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Heterogeneous Treatment Effects in the Incredible Years Teacher Classroom Management Programme - A Latent Profile Approach. 令人难以置信的学年教师课堂管理计划中的异质治疗效果--一种潜在特征方法。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-24 DOI: 10.1007/s11121-024-01733-3
Håvard Horndalen Tveit, Frode Stenseng

Heterogeneous effects from interventions often remain hidden in between-group analyses, risking overgeneralized conclusions of treatment effects. In this exploratory study, we performed latent profile analysis to unveil differential treatment effects among children in The Incredible Years Teacher Classroom Management Programme (IY TCMP). This program has previously been shown to reduce behavioral problems in preschools and schools in total samples and subgroups. A total of 726 children (48.7% girls; Mage = 4.21 years; SDage = 0.86) from 92 childcare centers in Norway participated in either the intervention (n = 338) or the matched control condition (n = 388). First, by conducting latent profile analysis on baseline levels of child-teacher relationship (closeness, conflict), behavioral problems, and social competence, three distinct profiles were identified: High Risk (26.4%), Moderate Risk (42.8%), and Low Risk (30.7%) - each profile with unique characteristics. Second, we tested for within-profile, condition-by-time interactions following the intervention, showing distinct treatment responses for each profile. High-risk profiles profited most from the IY TCMP, with a substantial decrease in externalizing problems, more teacher closeness, and less teacher conflict. Moderate-risk profiles also gained better teacher-child relationships and improved social competence. The Low-Risk profiles showed no effects from the intervention. It is argued that latent profile analysis presents a feasible approach for examining within-sample heterogeneity in intervention research. It also reveals crucial information on treatment variability, as demonstrated in the Incredible Years Programme.

在组间分析中,干预措施的异质性效果往往被掩盖,从而有可能得出过于笼统的治疗效果结论。在这项探索性研究中,我们进行了潜在特征分析,以揭示 "不可思议年 "教师课堂管理计划(IY TCMP)对儿童的不同治疗效果。该计划曾在总体样本和亚组样本中被证明能减少学前班和学校中的行为问题。来自挪威92个托儿所的726名儿童(48.7%为女孩;年龄:4.21岁;平均年龄:0.86岁)参加了干预项目(人数:338人)或匹配对照项目(人数:388人)。首先,通过对师幼关系(亲密程度、冲突)、行为问题和社交能力的基线水平进行潜特征分析,确定了三种不同的特征:高风险(26.4%)、中度风险(42.8%)和低风险(30.7%)--每个特征都有其独特性。其次,我们测试了干预后不同情况下不同时间的相互作用,结果显示每种情况都有不同的治疗反应。高风险学生从 IY TCMP 中获益最多,他们的外化问题大幅减少,与教师的关系更加亲密,与教师的冲突减少。中度风险幼儿也获得了更好的师幼关系和更高的社交能力。低风险儿童的干预效果不明显。本文认为,潜在特征分析是在干预研究中检查样本内异质性的一种可行方法。正如 "不可思议的岁月 "计划所展示的那样,它还揭示了有关治疗可变性的重要信息。
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引用次数: 0
Family Check-Up Online: Effects of a Virtual Randomized Trial on Parent Stress, Parenting, and Child Outcomes in Early Adolescence. 在线家庭体检:虚拟随机试验对青春期早期父母压力、养育子女和儿童结果的影响。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-24 DOI: 10.1007/s11121-024-01725-3
Anne Marie Mauricio, Katherine A Hails, Allison S Caruthers, Arin M Connell, Elizabeth A Stormshak

We adapted the Family Check-Up Online (FCU-O) (1) to support families coping with pandemic-related stressors to prevent behavioral and emotional problems among middle school youth and (2) for smartphone delivery to increase access and reach during the COVID-19 pandemic. This study evaluated the direct and indirect effects of the adapted FCU-O at 4-months post-baseline. The FCU-O combines online parenting support with telephone coaching. Participants were primary caregivers of children ages 10 to 14 years. Eligibility included endorsing depression on the PHQ-2 or significant stress on a 4-item version of the Perceived Stress Scale. We randomly assigned participants to the adapted FCU-O (N = 74) or a waitlist control condition (N = 87). Participants predominantly self-identified as female (95%), 42.77 years old on average, and White (84.6%). Outcomes included caregiver reports of perceived stress and parenting, and youth conduct problems and depressive symptoms. Using a multilevel modeling approach, we tested intent-to-treat intervention effects at 4-months, with time points nested within participants. The FCU-O reduced caregiver stress and improved proactive parenting and limit setting but had no effects on youth outcomes. Effect sizes were small to moderate (Cohen's d ranged from .37 to .57). We examined indirect effects on youth outcomes at 4-months via changes in caregiver stress and parenting at 2-months. Mediation analyses suggested indirect effects on youth depressive symptoms via reductions in caregiver stress and increases in proactive parenting. Results indicate the FCU-O has potential as a public health intervention for families facing extreme stressors such as those during the COVID-19 pandemic. ClinicalTrials.gov Identifier: NCT05117099.

