Effects of NBP for Children of Divorce 15 Years Later

描述(由申请人提供)：拟议的项目是对240名年轻人的15年跟踪调查，他们的家庭参与了新开始计划(NBP)的试验性评估，NBP是一项针对离婚家庭的预防性干预措施。NBP是在儿童后期提供的；后续将在成年后进行。家庭被随机分配到三种条件中的一种：母亲计划(MP)、母子双重计划(MPCP)或文学控制(LC)条件。项目旨在利用经验支持的改变策略来改变孩子离婚后心理健康问题的几个可能的中介因素。该节目的实施非常逼真，并使用了多方法、多记者评估。意向处理分析显示，在后测和6个月的随访中，项目对外化问题的影响。MPCP不具有相加效应。这项为期6年的随访包括91%的有条件的家庭，发现参与计划的多个好处，包括一年内被诊断为精神障碍的患病率降低了53%；外化和内化问题、酒精使用和大麻使用的水平降低；性伴侣减少；能力和平均绩点增加。MPCP没有发生相加效应。适度分析表明，进入NBP的儿童以后出现问题的风险水平较高，显示出更大的计划好处。计划对青少年结果的影响是通过改善父母教养方式以及儿童时期的内化和外化问题来实现的。本申请有四个具体目标：(1)检查NBP对青少年(YA)的心理健康和物质使用问题和障碍、关键发展任务的成功、与父母的关系、身体健康结果和能力以及YAS母亲的心理健康问题的有效性；(2)检查NBP在青春期的计划效果是否通过计划诱导的青春期变化来调节；(3)检查计划效果是否受到基线风险水平和父母教育和职业的调节；以及(4)对NBP进行经济分析。将使用协方差分析、混合模型方差分析、Logistic回归和潜在增长曲线建模来检验目标。这项拟议的研究具有重要的公共卫生意义，并与NIMH的优先事项一致，以支持预防计划的长期后续行动(NIMH，1998)。

DESCRIPTION (provided by applicant): The proposed project is a 15-year follow-up of 240 young adults whose families participated in an experimental evaluation of the New Beginnings Program (NBP), a preventive intervention for divorced families. The NBP was provided in late childhood; the follow-up will occur in young adulthood. Families were randomly assigned to one of three conditions: mother program (MP), dual-component mother and child program (MPCP), or literature-control (LC) condition. Programs were designed to change several putative mediators of children's post-divorce mental health problems using empirically-supported change strategies. The program was implemented with very high fidelity and multi-method, multi-reporter assessments were used. Intent-to-treat analyses showed program effects on externalizing problems at posttest and 6-month follow-up. The MPCP did not have additive effects. The 6-year follow-up, which included 91% of families assigned to condition, found multiple benefits of program participation, including a 53% reduction in one-year prevalence of diagnosed mental disorder; reduced levels of externalizing and internalizing problems, alcohol use, and marijuana use; fewer sexual partners; and increased competence and grade point average. Additive effects of the MPCP did not occur. Moderational analyses showed that children who entered NBP with higher levels of risk for later problems showed greater program benefits. Program effects on adolescent outcomes were mediated by improvements in parenting and internalizing and externalizing problems in childhood. This application has four specific aims: (1) Examine the efficacy of NBP on young adults' (YA) mental health and substance use problems and disorders, success in key developmental tasks, relationships with their parents, physical health outcomes and competencies, as well as on the mental health problems of YAs' mothers; (2) Examine whether the program effects in young adulthood are mediated by program- induced changes in adolescence; (3) Examine whether the program effects are moderated by baseline level of risk and parental education and occupation; and (4) Conduct an economic analysis of NBP. Analysis of covariance, mixed-model analysis of variance, logistic regression and latent growth curve modeling will be used to test the aims. The proposed research has important public health significance and is consistent with NIMH priorities to support long-term follow-up of prevention programs (NIMH, 1998).