Developing a Client Assignment Model for RECAP Treatment

描述（由申请人提供）：本研究计划的主要目标是制定预防/干预计划，这些计划（a）适用于非研究条件，（B）有效减少青春期前儿童中同时发生的内化和外化问题，以及（c）能够防止这些问题变得更加严重。拟议的项目侧重于RECAP计划，一个以学校为基础的计划，治疗儿童的共同发生的内化和外化的问题。拟议项目的具体目标是：（1）为RECAP治疗方案的不同强度开发一个客户分配模型，这需要（步骤1）识别治疗反应的调节剂（即，鉴别不同治疗反应的预测因子），和（步骤2）开发分步护理分配算法。如果拟议的研究成功确定了差异治疗反应的预测因素，未来的研究将实施开发过程的第3步，即测试分步护理分配算法是否与随机分配相比具有更好的结局。当前拟议项目的具体目标还包括（2）确定RECAP治疗效果的变化过程，以及（3）进行第二次结果研究，以确认先前研究的结果，表明RECAP是有效的。项目参与者将是来自四所小学的340名儿童及其家庭，这些小学为低收入社区服务，参与的儿童将经历更高水平的内化和外化问题。受试者将被分配到治疗服务强度不同的四种治疗方案中的一种：（a）无治疗对照组;（B）基于RECAP教师课堂部分的治疗方案;（c）包括教师课堂部分和儿童部分的治疗方案;（d）包括上述两个部分以及家长培训部分的治疗方案。干预措施将持续一个学年，有四组参与者。将在四个时间点对症状、适应功能以及RECAP治疗效果的假设调节剂和介导剂进行评估。

DESCRIPTION (provided by applicant): The broad goal of this program of research is develop prevention/intervention program(s) that are (a) applicable under non-research conditions, (b) effective at reducing co-occurring internalizing and externalizing problems among pre-adolescent children, and (c) able to prevent these problems from becoming more serious. The proposed project focuses on the RECAP program, a school-based program for treating children's co-occurring internalizing and externalizing problems. The specific aims of the proposed project are to: (1) develop a client assignment model for different intensities of the RECAP treatment program, which requires (Step 1) identification of moderators of treatment response (i.e., identification of predictors of differential treatment response), and (Step 2) development of a Stepped Care assignment algorithm. If the proposed study is successful in identifying predictors of differential treatment response, a future study will implement Step 3 of the development process, which is to test whether the Stepped Care assignment algorithm is associated with better outcomes than random assignment. Specific Aims for the current proposed project also include (2) determining change processes underlying RECAP's treatment effects, and (3) conducting a second outcome study to confirm the results of a previous study indicating that RECAP is efficacious. Project participants will be 340 children and their families from four elementary schools serving low income neighborhoods, with participating children experiencing elevated levels of internalizing and externalizing problems. Participants will be assigned to one of four treatment variants varying in the intensity of treatment services: (a) a no treatment control group; (b) a treatment variant based on the RECAP teacher classroom component; (c) a treatment variant including the teacher classroom component as well as a child component; (d) a treatment variant including both of the preceding components as well as a parent training component. The intervention will last one academic year, with four cohorts of participants. Assessments will occur at four time points on symptoms, adaptive functioning, and hypothesized moderators and mediators of RECAP's treatment effects.