Family Groups for Urban Youth with Disruptive Behavior

 描述（由申请人提供）：一个多家庭组（MFG）是一个以家庭为中心，小组交付，循证，手动干预，目标是最常见的原因转介到公共资助的诊所：青年对立违抗和行为障碍。MFG针对的是一直与儿童期行为障碍的发生和维持有关的家庭因素，并整合了现有循证实践（EBP）的组成部分。MFG服务提供模式是与城市父母和服务提供者合作开发的，以解决与EBP推出相关的严重挑战：家庭参与率低;提供者的吸收率低;诊所和提供者对保持忠诚度的障碍;以及对儿童结局的影响减弱。为响应RFA 15-320，检验治疗、预防和服务干预措施有效性的临床试验，拟定的研究将采用混合方法II型有效性-实施混合研究设计。与纽约州心理健康办公室（OMH）合作，这项纵向研究将在纽约市OMH许可的儿童行为健康诊所系统（n=134）中进行。我们将使用混合方法，涉及268名提供者和2 688名青少年（7至11岁）的成年照顾者。本研究的具体目的是：1）研究MFG对城市青少年ODD和CD的短期和纵向影响（复制）; 2）家庭一级调解员（如养育，家庭过程）的儿童结果; 3）诊所（准备采用创新、领导支持和氛围）和提供商级别的主持人（准备，动机和忠诚度）的MFG的实施和整合; 4）CITS对诊所和供应商的MFG的实施和整合水平主持人的影响。在本RCT中，诊所将按行政区（曼哈顿、皇后区、布朗克斯、布鲁克林、史坦顿岛）分层，并在行政区内随机分配至3种研究条件：1）MFG+ CIT; 2）MFG（接受标准研究培训和咨询）或3）标准治疗。将在基线、8周和16周以及6个月时收集数据。在第一阶段（重点是执行）和第二阶段（一体化），我们的团队包括NYSOMH研究和政策领导的最高水平。McKay和Hoagwood是NYS诊所技术援助中心，NIMH资助的国家系统儿童循证实践实施高级中心（IDEAS; P30 MH 09032）和城市儿童心理健康服务合作研究中心（CCCR; P20 MH 085983）的联合主任。来自IDEAS/CCCR中心顾问的先进方法学专业知识（Jaccard，Palinkas）和政策（Hogan，Bradbury，Goldman）咨询将研究定位为最大的公共卫生影响。这个团队是唯一准备建立在现有的研究和服务基础设施内的国家公共精神卫生系统进行这项研究。由于以全国为重点的中心和与纽约大学的合作伙伴关系，这项研究的结果是立即可采取行动的。

 DESCRIPTION (provided by applicant): A multiple family group (MFG) is a family-centered, group delivered, evidence-informed, manualized intervention that targets the most common reason for referral to publicly funded clinics: youth oppositional defiant and conduct disorders. MFGs target family factors which have been consistently implicated in the onset and maintenance of childhood behavioral disorders and integrate components of existing evidence-based practices (EBPs). The MFG service delivery model was developed in collaboration with urban parents and service providers to address the serious challenges associated with EBP roll-outs: low rates of family involvement; poor uptake by providers; clinic and provider impediments to maintaining fidelity; and attenuated child outcome effects. The proposed study, in response to RFA 15-320, Clinical Trials to Test the Effectiveness of Treatment, Preventative, and Services Interventions, will employ a mixed methods Type II effectiveness-implementation hybrid research design. In collaboration with the NYS Office of Mental Health (OMH), this longitudinal study will be conducted across the NYC OMH licensed child behavioral health clinic system (n=134). We will use mixed methods, and involve 268 providers and 2,688 adult caregivers of youth (7 to 11 years). The following Specific Aims guide this study: To examine 1) short-term and longitudinal impact of MFGs on urban youth with ODD and CD (replication); 2) family-level mediators (e.g. parenting, family process) of child outcomes; 3) clinic (readiness to adopt an innovation, leadership support and climate) and provider level moderators (preparedness, motivation and fidelity) of MFG implementation and integration and; 4) the impact of CITs on clinic and provider level moderators of MFG implementation and integration. In this RCT, clinics will be stratified by borough (Manhattan, Queens, Bronx, Brooklyn, Staten Island) and randomly assigned within borough to 3 study conditions: 1) MFG+CITs; 2) MFG (with standard research training and consultation) or; 3) Standard Care. Data will be collected baseline, 8 and 16 weeks and 6 mo. follow-up) in Phase 1 (focus on implementation) and Phase II (integration). Our team includes the highest level of NYSOMH research and policy leadership. McKay and Hoagwood are the co-Directors of the NYS Clinic Technical Assistance Center, the NIMH-funded Advanced Center on Implementation of Evidence-based Practice for Children in State Systems (IDEAS; P30 MH09032) and the Center for Collaborative Urban Child Mental Health Services Research (CCCR; P20 MH085983). Advanced methodological expertise (Jaccard, Palinkas) and policy (Hogan, Bradbury, Goldman) consultation from IDEAS/CCCR Center advisors position the study for maximum public health impact. This team is uniquely prepared to build on an existing research and service infrastructure within a state public mental health system to conduct this study. Because of the nationally- focused centers and the partnerships with NYSOMH, the findings from this study are immediately actionable.