我们对在线家庭体检(FCU-O)进行了改编(1),以支持家庭应对与大流行相关的压力,预防中学生出现行为和情绪问题;(2)在 COVID-19 大流行期间使用智能手机提供服务,以增加访问量和覆盖面。本研究评估了改编后的 FCU-O 在基线后 4 个月的直接和间接效果。FCU-O结合了在线育儿支持和电话辅导。参与者为 10 至 14 岁儿童的主要照顾者。合格条件包括在 PHQ-2 中认可抑郁或在 4 个项目的感知压力量表中认可显著压力。我们将参与者随机分配到经过改编的 FCU-O(74 人)或候补对照组(87 人)。参与者主要自我认同为女性(95%)、平均年龄 42.77 岁、白人(84.6%)。研究结果包括照顾者对压力感知和养育子女情况的报告,以及青少年行为问题和抑郁症状。我们采用多层次建模方法,测试了 4 个月的干预效果,并将时间点嵌套在参与者中。FCU-O降低了照顾者的压力,改善了积极主动的养育方式和限制设置,但对青少年的结果没有影响。效果大小为小到中等(Cohen's d 从 0.37 到 0.57 不等)。我们通过 2 个月时照顾者压力和养育方式的变化,考察了 4 个月时对青少年结果的间接影响。中介分析表明,照顾者压力的减少和积极养育的增加对青少年抑郁症状有间接影响。研究结果表明,FCU-O 有可能成为一种公共卫生干预措施,适用于面临极端压力(如 COVID-19 大流行期间的压力)的家庭。ClinicalTrials.gov Identifier:NCT05117099。
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引用次数: 0
Parenting Profiles in Military Families: Intervention-Related Transitions and Relationships to Child Adjustment 军人家庭的养育概况:与干预有关的转变以及与儿童适应的关系
IF 3.5 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-16 DOI: 10.1007/s11121-024-01721-7
Sun-Kyung Lee, Abigail H. Gewirtz, Timothy F. Piehler

Parenting programs aim to improve parenting quality, which may, in turn, support various aspects of child development, including behavior and mental health. However, parenting interventions show considerable heterogeneity in response patterns across different families, demonstrating that they are not one-size-fits-all programs. This variability points to a need for greater understanding of which families benefit most from these interventions and how to improve response among those who do not. Following this literature gap, this study employed a person-centered approach to identify different parenting profiles associated with heterogeneity in treatment responses to a family-based prevention interventions adapted for military families. This study used data from a randomized controlled trial of the ADAPT intervention for 336 US military families in which at least one parent had deployed to war. Latent profile analyses revealed three unobserved parenting profiles among mothers and fathers, reflecting High positive, Moderate positive, and Coercive parenting styles. Latent transition analysis (LTA) suggested that the ADAPT program led to improvements in parenting, particularly among mothers who began the program with moderate or typical levels of parenting skills, and that these positive changes in parenting may help to decrease child externalizing problems. For fathers, the ADAPT program was most effective in preventing declines in positive parenting among those with initially typical levels of positive parenting. Overall, study findings demonstrate considerable heterogeneity in parenting behavior among a sample of military families that is associated with variability in parent responses to the evidence-based parenting program.

