Implementation of Evidence-Based Preventive Parenting Programs

描述（由申请人提供）：当基于证据的项目（ebp）被转化为现实环境时，执行不力解释了效应大小的显著降低（Henggeler, 2004）。实施的多个维度影响结果（Durlak & DuPre, 2008），但只有四个维度发生在项目的交付过程中，因此，它们是项目设计和实施之间潜在的可修改的脱节来源：1)保真度（课程提供者提供的数量），2)积极适应性（提供者在提供过程中添加的无脚本内容的质量），3)提供质量（提供者提供材料和与参与者互动的技能，以及4）参与者响应性（项目参与水平，如参与者出勤和项目技能的使用）。确定监测这四个维度的有效方法（Schoenwald等人，2011），并了解它们如何与影响结果相互关联（Berkel， Mauricio等人，2011），以及跨会话的变化，对于在现实环境中保持EBP效果具有重要意义。拟议的研究使用来自nida资助的新起点计划（NBP; R01DA026874）有效性试验的数据和我们将收集的独立观察者数据。NBP是一种育儿干预，通过对以干预为目标的育儿中介（McClain, et al., 2010）的影响，改善父母离婚后青少年的物质使用和心理健康结果（Wolchik, et al., 2002）。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。有效性试验将只收集10%疗程的独立观察者数据，并且只检查实施对结果的简单、直接影响。本研究建立在NBP试验的基础上，收集了100%的独立观察者数据，提供了解决3个研究目标所需的数据，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、提供自我报告和主管评级中的信度和预测效度。我们还研究了采样策略，以确定必须采样的最佳数据量（例如，10%或20%），以可靠地评估保真度、积极适应性和质量，以及这是否取决于项目活动类型（例如，教学与技能实践）或提供者特征（例如，经验，对ebp的态度）。在目标2中，我们

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.