Prevention Science最新文献

To identify factors in adolescence that predict the onset of sexual violence in adolescence and young adulthood. Data were analyzed from six survey waves of the longitudinal Growing up with Media Study (2008-2018) conducted in the USA. Participants were 778 youth 13-18 years old at baseline, who completed online surveys assessing sexual violence behaviors and predictors. Sexual violence perpetration behaviors included sexual assault, rape, attempted rape, and coercive sex. Only 2% of females and 3% of males reported their first sexual violence perpetration by age 14. In contrast, by age 18, 6% of females and 12% of males had perpetrated their first sexual violence. For both males and females, the rate of the onset seems to plateau by age 22. Predictors of the onset of sexually violent behavior for those who began perpetrating when they were 14-17 years old were largely similar to those who began perpetrating when they were 18-25 years old. Alcohol plus other substance use, aggressive and delinquent behavior, caregiver monitoring, behavior problems at school, externalizing peers, exposure to community violence, and exposure to violent media were all implicated. Early prevention-well before college and perhaps even before high school-is needed to have an impact on the onset of sexual violence perpetration, as most perpetrators of sexual violence will have acted for the first time by age 23. Several modifiable risk factors observed in adolescence could signal the opportunity for targeted prevention to reduce the odds of onset of sexual violence.

Canada lacks an approach to early childhood mental health prevention aimed at decreasing barriers to care among highest-needs families. In this Canadian randomized controlled trial, we aimed to evaluate whether participation in the Family Check-Up® (FCU®) would be associated with lower severity of child behavior problems (primary outcome) and caregiver psychological distress and daily parenting stress (secondary outcomes). Eligible caregivers of children aged 2-4 years with (i) high severity of behavior problems and/or (ii) above-average severity plus ≥ 1 family psychosocial risk factor were recruited from early education, community, and clinical settings in Hamilton, Ontario. Randomization: either the FCU® or a community comparison arm (206 analyzed of 207 enrolled). Caregiver reports on their child's behavior problems (primary outcome, Child Behavior Checklist Externalizing Problems Scale), caregiver psychological distress, and daily parenting stress (secondary) were obtained 12 months after study enrolment, and rates of change were modeled over 0, 6, and 12 months. FCU® participants reported lower child behavior problem severity scores 12 months post-enrolment than did community comparison participants (d = 0.38, p < 0.01). Caregiver psychological distress (d = 0.17, p = 0.3) and parenting stress (d = .05, p = 0.8) did not differ significantly between arms. FCU® participants reported improvements in the severity of child behavior problems, relative to a community comparison group, but not in caregiver distress or parenting stress at 12 months. Positive results for primary outcome indicate the FCU's® promise as an effective child mental health prevention program in Canada. Further evaluation of intensified caregiver mental health supports may be warranted. Trial registered at Clinicaltrials.gov (#NCT02800603).

This commentary responds to the paper recently published in Prevention Science, entitled "The Promise and Challenges of Integrating Biological and Prevention Sciences: A Community-Engaged Model for the Next Generation of Translational Research" by Leve and colleagues (2024). A framework is advanced to provide a rationale for and facilitate the difficult and oft-avoided task of integrating concepts, techniques, methods, and datasets from diverse disciplines. The unfortunate reality is that disciplines germane to prevention continue to be highly siloed. The field of prevention science stands to benefit from knowledge that leads to greater precision-based-and thereby more effective-approaches to intervention. What is particularly underappreciated is the potential for this information to also guide policymaking based on what we could learn about the social-ecological conditions that impact child and youth brain and behavioral development and are alterable in response to evidence-informed public health policies. In this commentary, we offer some context for and appraisal of the paper and provide additional rationale for a precision-based approach with appropriate precautions for the research and utility of findings. Discussion ensues on the economic pros and cons and the policy implications of this integrative "neuroprevention" strategy should the field of prevention science accept the challenge.

