Implementation of Evidence-Based Preventive Parenting Programs

描述(由申请人提供)：糟糕的实施解释了当基于证据的计划(EBP)被转化为现实世界环境时，效果大小的显著减少(Henggler，2004)。实施影响结果的多个方面(Durlak&Dupre，2008)，但只有四个方面出现在计划课程的交付中，因此，它们是计划设计和实施之间潜在的可修改的脱节来源：1)保真度(课程提供者提供的课程数量)，2)积极的适应(提供者在交付期间添加的非脚本内容的质量)，3)交付的质量(提供者提供材料并与参与者互动的技能，以及4)参与者的响应性(计划参与度，如参与者的出勤率和计划技能的使用)。确定有效的方法来监测这四个维度(Schoenwald等人，2011年)，并了解它们与影响结果(Berkel，Mauricio等人，2011年)和跨会议变化的相互关系，对于在现实世界环境中维持EBP效应具有重要意义。这项拟议的研究使用了NIDA资助的新开端计划有效性试验(NBP；R01DA026874)的数据和我们将收集的独立观察员数据。NBP是一种育儿干预措施，通过对干预目标的育儿中介的影响(McClain等人，2010年)，改善青少年物质使用和应对父母离婚的心理健康结果(Wolchik等人，2002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个干预小组的约550名家长提供NBP。有效性试验将只在10%的会议上收集独立观察员的数据，并且只审查执行对结果的简单、直接的影响。这项研究建立在NBP试验的基础上，通过收集100%会议的独立观察员数据，提供必要的数据来解决3个研究目标，这些研究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，我们比较了保真度、积极适应和质量在独立观察者评级中的可靠性和预测效度，并提供了自我报告和主管评级。我们还检查抽样策略，以确定必须抽样以可靠地评估保真度、积极适应和质量的最佳数据量(例如，10%、20%)，以及这是否取决于计划活动类型(例如，教学实践与技能实践)或提供者特征(例如，经验、对EBP的态度)。在目标2中，我们 测试解释执行对结果的影响的理论框架，并检查父母性别和种族在这些框架中的作用。目的2建立在现有研究的基础上，通过检验：a)关于提供者行为(即忠诚度、适应性、质量)对反应和结果的影响的温和和冥想假设，b)提供者行为对反应和结果的时间优先效应，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，我们考察了保真度、适应性和质量随时间的变化，以及提供商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.