亲职教育项目旨在提高亲职教育的质量,进而促进儿童各方面的发展,包括行为和心理健康。然而,亲职教育干预措施在不同家庭中的反应模式存在很大差异,这表明它们并不是 "一刀切 "的计划。这种差异性表明,需要进一步了解哪些家庭从这些干预措施中受益最多,以及如何改善那些没有受益的家庭的反应。根据这一文献空白,本研究采用了一种以人为本的方法,来识别不同的养育特征,这些特征与针对军人家庭调整的基于家庭的预防干预措施的治疗反应的异质性有关。本研究使用了针对 336 个美国军人家庭的 ADAPT 干预随机对照试验的数据,在这些家庭中,父母至少有一方被派往战场。潜特征分析表明,在母亲和父亲中存在三种未观察到的养育特征,分别反映了高度积极、中度积极和强迫性养育风格。潜移默化分析(LTA)表明,ADAPT 计划改善了养育子女的方式,尤其是那些在计划开始时养育子女的技能处于中等或典型水平的母亲,这些积极的养育子女方式的改变可能有助于减少儿童的外部化问题。对于父亲来说,ADAPT 计划在防止那些最初具有典型积极养育水平的父亲的积极养育水平下降方面最为有效。总之,研究结果表明,在军人家庭样本中,养育行为存在相当大的异质性,这与家长对循证养育计划的反应存在差异有关。
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引用次数: 0
Testing an Organizational Implementation Process Model Related to Teachers’ Implementation-Related Attitudes and Behaviors: a Multilevel Mediation Analysis 测试与教师实施态度和行为相关的组织实施过程模型:多层次中介分析
IF 3.5 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-13 DOI: 10.1007/s11121-024-01722-6
Catherine M. Corbin, Yanchen Zhang, Mark G. Ehrhart, Jill Locke, Aaron R. Lyon

The effectiveness of school-based universal prevention programs is frequently diminished due to low-quality implementation. Organizational factors support high-quality implementation because of their broad influence across implementers. Conceptually, implementation leadership (i.e., behaviors that prioritize, reward, and support evidence-based practice [EBP] implementation) works to embed a favorable implementation climate (i.e., implementers’ collective perceptions that their organization prioritizes, rewards, and support EBP implementation) leading to improved implementation citizenship behavior and attitudes toward EBP. This organizational implementation process model has some empirical support but has not been tested in a multilevel framework or related to hypothesized attitudinal and behavioral outcomes. The sample included 319 teachers across 39 US public elementary schools; all were implementing Schoolwide Positive Behavior Interventions and Supports. Multilevel mediation (level 1 = teacher, level 2 = school) was used to test the indirect association of implementation leadership on implementation-related attitudes and behaviors via implementation climate across two time points (fall and spring). At the school level, the organizational implementation process model was validated related to implementation citizenship behavior, but not attitudes toward EBP. At the teacher level, the process model was validated related to both outcomes, and there was a significant direct effect of implementation leadership on attitudes toward EBP. Developing strong leaders for implementation seems key to achieving high-quality EBP implementation. Implications for schools, principal training, and research are discussed.

由于实施质量不高,校本普及预防计划的效果经常被削弱。组织因素因其对实施者的广泛影响而支持高质量的实施。从概念上讲,实施领导力(即优先考虑、奖励和支持循证实践(EBP)实施的行为)可以营造良好的实施氛围(即实施者集体认为其组织优先考虑、奖励和支持 EBP 实施),从而改善实施公民行为和对 EBP 的态度。这一组织实施过程模型有一定的实证支持,但尚未在多层次框架内进行测试,也未与假设的态度和行为结果相关联。样本包括 39 所美国公立小学的 319 名教师;所有教师都在实施全校范围的积极行为干预和支持。采用多层次调解(第 1 层 = 教师,第 2 层 = 学校)的方法,通过两个时间点(秋季和春季)的实施氛围,检验实施领导对实施相关态度和行为的间接影响。在学校层面,组织实施过程模型与实施公民行为相关,但与对 EBP 的态度无关。在教师层面,过程模型与这两种结果都有关系,而且实施领导对 EBP 的态度有显著的直接影响。培养强有力的实施领导者似乎是实现高质量 EBP 实施的关键。本文讨论了对学校、校长培训和研究的启示。
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引用次数: 0
The Promise and Challenges of Integrating Biological and Prevention Sciences: A Community-Engaged Model for the Next Generation of Translational Research. 生物科学与预防科学相结合的前景与挑战:下一代转化研究的社区参与模式。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-03 DOI: 10.1007/s11121-024-01720-8
Leslie D Leve, Mariano Kanamori, Kathryn L Humphreys, Sara R Jaffee, Robin Nusslock, Veronica Oro, Luke W Hyde

