由一名法官、一名管理员、一名服务提供者和四名家长组成，以及 来自与家长和服务提供商的用户测试会议的数据将用于完善干预措施。这个 随机试点将由法官要求参加新干预或现有法院的父母组成 程序。家长将选择加入或退出研究部分。将采用定性和定量相结合的方法 收集有关可接受性、可行性、适当性和可用性以及家长使用 干预技能。参与前后，家长将填写IPC问卷和儿童心理问卷 健康问题。具体目标是：1)使用HCD方法开发符合 家庭法院，适用于高IPC分居/离婚父母和2)试点测试 对被法院命令出席的高IPC家庭进行干预。这项提议推进了NIMH的战略 计划(3.2，4.2)，该计划鼓励调查人员调整现有干预措施，以优化结果和 利用与利益攸关方的有效研究-实践伙伴关系来制定可扩展的干预措施。