Efficacy trial of a school-based preventive intervention

描述（由申请人提供）：该项目满足以下需求：(1)对已经出现心理健康问题的幼儿进行可负担和可持续的“指示”预防性干预，以及(2)可以在可访问的“现实世界”环境中有效提供的干预。本提案为一项随机对照试验（RCT）寻求RO1资金，以评估促进弹性儿童倡议（PRCI）在减少城市少数民族儿童心理健康问题和预防未来疾病和昂贵服务方面的功效。PRCI是初级精神卫生项目（PMHP）的第二代改编。以学校为基础的PMHP是40年前由Cowen和他的同事开发的，并已在美国的1500所学校推广。PMHP项目的优势包括对学校的生态有效性和适度的成本。PRCI显著修改了PMHP中使用的干预内容和实施方法。在PRCI中，儿童通过24次校本导师学习情绪调节和应对的行为和认知技能。在10次家访中，导师们教导父母帮助孩子发展技能。PRCI的初步试验表明，干预在短期内减少了儿童的问题，并且在目标行为和情感结果方面比PMHP有更大的影响。需要这项试验来确定PRCI干预的长期疗效。在这项为期5年的研究中，将从5所城市学校的75个教室中随机分配200名儿童进行PRCI干预，200名儿童进行对照。(1)“我们将比较30个月来外化和内化问题的干预和控制水平、服务需求和家庭功能指数，以评估项目的效果。(2)我们将努力确定实现积极成果所需的实施保真度水平。(3)我们将检验PRCI对儿童发展影响机制的假设。该项目有可能将改进的干预措施推广到目前正在实施PMHP的1000多所学校和美国其他学校，从而对公共卫生产生积极影响。从推进预防科学的角度来看，拟议的研究可以为改进社区干预措施和有效使用经过专门培训的非专业干预措施提供所需的知识。

DESCRIPTION (provided by applicant): This project responds to the need for (1) affordable and sustainable 'indicated' preventive interventions for young children already showing emerging mental health problems, and for (2) interventions that can be delivered effectively in accessible, 'real-world' settings. This proposal seeks RO1 funding for a randomized controlled trial (RCT) to evaluate the efficacy of the Promoting Resilient Children Initiative (PRCI) in Deducing mental health problems among urban, minority children and in preventing future disorders and costly services. The PRCI is a second-generation adaptation of the Primary Mental Health Project (PMHP). The school-based PMHP was developed 40 years ago by Cowen and colleagues and has been disseminated to 1,500 schools in the U.S. The PMHP program's strengths include ecological validity for schools and moderate cost.. PRCI significantly modifies both the intervention content and method of implementation used in PMHP. In PRCI children learn behavioral and cognitive skills for emotion regulation and for coping in 24 sessions with school-based Mentors. In 10 home visits the Mentors teach parents to assist their children in developing skills. A preliminary trial of PRCI suggests that the intervention reduces children's problems in the short-term and has a larger impact than PMHP on targeted behavioral and emotional outcomes. This trial is needed to determine the longer-term efficacy of the PRCI intervention. For the proposed 5-year study, 200 children will be randomly assigned to PRCI intervention and 200 to control conditions from 75 classrooms in 5 urban schools. (1)"We will compare intervention and control levels of externalizing and internalizing problems, need for services, and indices of family functioning over 30 months to assess program efficacy. (2) We will seek to determine levels of implementation fidelity required to achieve positive outcomes. (3) We will test hypotheses about mechanisms that govern the impact of PRCI on children's development. This project can have a positive public health impact through the potential to expand an improved intervention to more than 1,000 schools currently implementing PMHP and to other schools in the U.S. From the standpoint of advancing prevention science, the proposed study can contribute to knowledge needed to improve interventions in communities and the effective use of specially trained non-professional intervenors.