Theory-driven, human-centered design-based adaptation and pilot test of an intervention to reduce interparental conflict to prevent children's mental health problems after separation/divorce

以理论为驱动、以人为中心的设计为基础的干预措施的适应性和试点测试，以减少父母间冲突，预防分居/离婚后儿童的心理健康问题

• 批准号: 10609051
• 负责人: Karey O'Hara
• 金额: $ 27.48万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10609051
• 关键词: Address; Administrator; Adopted; Adoption; Age; Child; Child Mental Health; Collaborations; Conflict (Psychology); County; Data; Decision Making; Development; Diagnosis; Disease; Divorce; Evidence based intervention; Exposure to; Family; Focus Groups; Foundations; Goals; High Prevalence; Hour; Hybrids; Individual; Intervention; Intervention Trial; Interview; Investigational Therapies; Legal; Link; Longevity; Longitudinal Studies; Mediator; Mental Health; Mental disorders; Methods; National Institute of Mental Health; Outcome; Parents; Partnership Practice; Persons; Population; Process; Public Health; Questionnaires; Randomized; Randomized, Controlled Trials; Recording of previous events; Reporting; Research; Research Personnel; Resources; Risk; Services; Shorthand; Strategic Planning; Structure; Subgroup; Surveys; System; Techniques; Testing; Treatment/Psychosocial Effects; United States National Institutes of Health; court; design; digital; divorce/separation; effectiveness/implementation trial; evidence base; experience; heuristics; high risk sexual behavior; human centered design; implementation framework; implementation outcomes; improved; interest; intervention refinement; peer; pilot test; prevent; programs; prototype; psychosocial; service providers; skills; societal costs; substance use; suicidal; theories; therapy design; therapy development; usability

PROJECT SUMMARY/ABSTRACT: About half of children in the U.S. experience parental divorce prior to age 16. Parental divorce confers risk for various mental health problems and disorders throughout the lifespan that incur significant individual and societal costs. Exposure to high levels of interparental conflict (IPC) accounts for much of this increased risk. The high prevalence of parental divorce, its significant public health burden, and the strong link between IPC and children's mental health problems highlight the importance of interventions that reduce post- separation/divorce IPC. Many family courts mandate high-IPC separated/divorcing parents to attend interventions but none of the currently implemented interventions has been rigorously evaluated. Although two interventions have reduced IPC in divorced families in randomized controlled trials, neither has been adopted as a service by family courts, and thus are not reaching high-IPC parents. The current project represents a foundational step toward reducing the public health burden of parental divorce by developing and testing a scalable intervention to reduce IPC. It will use an established adaptation framework and human-centered design (HCD) methods to develop a relevant, useful, and engaging intervention for high-IPC parents that will be adopted and sustained by family courts. The project will adapt strategies from the two rigorously evaluated interventions that have reduced IPC; follow an established framework for adapting interventions; use HCD, which has been shown to improve effects and scalability of psychosocial interventions; and use state-of-the-art analytic techniques. We will analyze results from a survey of family court judges and administrators to determine the intervention format (i.e., digital, in-person, hybrid). In semi-structured interviews and focus groups, court-based service providers and high-IPC parents will provide qualitative and quantitative data about the intervention content and engagement strategies. These data will be used to develop a prototype of the intervention. Input from an advisory board, which consists of a judge, an administrator, a service provider, and four parents, and data from user testing sessions with parents and service providers will be used to refine the intervention. The randomized pilot will consist of parents mandated by judges to attend the new intervention or the existing court program. Parents will opt in or out of the research component. Qualitative and quantitative methods will be used to collect data on acceptability, feasibility, appropriateness, and usability as well as parents' use of the intervention skills. Before and after participation, parents will complete questionnaires on IPC and child mental health problems. The specific aims are to: 1) Use HCD methods to develop an intervention that fits with the family court and is contextually appropriate for high-IPC separated/divorcing parents and 2) Pilot test the intervention with high-IPC families ordered to attend by the court. This proposal advances NIMH's strategic plan (3.2, 4.2), which encourages investigators to adapt existing interventions to optimize outcomes and leverage effective research-practice partnerships with stakeholders to develop scalable interventions.

项目摘要/摘要： 美国约有一半的儿童经历了16岁之前的父母离婚。父母离婚赋予了风险 在整个生命周期中，各种心理健康问题和疾病都引起了重要的个体和 社会成本。暴露于高水平的父母冲突（IPC）占这种风险的大部分。 父母离婚的高流行，其巨大的公共卫生负担以及IPC之间的牢固联系 儿童的心理健康问题强调了干预措施的重要性，以减少后 分离/离婚IPC。许多家庭法院要求高级IPC分居/离婚父母参加 干预措施，但目前实施的干预措施均未进行严格评估。虽然两个 在随机对照试验中，离婚家庭中的IPC减少了，两者都没有采用 作为家庭法院的服务，因此没有到达高IPC父母。当前项目代表 通过开发和测试A来减轻父母离婚的公共卫生负担 可扩展干预以减少IPC。它将使用已建立的适应框架和以人为本的框架 设计（HCD）方法是为高IPC父母开发相关，有用和引人入胜的干预措施 被家庭法院采用和维持。该项目将调整两个严格评估的策略 减少IPC的干预措施；遵循既定框架进行调整干预措施；使用HCD， 已显示可改善社会心理干预的效果和可伸缩性；并使用最新的 分析技术。我们将分析家庭法官和管理人员的调查结果 确定干预格式（即数字，面对面，混合动力）。在半结构化访谈和焦点小组中， 基于法院的服务提供商和高级IPC父母将提供有关有关的定性和定量数据 干预内容和参与策略。这些数据将用于开发干预的原型。 顾问委员会的投入，该委员会由法官，管理员，服务提供商和四个父母组成，以及 用户测试与父母和服务提供商的数据将用于完善干预措施。这 随机飞行员将由法官要求参加新干预或现有法院的父母组成 程序。父母会选择进出研究部分。定性和定量方法将使用 收集有关可接受性，可行性，适当性和可用性的数据，以及父母的使用 干预技能。参与之前和之后，父母将填写有关IPC和儿童精神的问卷 健康问题。具体目的是：1）使用HCD方法开发与该干预措施 家庭法院，在上下文上适用于高级IPC分居/离婚的父母，2）试点测试 与法院下令参加的高级IPC家庭的干预。该提议提高了NIMH的战略 计划（3.2，4.2），该计划鼓励调查人员适应现有干预措施，以优化结果和 利用与利益相关者建立可扩展干预措施的有效研究实践伙伴关系。