Developing a Client Assignment Model for RECAP Treatment

描述（由申请人提供）：本研究项目的总体目标是制定预防/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共同发生的内化和外化问题，以及(c)能够防止这些问题变得更严重。拟议项目的重点是RECAP项目，这是一个以学校为基础的项目，用于治疗儿童同时出现的内化和外化问题。拟议项目的具体目标是：(1)为不同强度的RECAP治疗方案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因子（即识别差异治疗反应的预测因子），以及（步骤2）开发阶梯式护理分配算法。如果提出的研究成功地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，即测试阶梯式护理分配算法是否比随机分配具有更好的结果。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，以确认先前研究表明RECAP有效的结果。项目参与者将是来自四所服务于低收入社区的小学的340名儿童及其家庭，参与项目的儿童将面临更严重的内化和外化问题。参与者将被分配到治疗服务强度不同的四种治疗变体中的一种：(a)无治疗对照组；(b)基于RECAP教师课堂部分的治疗变体；(c)一种治疗方式，包括教师课堂部分和儿童部分；(d)包括上述组成部分和家长培训组成部分的治疗变体。干预将持续一个学年，有四组参与者。评估将在四个时间点进行，包括症状、适应性功能以及RECAP治疗效果的假设调节因子和中介因子。

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.