Transdisciplinary Approach to Understand Variability in Preventive Intervention O

跨学科方法来理解预防性干预的可变性

• 批准号: 8247133
• 负责人: Celene Domitrovich
• 金额: $ 81.9万
• 依托单位: RESEARCH TRIANGLE INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8247133
• 关键词: Academic achievement; Address; Area; Arousal; Baltimore; Behavior Disorders; Behavioral; Brain; Child; Cities; Clinical Trials Design; Cognitive; Communities; Development; Discipline; Educational workshop; Elements; Emotional; Exhibits; Fostering; Generations; Goals; Incentives; Individual Differences; Intervention; Intervention Studies; Intervention Trial; Interview; Investigation; Knowledge; Legitimacy; Measures; Mediating; Mediation; Mediator of activation protein; Modeling; Monitor; Neurobiology; Neurocognition; Neurosciences; Outcome; Parents; Participant; Pathway interactions; Pharmaceutical Preparations; Physiological; Physiology; Population; Prevention; Prevention Research; Prevention program; Preventive; Preventive Intervention; Problem behavior; Process; Protocols documentation; Psychopathology; Refractory; Regulation; Relative (related person); Research; Risk; Risk Behaviors; Role; School-Age Population; Schools; Science; Self-control as a personality trait; Staging; Stress; Students; Subgroup; Symptoms; System; Teenagers; Telephone Interviews; Testing; Theoretical model; Thinking; Treatment Efficacy; Work; Youth; active control; base; brief intervention; cognitive function; cognitive neuroscience; cohort; cost effectiveness; design; developmental psychology; elementary school; emotion regulation; evidence base; experience; externalizing behavior; falls; first grade; follow-up; high risk behavior; improved; innovation; intervention effect; kindergarten; optimism; peer; post intervention; programs; public health relevance; randomized trial; response; second grade; skills; teacher; theories; universal prevention

DESCRIPTION (provided by applicant): Identifying which interventions work best for who is a critical, yet unresolved, issue in prevention science. There has been a paucity of research on underlying mechanisms by which change occurs in prevention models with early school-aged children in spite of growing evidence that a high level of brain plasticity characterizes the early stages of development, providing an optimal window of opportunity. Moreover, no school-based prevention trials have utilized a model of intervention responsively that incorporates the new generation of scientific disciplines, thus limiting the ability to address these issues in an integrated and translational fashion. Existing studies also lack measures reflective of processes (e.g., neurocognition and physiology) shown to modulate skills (e.g., inhibitory control and emotion regulation) that have repeatedly been implicated in high-risk behaviors. To fill these gaps in knowledge, the proposed 5-year R01 study would be the first in-depth school-based intervention trial that infuses relevant aspects of cognitive neuroscience with existing theories of developmental psychology and prevention science. The ultimate goal is to identify underlying conditions (inhibitory control and emotional regulation) that may serve to both mediate and moderate intervention effects in the early years of schooling. Accordingly, we propose to conduct a theory-driven examination of Promoting Alternative Thinking Strategies (PATHS), an evidence- based model with replicated outcome effects, to understand how the intervention works and for whom. The PATHS program will be implemented in kindergarten classrooms through first grade in 2-3 schools (Ne150) with an additional 2-3 schools as an active control condition (Ne150) using a randomized trial design. These Baltimore City schools serve a demographically mixed community with relatively low academic achievement and a high level of behavioral problems. Two cohorts of kindergartners will receive PATHS for two consecutive years, while the control school will receive professional development workshops as well as incentives, testing, and observations similar to the experimental schools. Pretesting will be conducted in the fall of K to assess background and behavioral factors, cognitive functioning, and emotional regulation (measured by physiological stress reactivity). Measures will be repeated once at the completion of the school year, again at the end of first grade, and then a follow-up at 6 months following program completion during second grade for each cohort. Directly following from the recent conceptual and empirical work of the study team and others, this study represents a substantial innovation with implications for reducing behavioral disorders in youths. It is critical to identify underlying bases for individual differences in intervention responsively to tailor preventive approaches to specific needs of subgroups, thereby enhancing efficiency, cost-effectiveness, and maximization of impact. PUBLIC HEALTH RELEVANCE: Collaborative transdisciplinary work integrating developmental psychopathology, neuroscience, and prevention science promises to significantly advance not only an etiological understanding of risk behaviors but also of variability in intervention efficacy via the use of a multiple-levels approach. There is a clear scientific need to examine both mediators and moderators of preventive intervention effects to better understand their mechanisms of action. The proposed study will identify underlying conditions that mediate ultimate outcomes of a model preventive intervention to substantially improve our ability to monitor program effects and target program components. Use of a multiple-levels approach such as the one proposed herein offers optimism that preventive intervention research will continue to advance in terms of its sophistication and comprehensiveness, and translational efforts to develop interventions that promote resilient functioning will be fostered. Ultimately, knowledge generated from this study will highlight areas in need of improvement for a class of preventive interventions that are used in many U.S. elementary schools, as well as the design of new components that are better suited to various subgroups.

