PRINCIPAL RESEARCH CORE

主要研究核心

• 批准号: 7677752
• 负责人: NICHOLAS IALONGO
• 金额: $ 81.63万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7677752
• 关键词: Academic achievement; Address; Adolescent; Affect; Aggressive behavior; Baltimore; Behavior; Behavior Disorders; Behavior Therapy; Burn injury; Child; Chronic stress; Cities; Communities; Conflict (Psychology); Data; Development; Discipline; Disease; Drops; Early treatment; Educational Curriculum; Educational process of instructing; Effectiveness; Emotional; Employee; Ensure; Environment; Evaluation; Exclusion Criteria; Exhibits; Failure; Family; Feasibility Studies; Funding; Health Professional; Health Services Research; High Prevalence; Impairment; Incidence; Individual; Institutes; Institution; Intervention; Learning; Link; Mainstreaming; Manuals; Mental Health; Mental disorders; Mission; Modeling; Normal Range; Outcome; Ownership; Participant; Pathway interactions; Peer Group; Policy Maker; Preparation; Prevalence; Prevention; Prevention program; Preventive; Preventive Intervention; Problem Solving; Process; Programmed Learning; Provider; Psyche structure; Psychotherapy; Randomized; Recording of previous events; Research; Research Design; Research Methodology; Research Personnel; Resolution; Risk; School Teachers; Schools; Scientist; Services; Social Behavior; Social Development; Social Problems; Social Values; Structure; Students; Substance abuse problem; System; Testing; Thinking; Toddler; Training; United States Substance Abuse and Mental Health Services Administration; Work; Youth; anti social; base; checkup examination; clinical epidemiology; coping; depression; deviant; disability; dosage; drug-free school; early starter; effective intervention; effectiveness research; effectiveness trial; elementary school; emotion regulation; evidence base; high risk; improved; indicated prevention; innovation; meetings; middle school; prevent; programs; research study; science education; skills; social; success; teacher; universal prevention

There is a need to move from efficacy to effectiveness research. Researchers affiliated with the JHU CPEI have a long history of conducting research on the intersection between efficacy (e.g., randomization of teachers and students at the level of classroom, within school controls, rigorous training of teachers and mental health professionals, and intervention manuals) and effectiveness (e.g., the absence of participant exclusion criteria, the teachers and other interveners were employees of the schools, not randomly assigned) (e.g., lalongo et al., 2001; Bradshaw et al., in press). Recent research reviews of efficacy studies document the growing number of preventive interventions that either reduce the onset of common mental disorders or decrease the duration and disability of initial episodes of these disorders (Burns et al., 2002; Coie et al., 1993; Greenberg et al., 1999, 2001; Hawkins & Catalano, 2004; Kazdin, 2000; National Advisory Mental Health Council's Services Research and Clinical Epidemiology Workgroup, 2006; Olds et al., 1999; Rones & Hoagwood, 2000; SAMHSA, 2007; Weisz et al., 2005; Wilson & Lipsey, 2007). Federal initiatives, (e.g., Safe Schools/Healthy Students and the Safe and Drug Free School Program) require applicants to use empirically validated interventions. Despite the large number of efficacy studies that demonstrate effective prevention or problem reduction when treated early, few studies examine (1) whether efficacious programs exhibit equally positive outcomes when implemented in natural service/treatment settings; (2) how dosage and quality of implementation affect outcomes; (3) how different program models and training strategies affect outcomes; and (4) the conditions necessary for successful program outcomes in natural settings with local ownership of the intervention process (Mrazek & Haggerty, 1994). The next challenge facing prevention and intervention scientists is to help practitioners put effectively "proven programs" into practice and achieve the same outcomes as observed in research studies. There is a continuing need for research on the combination of evidence-based and promising universal interventions. In addition to the aim of moving from efficacy to effectiveness, we will continue to address the need for integrated prevention models that seamlessly combine different types of universal interventions at the elementary school level (K-5). Currently, there is little integration between models and thus schools are not able to systematically integrate different universal program strategies (e.g., school-wide discipline, individual teacher support for classroom management, social-emotional learning programs). Neither developers nor services researchers have made substantial effort to integrate programs and develop