Understanding the factors contributing to adolescent antisocial behavior is crucial for effective interventions. Protracted development of cognitive control systems supporting inhibitory control may be linked to increases in adolescent antisocial behavior, suggesting the promotion of inhibitory control as a potential preventative strategy. Concurrently, social contextual factors, including peer relationships, parent-child dynamics, and the neighborhood environment, may exacerbate or buffer the risk posed by low inhibitory control. In a large, longitudinal sample of youth from racially and ethnically diverse low-income families (N = 731), we examined the association between inhibitory control (age 10.5) and antisocial behavior (age 14) and explored contextual factors (neighborhood, peer relationships, parent-child relationship) as potential moderators. Lastly, we investigated whether a randomized controlled trial of the Family Check-Up (FCU) intervention started at age 2 predicted a decreased youth report of antisocial behavior in adolescence via increased inhibitory control in late childhood. We found that lower inhibitory control in late childhood predicted increased antisocial behavior in adolescence. For youth with low inhibitory control, living in a dangerous neighborhood or associating more with deviant peers increased the risk for adolescent antisocial behavior. Finally, the FCU intervention indirectly reduced youth-reported adolescent antisocial behavior via enhancing inhibitory control in late childhood, and the indirect effect was strongest for youth in risky contexts (e.g., low parental knowledge and control). Although risky contexts can exacerbate individual risks related to deficits in inhibitory control, greater inhibitory control may be a protective factor. Additionally, early childhood interventions can improve inhibitory skills and decrease the risk of adolescent antisocial behavior, particularly for youth within risky contexts.

This study evaluated direct and indirect effects of the Family Check-Up Online (FCU-O) across two distinct randomized trials with middle school youth and families. The FCU-O is a digital health adaptation of the Family Check-Up that is delivered in a brief, online format with supportive coaching. The FCU-O was delivered to parents of middle school youth with a focus on targeting both proximal and distal outcomes that impact the development of conduct problems, including a range of parenting skills, effortful control, and youth emotional problems. Participants were primary caregivers of children aged 10 to 14 years. Eligibility varied across the trials and included endorsing depression or significant stress, or having a child enrolled in a school with limited resources. A total of 374 participants across trials were included in the analysis and were randomly assigned to receive the intervention or control. Using Integrative Data Analytic techniques, we examined the effects of random assignment on a range of outcomes, including emotional and behavior problems, parenting skills, parenting confidence, and effortful control. We examined the indirect effects of the FCU-O on changes in conduct problems from baseline to 6 months via changes in mediator variables at the first follow-up assessment (2-3 months). The FCU-O improved emotional problems, effortful control, parenting confidence, and parent sense of importance at the first follow-up. Mediation analyses suggested indirect effects on conduct problems at 6-month follow-up via improvements in effortful control and emotional problems, but not via improvements in parenting confidence or sense of parenting importance. Results indicate the FCU-O has potential as a public health intervention for families with middle school youth to reduce behavioral risk. ClinicalTrials.gov Identifier: NCT03060291; NCT05117099.

Cogent indicated prevention with young children at risk for early onset conduct problems needs to address multiple domains of influence in school and home settings. A multicontextual preventive intervention (MPI) spanning grades one and two was conducted in schools serving economically disadvantaged communities and evaluated separately for boys and girls. The cluster randomized design evaluated children nested within schools receiving either the MPI (6 schools), which consisted of after-school reading-mentoring, home-based family, peer coping-skills, and classroom components, or a control condition (6 schools) involving a school-wide conflict management program without targeted intervention. Drawn at the end of kindergarten based on elevated behavioral difficulties and first-grade attendance at one of the 12 schools, the two subsamples consisted of 193 boys and 171 girls (63% in households with annual income < $15,000; 95% Black children). Extensive fidelity data indicated that the MPI components were well implemented. The two post-intervention third-grade outcomes in this report are academic performance and social/behavioral adjustment. The analyses involved a linear mixed effects model controlling for school. The key finding for the male subsample was that the MPI produced greater overall and language-arts/reading achievement, measured by report cards for the entire third-grade school year, compared with the control group. MPI-control differences did not emerge for externalizing problems and social competence assessed via teacher and parent report. In the face of elevated risk and poverty, the study underscored the importance of contributions from community-based reading-mentors, positive and inclusive classrooms, and nurturing family contexts in achieving academic gains.

