Fostering Healthy Futures Efficacy Trial for Preadolescent Youth in Foster Care

描述（由申请人提供）：有虐待和寄养安置史的青少年面临着许多心理健康，行为和社会问题的风险，导致具有重大公共卫生意义的不良生活过程结果。此R 01应用程序寻求支持的培育健康未来计划（FHF），旨在促进亲社会发展的预防性干预措施的5年疗效试验，并减少寄养青少年的问题行为。家庭保健基金是一种创新的、对文化敏感的、多组成部分的干预措施，针对的是受到虐待和寄养的9-11岁儿童。通过为期9个月的干预，包括筛选评估，一对一指导和技能小组，FHF针对认知，社会和行为领域，以建立能力，改善心理健康功能和生活质量，减少问题行为和不良生活结果（例如逮捕，辍学，限制性安置）。将在基线（随机化前）、干预后和1年随访时对青少年、护理人员和教师进行评估。数据还将包括儿童福利、教育和少年司法记录。在一个县进行的FHF随机对照试点试验为指导和技能组组件制作了程序手册，并提供了程序可行性的证据，具有较高的招募率和保留率。FHF试点研究已经证明了对假定的中介者的积极初步影响，包括青少年的社会功能，态度，应对技能，行为调节和课外参与（cfe从.23-72）。它还表现出对远端结果的积极影响，包括问题行为，能力，限制性安置的数量和生活满意度（cfe从0.2S-0.75）。最后，试点研究已经产生了初步的效应量，使我们能够指定一个全面的疗效试验所需的样本量。FHF项目的多县随机对照试验（256名青年）将使我们能够：1）检查干预对近端和远端结局的影响，2）检查干预的潜在调节因素，3）进行中介分析，以确定该项目可能增强结局的机制，以及4）进行组内分析。其目标是设计更有效的干预措施，从而减少残疾、发病率和死亡率，不仅针对寄养青年，而且针对所有高危青年。

DESCRIPTION (provided by applicant): Youth with a history of maltreatment and foster care placement are at risk for a host of mental health, behavioral, and social problems, resulting in adverse life-course outcomes of great public health significance. This R01 application seeks support for a 5-year efficacy trial of the Fostering Healthy Futures Program (FHF), a preventive intervention designed to promote prosocial development, and to reduce problem behaviors for youth in foster care. FHF is an innovative, culturally-sensitive and multi-component intervention for 9-11-year-old children who have been maltreated and placed in foster care. Through a 9- month intervention that includes screening assessments, one-on-one mentoring, and skills groups, FHF targets cognitive, social and behavioral domains in order to build competencies, improve mental health functioning and quality of life, and reduce problem behaviors and adverse life outcomes (e.g. arrests, school dropout, restrictive placements). Assessments with youth, caregivers and teachers will be conducted at baseline (pre-randomization), post-intervention, and 1-year follow-up. Data will also include child welfare, educational, and juvenile justice records. A randomized controlled pilot trial of FHF in one county has produced program manuals for the mentoring and skills group components, and evidence of program feasibility, with high recruitment and retention rates. The FHF pilot study has demonstrated positive preliminary effects on putative mediators, including youths' social functioning, attitudes, coping skills, behavioral regulation, and extracurricular involvement (cfe from .23-72). It has also demonstrated positive effects on distal outcomes, including problem behaviors, competencies, number of restrictive placements, and life satisfaction (cfe from .2S-.75). Finally, the pilot study has generated preliminary effect sizes that have enabled us to specify the sample size necessary for a full-scale efficacy trial. A multi-county randomized controlled trial of the FHF program with 256 youth will enable us to: 1) examine intervention effects on both proximal and distal outcomes, 2) examine potential moderators of the intervention, 3) conduct mediational analyses to identify the mechanisms by which the program may enhance outcomes, and 4) conduct within-group analyses. The goal is to design more efficacious interventions, thereby reducing disability, morbidity, and mortality, not only for youth in foster care, but for all high-risk youth.