An evidence-based family support program for parents and children in Palestine: A theory-based intervention

项目总结/摘要 几乎没有证据为基础的方案存在，以支持受社会政治冲突影响的儿童和家庭，尽管 有文件证明，他们的情绪和行为调整问题的风险增加， 在社会生态的多个层面上暴露于冲突和暴力（例如，政治、社会和 家庭）。因此，迫切需要一个以证据为基础的方案，以减轻政治暴力的影响 对儿童和家庭的整体福祉。目前的研究将进行严格的评估， 在巴勒斯坦，包括西岸和加沙地带，以理论为驱动的、以家庭为基础的干预方案。 牢固地扎根于巴勒斯坦的文化背景，但对接触到 社会政治暴力，该项目的长期目标是提供一个以家庭为重点的干预方案 （促进积极的家庭未来; PPFF），可以促进个人的安全感和支持， 慢性逆境的背景下。其目的是评估这一干预方案的背景下， 随机临床试验（RCT）在西岸和加沙（N=300）。核心假设是， 会对家庭冲突、父母精神病理学和家庭中的父母安全感产生直接的积极影响， 以及青少年在家庭中的情感安全，对青少年的适应产生连锁效应。 与家庭系统理论相一致，我们进一步假设，对父母的治疗效果将介导 治疗对青少年适应的影响。其基本原理是， 在长期遭受暴力侵害的家庭中，促进积极运作的一个关键方法是建立一个有效的家庭制度。的 将从三个具体目标评估假设：1）评估循证家庭的有效性 支持计划; 2）检查治疗变化的过程模型，以及3）检查 父母和孩子的功能。为了实现这些目标，本研究将是一项采用纵向设计的RCT （N=300）在基线（T1）、试验后（T2）、6个月随访（T3）和12个月时进行多方法评估 随访（T4）。研究中的家庭将平均分布在西岸（n=150）和加沙 剥离（n=150）。家庭将被随机分配到干预条件（PPFF）或常规治疗（TAU）。 每个领土将有一个执行伙伴，执行伙伴和调查员将开展工作 共同确保研究程序在各研究中心平行实施。数据收集将 由来自第三方调查和政策研究组织的训练有素的研究人员进行。该提案 旨在通过采用新的理论来改变当前的研究和临床范式， 概念、途径和方法。这一贡献将是显著的：1）进一步开发新的 在这些高风险环境中进行基于药物的干预的方向，以及2）推进相对简短， 一个具有成本效益的计划，可以随时实施，以帮助儿童和家庭暴露于继续 巴勒斯坦的冲突，有可能在其他情况下扩大规模。

PROJECT SUMMARY/ABSTRACT Few evidence-based programs exist to support children and families affected by sociopolitical conflict, despite documented evidence of their heightened risk for emotional and behavioral adjustment problems associated with exposure to conflict and violence at multiple levels of the social ecology (e.g., political, community, and family). Thus, a critical need exists for an evidence-based program to ameliorate the impact of political violence on the overall well-being of children and families. The current study will conduct a rigorous evaluation of a theoretically-driven, family-based intervention program in Palestine, including both the West Bank and Gaza. Firmly grounded in the cultural context of Palestine but with broad implications for individuals exposed to sociopolitical violence, the long-term goal of this project is to provide a family-focused intervention program (Promoting Positive Family Futures; PPFF) that may facilitate individuals’ sense of safety and support in the context of chronic adversity. The objective is to evaluate this intervention program in the context of a randomized clinical trial (RCT) in the West Bank and Gaza (N=300). The central hypothesis is that the program will have direct positive effects on family conflict, parent psychopathology and parental security in the family as well as on adolescent emotional security in the family, with cascading effects on adolescent adjustment. Consistent with family systems theory, we further hypothesize that treatment effects on parents will mediate on the effects of the treatment on adolescent adjustment. The rationale is that bolstering resilience in family systems is a key approach to promoting positive functioning in families exposed to chronic violence. The hypothesis will be evaluated with three specific aims: 1) evaluate the efficacy of an evidence-based family support program; 2) examine process models of treatment change, and 3) examine interrelations between parent and child functioning. To achieve these aims, the study will be an RCT employing a longitudinal design (N=300) with multi-method assessments at baseline (T1), post-test (T2), 6-month follow-up (T3) and 12-month follow-up (T4). Families included in the study will be evenly divided between the West Bank (n=150) and Gaza Strip (n=150). Families will be randomized into the intervention condition (PPFF) or treatment as usual (TAU). Each territory will have an implementing partner, and implementing partners and investigators will work together to ensure the study procedures are implemented in parallel across sites. Data collection will be conducted by trained research staff from a third-party survey and policy research organization. The proposal seeks to shift current research and clinical paradigms in these contexts by employing novel theoretical concepts, approaches, and methodologies. The contribution will be significant by 1) further developing new directions for empirically-based interventions in these high-risk contexts, and 2) advancing a relatively brief, cost-effective program that can be readily implemented to help children and families exposed to continuing conflict in Palestine, with the potential to be brought to scale in other contexts.