combined packages that schools can implement. We began this work in our current ACISR with an innovative model that integrates the Good Behavior Game (GBG; Barrish et al., 1969) and Promoting Alternative Thinking Strategies (PATHS; Greenberg & Kusche, 2004) (referred to as GBG+ PATHS). Strong pilot findings under ACISR funding has led us to recently receive funding from the Institute of Education Sciences (IES) for a 27-school, randomized controlled evaluation of GBG+PATHS versus GBG alone and standard setting (control).The proposed school-based intervention work we now propose includes pilot testing of the combination of complimentary, evidenced-based, universal interventions. As described in PRC Initiative 1, we are proposing to combine Positive Behavior Intervention Supports (PBIS; Sugai & Horner, 2006) and Classroom Checkup (CCU; Reinke et al., 2007) with the GBG+PATHS combination. We expect that the combination of PBIS and CCU should further improve teacher implementation of GBG+PATHS and in turn increase their impact on early aggressive and, later antisocial behavior, substance abuse, and depression. There is a need for universal, selective, and indicated preventive interventions at multiple developmental periods. While continuing to focus on the elementary school years, K to grade 5, we are proposing to extend our intervention efforts to the middle school years. This new focus on middle school years, as reflected in PRC Initiatives 2-4, focuses on the further development of anti-social behavior that is shown by both "early" and "late starter" models as described by Patterson et al. (1992) and others (Moffitt, 1993). According to Patterson and colleagues, there are at least two major pathways or trajectories to serious antisocial behavior, substance abuse, and academic failure (also see Moffitt, 1993). The "early starter" trajectory begins in the toddler years, when parental success in teaching their child to interact within a normal range of compliance and aversive behavior is a prerequisite for the child's healthy social development. The second pathway - the "late starters" - characterizes the relatively high prevalence of late onset antisocial behavior and academic failure in the middle school years. Given the high rate of adolescent aggression, delinquency and school failure in high-risk urban environments, developing both universal and indicated interventions in the middle school years are essential to the reduction in disruptive aggression, delinquency, and school failure/drop-out. In the middle-school period programs are needed that both support teachers and schools to create safe and orderly school and classroom environments, further teach essential social and emotional skills (i.e. skills in emotion regulation, social problem solving and conflict resolution skills), and develop effective school-based indicated interventions that can be used by school-based professional staff. Without these multi-level models of intervention, it is likely that at-risk middle school students will drift into a deviant peer group, where antisocial behavior, substance abuse, poor academic achievement, and rejection of mainstream social values, mores and institutions are reinforced. Moreover, these youth will lack the necessary social survival skills to succeed as in the school, peer group, and family social fields and are at increased for depression (Patterson et al., 1982). Consequently, a sole focus on early intervention efforts may fail to address the needs of youth. Consistent with our second overarching aim, PRC Initiative 2 involves the pilot and feasibility testing of an extension of our K-5 integration of GBG+PATHS for grades 6-8. In PRC Initiative 3, we will develop and test the impact of another universal prevention program for middle school youth which aims to prevent depression using a classroom-based preventive intervention. As described above, the Patterson model suggests that depression may be a consequence of antisocial behavior, particularly in the middle school years. Thus, we are proposing to test alternative delivery models of the Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS) curriculum with BCPSS sixth graders. Finally, at the indicated level, PRC Initiative 4 seeks to develop and pilot test a developmental extension of Coping Power (Lochman & Wells, 1007) for grades 6-8. Coping Power was originally developed for aggressive/disruptive 4 and 5th graders and our current ACISR has been testing the feasibility of Coping Power in BCPSS to ensure it addressed contextual and cultural factors relevant to urban youth. In the current application, we propose to make developmental adaptations to the Coping Power Program and make other augmentations to increase generalizability and parental engagement during the middle school years.