Theoretical models and empirical research have highlighted the impact of economic disadvantage on children's psychosocial development broadly and the onset, maintenance, and treatment of early-onset (3-8 years) behavior disorders (BDs) more specifically. In the context of intervention, evidence suggests that economic disadvantage may pose risk for diminished parent-mediated treatment efficacy (e.g., Behavioral Parent Training [BPT]) given its impact on salient factors in the family system. Though, studies have shown significant variability in BPT outcomes within families experiencing economic disadvantage, suggesting that additional influences may further contribute to disparities in the trajectory of treatment and maintenance of treatment gains for this population. To address this gap in existing knowledge, financial strain, or the inability to meet financial needs, was examined in families (N = 54) of young children (3-8 years old) with low-income and clinically elevated behavior problems participating in one BPT program, Helping the Noncompliant Child (HNC). Results demonstrated that families who experienced greater levels of financial strain prior to engaging in HNC exhibited diminished maintenance of parent reported child behavior gains following treatment. Financial strain did not significantly influence rate of change or maintenance of treatment gains for HNC clinician-coded child compliance. Clinical implications and directions for future research are discussed. ClinicalTrials.gov Identifier: NCT02191956, registered on 6/18/2014.

High-quality supervision for teachers in early care and education (ECE) is essential for building positive teacher-child relationships and enhancing ECE program quality, which in turn promotes healthy social-emotional and academic development in young children. Reflective supervision (RS) is a process-oriented and relationship-centered supervisory approach that has growing empirical evidence supporting its use. As the evidence base for RS continues to expand, and early childhood-serving settings-including ECE-increasingly consider this approach, understanding whether RS is likely to be routinely used in ECE settings and what helps or hinders use of this approach is critically important. Thus, the aims of this study were to assess the feasibility, acceptability, and appropriateness of RS in state-funded pre-Kindergarten (state pre-K) programs, as well as delineate the implementation determinants that either advanced or challenged the use of RS in state pre-K. This study was informed and guided by the updated Consolidated Framework for Implementation Research (CFIR) and the CFIR Outcomes Addendum. Participants included 11 state pre-K program supervisors who had been trained in RS. Participants completed brief measures of feasibility, acceptability, and appropriateness of RS, and semi-structured interviews. Descriptive analyses of quantitative measures revealed that participants perceived RS as feasible to implement in their programs, highly acceptable, and highly appropriate, thereby suggesting that RS is likely to be implemented successfully in this setting. Qualitative data obtained from interviews and coded using the updated CFIR lent greater nuance to these results by specifying the facilitators and barriers affecting implementation. All participants reported great need for RS at the supervisor, teacher, and child/family level, and identified numerous other facilitating factors within four CFIR domains (i.e., Innovation, Outer Setting, Inner Setting, and Individuals), ranging from the relative advantage of RS to individual supervisor motivation and capability. Participants also cited barriers to using RS, most notably staffing difficulties, competing demands, and lack of policy and leadership support. Through theory-driven implementation frameworks applied to a real-world ECE setting, these findings extend prior research suggesting that RS may be an effective supervisory approach by highlighting the contextual factors that make RS more or less likely to be adopted, used, and sustained in state pre-K.

Callous-unemotional (CU) traits are associated with severe conduct problems (CP) in youth. Causal theories for CU traits focus on emotion processing deficits that interfere with empathy development. However, though CU traits are consistently associated with deficits in affective empathy (i.e., emotional reactivity), the association between CU traits and cognitive empathy, which requires accurate emotion recognition, is less clear. We hypothesize that past inconsistencies in the associations between CU traits and emotion recognition may be due to interactions with conduct problems (CP) and age. To test this, a sample (N = 258) of school children in the 3rd, 6th, and 8th grades completed a computer task that assessed facial expression recognition, while caregivers and teachers reported on CU traits and CP. Results from hierarchical linear regression analyses indicated significant interactions between CU traits and CP in their associations with overall emotion recognition and with recognition of fearful and sad faces. In each case, CP showed a non-significant negative association with emotion recognition at high levels of CU traits. However, for fear and sadness recognition, CP was positively associated with accuracy at low levels of CU traits. Significant interactions between CU traits and age also emerged for recognition of fear and sadness, such that there were non-significant negative associations between CU traits and recognition accuracy in younger children, but significant positive associations in 8th grade students. These results have multiple implications as they help to clarify past inconsistencies on the association between CU traits and emotion recognition and can aid in the development of more effective interventions to prevent or treat conduct problems in young children.