Implementation of Evidence-Based Preventive Parenting Programs

描述（由申请人提供）：实施不佳解释了将循证项目（EBP）转化为现实环境时效应量的显著降低（Henggeler，2004）。执行工作的多个层面影响成果（Durlak & DuPre，2008），但只有四个发生在项目会话的交付过程中，因此，它们是项目设计和实施之间脱节的潜在可修改来源：1）保真度（课程提供者提供的数量），2）积极的适应（提供者在交付过程中所做的非脚本添加的质量），3）交付质量（提供者提供材料和与参与者互动的技能，以及4）参与者的反应能力（计划参与水平，如参与者出勤率和计划技能使用）。确定监测这4个维度的有效方法（Schoenwald等人，2011）以及了解它们如何相互关联，以影响结果（Berkel，Mauricio等人，2011年）和跨会话的变化有重要的意义，在现实世界中保持EBP的影响。拟议的研究使用来自NIDA资助的新开端计划（NBP; R 01 DA 026874）有效性试验的数据和我们将收集的独立观察员数据。NBP是一种父母干预措施，可改善青少年物质使用和心理健康结果，以应对父母离婚（Wolchik等人，2002）通过对干预为目标的养育调解人的影响（麦克莱恩，等人，2010年）。社区提供者将通过与亚利桑那州5个县级法院的合作，向75个干预小组的大约550名家长提供NBP。有效性试验将仅收集10%的会议的独立观察员数据，并仅检查实施对结果的简单直接影响。这项研究建立在NBP试验的基础上，收集了100%会议的独立观察员数据，提供了解决3个研究目标所需的数据，这些目标将为实施测量和理论中的关键问题提供信息。在目标1中，我们比较了独立观察员评级，提供自我报告和主管评级的可靠性和预测效度的保真度，积极适应和质量。我们还检查了采样策略，以确定最佳的数据量（例如，10%，20%），必须抽样以可靠地评估保真度，积极的适应性和质量，如果这取决于计划活动类型（例如，教学与技能实践）或提供者特征（例如，经验，对EBPs的态度）。在目标2中， 测试解释执行对成果的影响的理论框架，并在这些框架内审查父母性别和种族的作用。目标2建立在现有研究的基础上，通过测试：a）关于提供者行为影响的适度和冥想假设（即，忠诚度、适应性、质量）对反应性和结果的影响，B）提供者行为对反应性和结果的时间优先性影响，以及c）父母性别和种族对模型路径的调节作用。在目标3中，我们研究了保真度，适应性和质量随时间的变化以及提供者特征对这些变化的影响。

DESCRIPTION (provided by applicant): Poor implementation explains significant reductions in effect sizes when Evidence-Based Programs (EBPs) are translated to real-world settings (Henggeler, 2004). Multiple dimensions of implementation influence outcomes (Durlak & DuPre, 2008), but only four occur within the delivery of program sessions and, as a result, are potential modifiable sources of disconnect between the program as designed and as implemented: 1) fidelity (amount of curriculum providers deliver), 2) positive adaptations (the quality of unscriptd additions providers make during delivery), 3) quality of delivery (skill with which providers delivr material and interact with participants, and 4) participant responsiveness (level of program participation, such as participant attendance and program skill use). Identifying efficient methods to monitor these 4 dimensions (Schoenwald, et al., 2011) as well as understanding how they interrelate to influence outcomes (Berkel, Mauricio, et al., 2011) and change across sessions has important implications for maintaining EBP effects in real-world settings. The proposed research uses data from the NIDA-funded effectiveness trial of the New Beginnings Program (NBP; R01DA026874) and independent observer data that we will collect. NBP is a parenting intervention that improves youth substance use and mental health outcomes in response to parental divorce (Wolchik, et al., 2002) through effects on intervention-targeted parenting mediators (McClain, et al., 2010). Community providers will deliver the NBP to approximately 550 parents across 75 intervention groups through a partnership with 5 county-level courts in Arizona. The effectiveness trial will only collect independent observer data on 10% of sessions and only examine simple, direct effects of implementation on outcomes. This study builds on the NBP trial by collecting independent observer data for 100% of sessions, providing the required data to address 3 research aims that will inform critical questions in implementation measurement and theory. In Aim 1, we compare the reliability and predictive validity of fidelity, positive adaptation, and quality across independent observer ratings, provide self-report, and supervisor ratings. We also examine sampling strategies to identify the optimal quantity of data (e.g., 10%, 20%) that must be sampled to reliably assess fidelity, positive adaptations, and quality and if this is contingent on program activity type (e.g., didactic versus skills practice) or provider characteristics (e.g., experience, attitudes about EBPs). In Aim 2, we test theoretical frameworks explaining implementation effects on outcomes and examine the role of parent gender and ethnicity within these frameworks. Aim 2 builds on extant studies by testing: a) moderational and meditational hypotheses about the effects of provider behaviors (i.e., fidelity, adaptation, quality) on responsiveness and outcomes, b) the temporal precedence of provider behavior effects on responsiveness and outcomes, and c) the moderating effects of parent gender and ethnicity on model pathways. In Aim 3, we examine changes in fidelity, adaptation, and quality over time and the influence of provider characteristics on these changes.