Beginning with the successful sequencing of the human genome two decades ago, the possibility of developing personalized health interventions based on one's biology has captured the imagination of researchers, medical providers, and individuals seeking health care services. However, the application of a personalized medicine approach to emotional and behavioral health has lagged behind the development of personalized approaches for physical health conditions. There is potential value in developing improved methods for integrating biological science with prevention science to identify risk and protective mechanisms that have biological underpinnings, and then applying that knowledge to inform prevention and intervention services for emotional and behavioral health. This report represents the work of a task force appointed by the Board of the Society for Prevention Research to explore challenges and recommendations for the integration of biological and prevention sciences. We present the state of the science and barriers to progress in integrating the two approaches, followed by recommended strategies that would promote the responsible integration of biological and prevention sciences. Recommendations are grounded in Community-Based Participatory Research approaches, with the goal of centering equity in future research aimed at integrating the two disciplines to ultimately improve the well-being of those who have disproportionately experienced or are at risk for experiencing emotional and behavioral problems.

从二十年前人类基因组测序成功开始,根据个人的生物学特征制定个性化健康干预措施的可能性吸引了研究人员、医疗服务提供者和寻求医疗保健服务的个人的想象力。然而,将个性化医疗方法应用于情绪和行为健康方面,却落后于针对身体健康状况的个性化方法的发展。开发更好的方法,将生物科学与预防科学相结合,以确定具有生物基础的风险和保护机制,然后应用这些知识为情绪和行为健康的预防和干预服务提供信息,这具有潜在的价值。本报告是预防研究学会理事会任命的一个特别工作组的工作成果,该工作组旨在探讨生物科学与预防科学相结合所面临的挑战并提出相关建议。我们介绍了这两种方法结合的科学现状和进展障碍,随后提出了促进生物和预防科学结合的建议策略。这些建议以社区参与式研究方法为基础,目的是在未来的研究中以公平为中心,旨在整合这两个学科,最终改善那些经历过情绪和行为问题或面临这些问题风险的人的福祉。
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引用次数: 0
Pivoting Training and Coaching for an Early Numeracy Intervention During COVID-19. 在 COVID-19 期间,为早期算术干预开展枢轴培训和辅导。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-30 DOI: 10.1007/s11121-024-01713-7
David Fainstein, Ben Clarke, Derek Kosty, Lauren M Cycyk, Jessica Turtura, Christian T Doabler

Early numeracy skills are vital for kindergarten students because they provide the foundation for acquiring mathematics skills in both kindergarten and subsequent years. Teacher support to intervene with kindergarteners at risk for poor mathematics learning outcomes is a promising approach to addressing this achievement gap. The current study replicates previous work on an established early numeracy intervention, ROOTS. In this instance, ROOTS uses remote professional development as a novel format for interventionist training support during the COVID-19 pandemic. Findings indicate that interventionists receiving remote support for implementing ROOTS found training and coaching acceptable and feasible. Remote training and coaching supported strong levels of implementation fidelity. Furthermore, children who received the ROOTS intervention outperformed their control group peers on post-test measures of mathematics achievement within a randomized controlled trial research design. Outcomes and implications for using remote professional development as a format for supporting educators in their use of early numeracy intervention programs are discussed within a pandemic-response context.

早期计算技能对幼儿园学生至关重要,因为它们为学生在幼儿园及以后学习数学技能奠定了基础。对数学学习成绩较差的幼儿园学生进行教师支持干预,是解决这一成绩差距的有效方法。目前的研究重复了之前对成熟的早期算术干预--ROOTS--所做的工作。在这次研究中,ROOTS 采用了远程专业发展这种新颖的形式,在 COVID-19 大流行期间为干预者提供培训支持。研究结果表明,接受远程支持以实施 ROOTS 的干预者认为培训和辅导是可以接受和可行的。远程培训和指导支持了很高的实施忠诚度。此外,在随机对照试验研究设计中,接受 ROOTS 干预的儿童在数学成绩的后测指标上优于对照组儿童。在大流行病应对的背景下,讨论了将远程专业发展作为支持教育工作者使用早期算术干预计划的一种形式的成果和意义。
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引用次数: 0
Developmental Losses of Preschool Children Three Years into the COVID-19 Pandemic. COVID-19 大流行三年后学龄前儿童的发育损失。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-08 DOI: 10.1007/s11121-024-01716-4
Alejandro Vásquez-Echeverría, Meliza Gónzalez, Tianna Loose, Matilda Ciganda, Belén Díaz, Maite Liz, Clementina Tomás-Llerena, Sylvana M Côté

