Family Mediation Program for At-Risk Youth

描述（由申请人提供）：本试验的结果将为科学知识和临床实践提供初步证据，证明亲子调解对改善高危青少年问题行为和相关态度的有效性，并阐明其发生的过程。调解是一种解决争议的方法，通过中立的第三方协助冲突双方达成解决方案。目前，亲子调解项目在全国范围内都有提供，但就其对家庭功能和青少年问题行为（如物质使用）的影响而言，尚未得到严格的评估。此外，在评估其基本组成部分和调查这些组成部分如何与积极的家庭和青年结果相关方面，很少关注调解过程本身。本研究是针对初高中学生及其家长/监护人的亲子调解计划之初步评估。八所参与学校的学校辅导员将根据明确的标准识别出正在经历重大行为问题的青少年。在四所干预学校中被确定的青少年将由学校辅导员转介到亲子调解项目。在四所对照学校中确定的青少年将被分配到等候名单对照条件中。所有参与的青少年和家长将完成三个简短的调查（基线、6周随访、12周随访），以获得亲子调解对家庭功能指标、青少年主要问题行为和相关态度的短期影响的初步证据。参与亲子调解的家庭也将提供关于调解过程的反馈，以检查其与这些结果的关系。我们将使用该试点评估的数据来实现以下三个目标：1)调查接受亲子调解的家庭（150名父母/监护人和150名青少年）在12周内是否比未接受亲子调解的150个家庭（父母/监护人和青少年）的等候名单对照样本在家庭功能方面表现出更大的改善；2)调查在12周的时间里，接受亲子调解的家庭中的青少年在物质使用意图和行为、学校相关行为和态度、性活动意图和行为以及犯罪方面是否比等候名单对照样本有更大的改善；3)探讨家庭功能的改善是否能解释参与亲子调解的家庭对青少年问题行为及相关态度的改变；b)确定亲子调解过程中与家庭功能和青少年问题行为的积极结果最相关的方面，以及参与调解的家庭的相关态度。如果该试点评估结果有希望，我们将提交R01申请，进行更大样本量的随机试验，并显着延长随访期。

DESCRIPTION (provided by applicant): Results from this pilot cluster-randomized trial will inform both scientific knowledge and clinical practice by providing preliminary evidence on the efficacy of parent-child mediation for improving problem behaviors and related attitudes among at-risk youth, as well as elucidating the process through which this occurs. Mediation is a method of dispute resolution in which the parties in conflict are assisted in reaching a settlement through a neutral third party. Parent-child mediation programs are currently offered throughout the country, but have not been rigorously evaluated in terms of their impact on family functioning and youth problem behaviors such as substance use. Further, little attention has focused on the mediation process itself in terms of assessing its fundamental components and investigating how each of these components is related to positive family and youth outcomes. The proposed study involves a pilot evaluation of a parent-child mediation program for at- risk middle and high school students and their parents/guardians. School counselors at eight participating schools will identify youth who are experiencing significant behavioral problems based on well-defined criteria. Identified youth at the four intervention schools will be referred by school counselors to the parent-child mediation program. Identified youth at the four control schools will be assigned to a wait-list control condition. All participating youth and parents will complete three brief surveys (baseline, 6-week follow-up, 12-week follow-up) to obtain preliminary evidence of the short-term impact of parent-child mediation on indicators of family functioning, as well as key youth problem behaviors and related attitudes. Families who participate in parent-child mediation will also provide feedback on the mediation process in order to examine its associations with these outcomes. We will use data from this pilot evaluation to address the following three aims: 1) To investigate whether families who receive parent-child mediation (150 parents/guardians and 150 youth) show greater improvement in family functioning over a 12-week period compared to a wait-list control sample of 150 families (parent/guardian and youth) not receiving parent-child mediation; 2) To investigate whether youth in families who receive parent-child mediation show greater improvement in substance use intentions and behavior, school-related behavior and attitudes, sexual activity intentions and behavior, and delinquency over a 12-week period compared to a wait-list control sample; and 3) to gain a better understanding of intervention effects by: a) exploring whether improvements in family functioning serve as an explanatory mechanism for changes in youth problem behaviors and related attitudes among families who participate in parent-child mediation versus controls; and b) identifying aspects of the parent-child mediation process that are most related to positive outcomes in family functioning and youth problem behaviors and related attitudes among families who participate in mediation. If results from this pilot evaluation are promising, we will submit an R01 application to conduct a randomized trial with a larger sample size and significantly longer follow-up period. PUBLIC HEALTH RELEVANCE: There is considerable need for a brief, effective program for families experiencing severe parent-child conflict as a result of youth problem behavior that can be easily and inexpensively delivered in a wide range of settings. Parent-child mediation is a promising, yet understudied approach. By reducing parent-child conflict, increasing family communication, and teaching conflict resolution skills, parent-child mediation programs may not only improve family functioning, but may have a significant positive impact on a wide range of youth problem behaviors including substance use.