Digital implementation support strategies for caregiver home practice

项目摘要/摘要 已经开发了许多基于证据的预防性干预措施，以防止药物使用、身体和 精神疾病，并促进青少年的积极教育和社会成果。其中， 由照顾者调解的干预具有强大的效果，而这些效果是由有效的育儿技能促成的。然而， 这些干预措施的影响受到干预技能家庭实践率低的严重限制。 照顾者。为了解决这一研究与实践之间的差距，研究人员一直在调查障碍和 护理者参与的促进者，在很大程度上侧重于干预出席。增长的战略 照顾者的家庭技能实践仍然没有得到充分的审查。然而，照顾者的家庭实践是 理论上的干预有效性，并已被发现影响父母的行为和随后的孩子 除了出席率之外的其他结果。因此，支持育儿的下一个重要步骤 行为改变是为循证干预制定实施支持战略，目标是 特别是照顾者之家实习。 这项建议的K01指导研究科学家发展奖将开发和试验一种数字行为 改变干预措施，作为循证预防性干预的辅助手段。“模块化” 参与度和技能增强“(MESA)旨在增加照顾者的家庭干预实践 技能。在计划行为理论、习惯养成原则和复发预防理论的指导下， MESA将利用移动医疗技术(MHealth)来绕过和解决共同的障碍 居家实习包括居家实习意向、实习频率、居家实习能力及 保持干预技能。MESA将作为智能手机应用程序(即“应用程序”)开发。台地 将通过对照顾者家庭实践的障碍进行定性评估和细化来告知组件 通过直接利益相关者对设计要求的输入来优化可接受性和可行性。梅萨将成为 对48名照顾者进行试点，作为Bridges的辅助工具，这是一种针对青少年的循证干预 预防药物使用和促进心理健康。将采用整群随机对照设计 使得桥梁干预组将被随机分配到接受MESA(n=32)或主动对照 16例。这项研究的发现有可能改善照顾者的家庭实践、干预 广泛参与，并最终提高众多照顾者的有效性和公共健康影响- 居间干预。

PROJECT SUMMARY/ABSTRACT Many evidence-based preventative interventions have been developed to prevent substance use, physical and mental illness, and promote positive educational and social outcomes among adolescents. Among these, caregiver-mediated interventions boast strong effects that are mediated by effective parenting skills. However, the impact of these interventions is severely limited by low rates of home practice of intervention skills among caregivers. To address this research-to-practice gap, researchers have been investigating barriers and facilitators of caregiver engagement, focusing in large part on intervention attendance. Strategies for increasing caregivers' home practice of skills remain underexamined. Yet, caregiver home practice is a key component of theorized intervention effectiveness and has been found to impact parenting behaviors and subsequent child outcomes over and above that of attendance. Therefore, the next important step in supporting parenting behavior change is to develop implementation support strategies for evidence-based interventions that target caregiver home practice specifically. This proposed K01 Mentored Research Scientist Development Award will develop and pilot a digital behavior change intervention for use as an adjunct to an evidence-based preventative intervention. The “Modular Engagement and Skills Augmentation” (MESA) aims to increase caregivers' home practice of intervention skills. Informed by the theory of planned behavior, habit formation principles, and relapse prevention theory, MESA will leverage mobile health technologies (mHealth) to circumvent and problem solve common barriers to home practice including home practice intention, frequency of practice, home practice competence, and maintenance of intervention skills. MESA will be developed as a smartphone application (i.e., “app”). MESA components will be informed by a qualitative assessment of barriers to caregiver home practice and refined through direct stakeholder input on design requirements to optimize acceptability and feasibility. MESA will be piloted with 48 caregiver participants as an adjunct to Bridges, an evidence-based intervention for adolescent substance use prevention and mental health promotion. Cluster randomized controlled design will be utilized such that Bridges intervention groups will be randomly assigned to receive MESA (n = 32) or an active control (n = 16). Findings from this study have the potential to improve caregiver home practice, intervention engagement broadly, and ultimately boost effectiveness and public health impact of numerous caregiver- mediated interventions.