描述（由申请人提供）：确定哪些干预措施最适合谁，是预防科学中一个关键但尚未解决的问题。尽管越来越多的证据表明，高水平的大脑可塑性是发育早期阶段的特征，提供了最佳的机会之窗，但对学龄儿童预防模式发生变化的潜在机制的研究仍然很少。此外，没有任何基于学校的预防试验利用了包含新一代科学学科的响应式干预模式，从而限制了以综合和转化方式解决这些问题的能力。现有研究还缺乏反映调节技能（例如抑制控制和情绪调节）的过程（例如神经认知和生理学）的措施，而这些技能反复与高风险行为有关。为了填补这些知识空白，拟议的为期 5 年的 R01 研究将是第一个深入的基于学校的干预试验，它将认知神经科学的相关方面与现有的发展心理学和预防科学理论相结合。最终目标是确定可能在学校教育早期起到中介和调节干预作用的潜在条件（抑制控制和情绪调节）。因此，我们建议对促进另类思维策略（PATHS）进行理论驱动的检查，这是一种具有可复制结果效果的循证模型，以了解干预措施如何发挥作用以及对谁有效。 PATHS 计划将在 2-3 所学校 (Ne150) 的幼儿园教室到一年级实施，另外 2-3 所学校将采用随机试验设计作为主动控制条件 (Ne150)。这些巴尔的摩市的学校服务于人口结构复杂的社区，其学业成绩相对较低，行为问题也较多。两组幼儿园学生将连续两年接受 PATHS，而对照学校将接受专业发展研讨会以及与实验学校类似的激励、测试和观察。预测试将在 K 秋季进行，以评估背景和行为因素、认知功能和情绪调节（通过生理应激反应来衡量）。这些措施将在学年结束时重复一次，一年级结束时再次重复，然后在二年级课程完成后的 6 个月内对每个队列进行跟进。这项研究直接继承了研究小组和其他人最近的概念和实证工作，代表了一项重大创新，对减少青少年行为障碍具有重要意义。至关重要的是要及时确定干预中个体差异的根本基础，以便根据亚群体的具体需求制定预防方法，从而提高效率、成本效益和影响最大化。 公共卫生相关性：整合发展精神病理学、神经科学和预防科学的跨学科合作工作有望通过使用多层次方法，不仅显着促进对危险行为的病因学理解，而且促进对干预效果变异性的理解。显然，科学需要检查预防性干预效果的中介因素和调节因素，以更好地了解其作用机制。拟议的研究将确定介导模型预防性干预最终结果的潜在条件，以大幅提高我们监测计划效果和目标计划组成部分的能力。使用多层次方法（例如本文提出的方法）令人乐观地认为，预防性干预研究将在其复杂性和全面性方面继续进步，并且将促进开发促进弹性功能的干预措施的转化努力。最终，这项研究产生的知识将突出显示许多美国小学使用的一类预防干预措施需要改进的领域，以及更适合各个亚群体的新组件的设计。