Family Mediation Program for At-Risk Youth

描述(申请人提供)：这项整群随机试验的结果将提供初步证据，证明亲子调解在改善高危青少年的问题行为和相关态度方面的有效性，并阐明其发生的过程，为科学知识和临床实践提供信息。调解是一种解决争端的方法，通过中立的第三方协助冲突各方达成和解。目前全国各地都提供亲子调解计划，但没有严格评估其对家庭功能和青少年问题行为(如药物使用)的影响。此外，在评估调解进程的基本组成部分以及调查这些组成部分与家庭和青年的积极成果之间的关系方面，很少有人关注调解进程本身。这项拟议的研究涉及一项针对高危初中生及其父母/监护人的亲子调解计划的试点评估。八所参与学校的学校辅导员将根据明确的标准识别正在经历严重行为问题的年轻人。学校辅导员将把在四所干预学校发现的青少年转介到亲子调解计划中。在四所控制学校中被确认的青少年将被分配到轮候名单控制条件下。所有参与的青少年和家长将完成三次简短的调查(基线调查、6周跟踪调查、12周跟踪调查)，以获得亲子调解对家庭功能指标的短期影响的初步证据，以及关键的青少年问题行为和相关态度。参与亲子调解的家庭还将就调解进程提供反馈，以审查调解进程与这些结果之间的联系。我们将利用这项试点评估的数据来解决以下三个目标：1)调查接受亲子调解的家庭(150名家长/监护人和150名青少年)在12周内是否比没有接受亲子调解的150个家庭(父母/监护人和青少年)的轮候名单对照样本在家庭功能方面有更大的改善；2)调查接受亲子调解的家庭的青少年在12周期间是否比接受亲子调解的家庭的青少年在物质使用意图和行为、与学校相关的行为和态度、性行为意图和行为以及犯罪方面有更大的改善；3)通过以下方式更好地了解干预效果：a)探索家庭功能的改善是否可以解释参与亲子调解的家庭相对于对照家庭的青少年问题行为和相关态度的变化；以及b)确定亲子调解过程中与参与调解的家庭的家庭功能和青少年问题行为及相关态度的积极结果最相关的方面。如果这项试点评估的结果是有希望的，我们将提交R01申请，进行样本量更大、随访期明显更长的随机试验。

DESCRIPTION (provided by applicant): Results from this pilot cluster-randomized trial will inform both scientific knowledge and clinical practice by providing preliminary evidence on the efficacy of parent-child mediation for improving problem behaviors and related attitudes among at-risk youth, as well as elucidating the process through which this occurs. Mediation is a method of dispute resolution in which the parties in conflict are assisted in reaching a settlement through a neutral third party. Parent-child mediation programs are currently offered throughout the country, but have not been rigorously evaluated in terms of their impact on family functioning and youth problem behaviors such as substance use. Further, little attention has focused on the mediation process itself in terms of assessing its fundamental components and investigating how each of these components is related to positive family and youth outcomes. The proposed study involves a pilot evaluation of a parent-child mediation program for at- risk middle and high school students and their parents/guardians. School counselors at eight participating schools will identify youth who are experiencing significant behavioral problems based on well-defined criteria. Identified youth at the four intervention schools will be referred by school counselors to the parent-child mediation program. Identified youth at the four control schools will be assigned to a wait-list control condition. All participating youth and parents will complete three brief surveys (baseline, 6-week follow-up, 12-week follow-up) to obtain preliminary evidence of the short-term impact of parent-child mediation on indicators of family functioning, as well as key youth problem behaviors and related attitudes. Families who participate in parent-child mediation will also provide feedback on the mediation process in order to examine its associations with these outcomes. We will use data from this pilot evaluation to address the following three aims: 1) To investigate whether families who receive parent-child mediation (150 parents/guardians and 150 youth) show greater improvement in family functioning over a 12-week period compared to a wait-list control sample of 150 families (parent/guardian and youth) not receiving parent-child mediation; 2) To investigate whether youth in families who receive parent-child mediation show greater improvement in substance use intentions and behavior, school-related behavior and attitudes, sexual activity intentions and behavior, and delinquency over a 12-week period compared to a wait-list control sample; and 3) to gain a better understanding of intervention effects by: a) exploring whether improvements in family functioning serve as an explanatory mechanism for changes in youth problem behaviors and related attitudes among families who participate in parent-child mediation versus controls; and b) identifying aspects of the parent-child mediation process that are most related to positive outcomes in family functioning and youth problem behaviors and related attitudes among families who participate in mediation. If results from this pilot evaluation are promising, we will submit an R01 application to conduct a randomized trial with a larger sample size and significantly longer follow-up period.