Preventing substance use through hybrid web and in vivo delivery of Coping Power

描述（由申请人提供）：本提案将开发和测试应对能力计划的混合互联网增强版的可行性，该计划适用于有物质使用风险的五年级儿童。应对能力是一种预防性干预措施，已证明对有滥用药物和犯罪风险的青春期前儿童有效。尽管其预防效果已得到证实，但实施应对能力和类似的循证预防方案所需的时间长度已被确定为供应商采用此类方案以及父母出席和参与的障碍。为了解决这一障碍，该应用程序将开发一个混合版本的应对能力，这将允许它更有效地交付，大大减少面对面的会议，同时保留所有的核心内容（应对能力-互联网增强; CP-IE）。这一创新的、有针对性的预防方法将包括在6个月内每隔一周举行12次儿童会议，7次家长会议，以及参与者将在面对面会议之间访问的互联网媒体组件。使用互联网提供的媒体来加强干预措施，预计将进一步提高儿童和家长对干预措施相关内容的兴趣和保留。这是一致的经验证据表明，个人更加关注和学习更深入的多媒体演示比从只有口头的消息，导致更大的解决问题的转移，如肯尼迪的认知互动模型的多媒体互动研究。该提案将使CP-IE得以开发和试点测试。然后，来自8所学校的96名有风险，有攻击性的五年级学生将被随机分配参加CP-IE或照顾作为父母，使用配对抽样设计。CP-IE参与者将在面对面会议之间访问互联网提供的干预内容，包括为模拟关键应对能力主题而开发的动画视频。该提案的主要目的是：1）为有药物滥用风险的儿童及其父母开发一个有效的、互联网增强的混合版本的应对能力方案; 2）评估CP-IE方案在留住参与者方面的可行性，并确定儿童和家庭是否观看了高比例的CP-IE互联网提供的内容; 3）评估CP-IE计划的可接受性，如儿童，家长和学校辅导员评级所示，以及提供具有高度干预完整性和实施的CP-IE的能力 质量; 4）评估CP-IE是否促进了高水平的参与动机，对干预内容的理解和保持，以及儿童的社会认知，自我调节和社会能力以及父母的育儿实践的变化;以及5）将计划的可行性研究作为CP-IE大规模随机试验的基础。还将探讨CP-IE在可行性研究中的初步结果影响。如果它的可行性和 如果随后的疗效被记录下来，混合CP-IE计划可以更广泛地传播，因此在物质使用预防方面具有广泛的公共卫生意义。 公共卫生相关性：应对能力计划是一项多组分预防性干预措施，已证明其在预防高危青春期前儿童药物滥用和犯罪方面具有功效（Lochman &威尔斯，2002 a）和有效性（Lochman &威尔斯，2002 b; Lochman &威尔斯，2004）。该应用程序将开发一个混合版本的应对能力干预，这将允许交付所有的核心内容，从全长应对能力计划（通常有34个子会话和16个父会话），（12个孩子，7个家长会话），通过互联网交付的内容进行增强（包括视频建模、个性化反馈和消息特征; CP-IE）。如果其可行性和随后的疗效被记录在案，混合CP-IE计划可以更广泛地传播，从而在有针对性地预防儿童药物使用结果方面具有广泛的公共卫生意义。

DESCRIPTION (provided by applicant): This proposal will develop and test the feasibility of a hybrid internet-enhanced version of the Coping Power program for aggressive 5th grade children who are at risk for substance use. Coping Power is a preventive intervention with demonstrated efficacy and effectiveness for preadolescent children at-risk for substance abuse and delinquency. Despite its demonstrated preventive effects, the length of time required to implement Coping Power and similar evidence-based prevention programs has been identified as a barrier to providers' adoption of such programs and parents' attendance and engagement. To address this barrier, this application will develop a hybrid version of Coping Power which will permit it to be delivered more efficiently, with substantially fewer face-to-face sessions, while retaining all of the core content (Coping Power-Internet Enhanced; CP-IE). This innovative, targeted prevention approach will include 12 child sessions held every other week over a 6 month period, 7 parent sessions, and internet-delivered media components, which participants will access between in-person sessions. The use of internet-delivered media to augment the intervention is expected to further enhance children's and parents' interest in and retention of intervention- related content. This is consistent with empirical evidence that individuals pay more attention to and learn more deeply from multimedia presentations than from verbal-only messages, resulting in greater problem-solving transfer, as described in Kennedy's cognitive interaction model of multimedia interactivity research. This proposal will allow CP-IE to be developed and pilot-tested. Then, 96 at-risk, aggressive 5th grade students from 8 schools will be randomly assigned to participate in CP-IE or Care-as-Usual, using a matched pairs sampling design. CP-IE participants will access internet-delivered intervention content between in-person sessions, including animated videos that were developed to model key Coping Power topics. The primary aims of this proposal are to: 1) Develop an efficient, internet-augmented hybrid version of the Coping Power program for children who are at-risk for substance abuse and their parents; 2) Assess the feasibility of the CP-IE program in retaining participants, and in determining if children and families view a high rate of the CP-IE internet- delivered content; 3) Assess the acceptability of the CP-IE program, as indicated by child, parent and school counselor ratings, and ability to deliver CP-IE with high intervention integrity and implementation quality; 4) Assess if CP-IE promotes a high level of participant motivation in the program, comprehension and retention of intervention content, and change in children's social cognition, self-regulation, and social competence abilities and in parents' parenting practices; and 5) Use the planned feasibility study as a basis for a large-scale randomized trial of CP-IE. Preliminary outcome effects of CP-IE within the feasibility study will also be explored. If its feasibility and subsequent efficacy are documented, the hybrid CP-IE program can be disseminated much more widely, and thus have broad public health significance in substance use prevention. PUBLIC HEALTH RELEVANCE: The Coping Power program is a multi-component preventive intervention with demonstrated efficacy (Lochman & Wells, 2002a) and effectiveness (Lochman & Wells, 2002b; Lochman & Wells, 2004) for preventing substance abuse and delinquency in at-risk preadolescent children. This application will develop a hybrid version of the Coping Power intervention, which will allow for delivery of all of the core content from the full-length Coping Power program (which typically has 34 child sessions and 16 parent sessions) by providing a reduced number of in-person sessions (12 child, 7 parent sessions) that are enhanced by internet-delivered content (including video modeling, individualized feedback, and messaging features; CP-IE) between each in- person session. If its feasibility and subsequent efficacy is documented, the hybrid CP-IE program can be much more widely disseminated, and thus have broad public health significance in targeted prevention of substance use outcomes in children.