有必要从功效转变为有效性研究。研究人员隶属于JHU CPEI 有关于疗效之间相交的研究的悠久历史（例如，教师的随机化和 教室级别的学生，在学校控制中，对教师的严格培训和心理健康 专业人士和干预手册）和有效性（例如，缺乏参与者排除标准， 教师和其他干预者是学校的雇员，而不是随机分配）（例如，Lalongo等人，2001年； Bradshaw等人，印刷中）。效力研究的最新研究评论记录了预防性的越来越多 减少常见精神疾病发作或减少持续时间和残疾的干预措施 这些疾病的初始发作（Burns等，2002; Coie等，1993; Greenberg等，1999，2001; Hawkins＆＆ 加泰罗尼亚，2004年；卡兹丁，2000年；国家咨询心理健康委员会的服务研究和临床 流行病学工作组，2006年； Olds等，1999； Rones＆Hoagwood，2000年； Samhsa，2007年； Weisz等，2005; Wilson＆Lipsey，2007年）。联邦倡议（例如，安全学校/健康的学生以及无安全毒品 学校课程）要求申请人使用经验验证的干预措施。尽管有大量功效 表明早期治疗后有效预防或减少问题的研究，很少有研究检查（1） 在自然服务/治疗中实施时，有效的计划是否表现出同样积极的结果 设置; （2）剂量和实施质量如何影响结果； （3）不同的程序模型和 培训策略会影响结果； （4）自然成功计划成果所必需的条件 具有干预过程的本地所有权的设置（Mrazek＆Haggerty，1994）。面对的下一个挑战 预防和干预科学家是帮助从业人员有效地将“经过验证的计划”付诸实践，并 达到与研究中观察到的相同结果。 持续需要研究循证和有希望的普遍的结合 干预措施。除了从疗效转向有效性的目的外，我们还将继续满足需求 对于集成的预防模型，在基础上无缝结合不同类型的通用干预措施 学校级别（K-5）。目前，模型之间几乎没有集成，因此学校无法 系统地整合不同的通用计划策略（例如，范围的学科，个人老师 支持课堂管理，社会情感学习计划）。开发人员也不服务 研究人员已经付出了巨大的努力，以整合计划并开发学校可以可以 实施。我们以创新的模型在当前的ACISR中开始了这项工作，该模型整合了良好的行为 Game（GBG； Barrish等，1969）并促进其他思维策略（路径； Greenberg＆Kusche， 2004）（称为GBG+路径）。 ACISR资金下的强大试点调查结果使我们最近收到 教育科学研究所（IES）的资助 GBG+路径与单独使用GBG和标准设置（控制）。拟议的基于学校的干预工作我们 现在建议的包括对基于免费的，基于证据的普遍干预措施的组合进行试验测试。 如PRC倡议1中所述，我们提议结合积极的行为干预支持（PBIS； Sugai ＆Horner，2006年）和教室检查（CCU; Reinke等，2007）具有GBG+路径组合。我们期望 PBI和CCU的组合应进一步改善教师的GBG+路径的实施，进而 增加对早期侵略性和后来反社会行为，药物滥用和抑郁的影响。 需要在多个发展中进行通用，选择性和指示的预防性干预措施 时期。在继续专注于小学时代，K至5年级，我们建议扩展我们的 干预努力为中学时代。正如中国倡议所反映的那样，这是对中学年的新重点 2-4的重点是“早期”和“晚开始者”所显示的反社会行为的进一步发展 如Patterson等人所述的模型。 （1992）等（莫菲特，1993）。根据帕特森及其同事的说法 至少有两种主要的途径或轨迹来实现严重的反社会行为，滥用药物和学术 失败（另请参见Moffitt，1993）。 “早期起动器”轨迹始于幼儿时代，当时父母的成功 教孩子在正常的合规性和厌恶行为范围内进行互动是一个先决条件 孩子的健康社会发展。第二个途径 - “晚开始者” - 表征相对较高的特征 在中学时代，晚期发作反社会行为和学术失败的率。鉴于高率 在高风险城市环境中的青春期侵略，犯罪和学校失败，发展两者 在中学年份中指出的干预措施对于降低破坏性侵略至关重要， 犯罪和学校失败/辍学。在中学期间，都需要两个支持 教师和学校创建安全，有序的学校和课堂环境，进一步教授基本社交 和情感技能（即情绪调节的技能，社会问题解决和解决冲突技能），并且 开发有效的基于学校的指示干预措施，可以由学校的专业员工使用。没有 这些多层次的干预模式，处于危险的中学生可能会陷入一个异常的同伴 小组，反社会行为，滥用药物，学术成就不佳以及对主流社会的拒绝 价值观，道德和机构得到加强。而且，这些年轻人将缺乏必要的社会生存技巧 在学校，同伴小组和家庭社会领域取得成功，并增加了抑郁症（Patterson等人， 1982）。因此，唯一关注早期干预工作可能无法解决青年的需求。 与我们的第二个总体目标一致，PRC Initiative 2涉及飞行员和可行性测试 我们的K-5集成GBG+路径的扩展为6-8年级。在中国倡议3中，我们将开发和测试 另一个对中学青年的普遍预防计划的影响，旨在防止使用 基于课堂的预防性干预。如上所述，帕特森模型表明抑郁症可能 是反社会行为的结果，尤其是在中学时代。因此，我们建议测试 针对慢性压力的青少年的结构性心理治疗的替代分娩模型 （SPARCS）课程与BCPSS六年级学生。最后，在指示的水平上，中国倡议4试图发展 和试点测试6 - 8年级的应对能力的发展扩展（Lochman＆Wells，1007）。应对能力 最初是针对侵略性/破坏性4和5年级的开发的，我们目前的ACISR一直在测试 在BCPS中应对能力的可行性确保它解决了与城市青年有关的上下文和文化因素。 在当前的应用程序中，我们建议对应对能力计划进行发展的适应 在中学期间，增加了增加可推广性和父母参与度的增强。