The COVID-19 pandemic and resulting mitigation measures have led to increased vulnerabilities in early child development. However, research is scarce and there are no studies on the persistence of these losses three years into the pandemic among young children. To fill in this gap, we examined census-like evaluations of school readiness carried out among preschoolers in Uruguay. The assessments were carried out among 5 cohorts of 5-year-olds: who were assessed prior to the pandemic (2018, 2019); during the pandemic (2020, 2021); and after the health emergency declaration ended in Uruguay (2022). A total of 180,984 teacher evaluations were included covering cognitive, motor and socio-emotional development, as well as attitudes toward learning. Overall, we found that scores in most spheres of child development decreased from before to during the pandemic in 2020 and 2021. In 2022, scores returned to pre-pandemic levels. Our findings suggest the recovery of developmental losses among cohorts of children in kindergarten took more than two years in a country that experienced a mild-to-moderate impact of the COVID-19 pandemic.

COVID-19 大流行及由此产生的缓解措施导致儿童早期发展的脆弱性增加。然而,这方面的研究却很少,而且也没有关于大流行三年后这些损失在幼儿中的持续性的研究。为了填补这一空白,我们对乌拉圭学龄前儿童的入学准备情况进行了普查式评估。评估在 5 批 5 岁儿童中进行:他们在大流行之前(2018 年、2019 年)、大流行期间(2020 年、2021 年)和乌拉圭卫生紧急状态宣布结束之后(2022 年)接受评估。我们共纳入了 180984 份教师评价,内容涵盖认知、运动和社会情感发展以及学习态度。总体而言,我们发现在 2020 年和 2021 年的大流行期间,大多数儿童发展领域的得分都比流行前有所下降。2022 年,得分恢复到大流行前的水平。我们的研究结果表明,在一个受到 COVID-19 大流行轻度至中度影响的国家,幼儿园儿童群体的发展损失恢复需要两年多的时间。
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引用次数: 0
Correction: Considerations for Subgroup Analyses in Cluster-Randomized Trials Based on Aggregated Individual-Level Predictors. 更正:基于综合个体水平预测因素的分组随机试验中的亚组分析注意事项。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 DOI: 10.1007/s11121-024-01647-0
Brian D Williamson, R Yates Coley, Clarissa Hsu, Courtney E McCracken, Andrea J Cook
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引用次数: 0
Correction: A Mixed-Methods Approach for Evaluating Implementation Processes and Program Costs for a Hypertension Management Program Implemented in a Federally Qualified Health Center. 更正:采用混合方法评估在联邦合格医疗中心实施的高血压管理计划的实施过程和计划成本。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 DOI: 10.1007/s11121-024-01670-1
Aisha Tucker-Brown, Michelle Spafford, John Wittenborn, David Rein, Ashley Marshall, Kincaid Lowe Beasley, Marla Vaughan, Natalie Nelson, Michelle Dougherty, Roy Ahn
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引用次数: 0
The Association of Stigma, School, and Family Factors with Patterns of Substance Use Among LGBTQ Youth. 污名化、学校和家庭因素与 LGBTQ 青少年药物使用模式的关联。
IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 Epub Date: 2024-07-06 DOI: 10.1007/s11121-024-01703-9
Antonia E Caba, Jessica N Fish, Christopher W Wheldon, Ryan J Watson

Polysubstance use is associated with myriad short- and long-term health outcomes. Although prior research has documented differences in polysubstance use between lesbian, gay, bisexual, transgender, queer/questioning, and other sexual and gender minoritized (LGBTQ +) youth and their heterosexual/cisgender counterparts, as well as between subgroups of LGBTQ + youth, it is unknown how personal, family, and school factors are associated with substance use patterns among LGBTQ + youth. Using a large, national sample of 9646 LGBTQ + youth ages 13-17, we used latent class analysis to examine patterns of alcohol, tobacco, and marijuana use and to determine whether personal, family, and school factors predict class membership. We identified five classes of substance use: polysubstance use, polysubstance experimentation, dual alcohol and cannabis, alcohol, and no use. Greater depression and LGBTQ + victimization, and an ability to be oneself at school, were associated with greater odds of membership in the polysubstance use class, while higher levels of family connection and having a Gender Sexuality Alliance (GSA) at school were associated with lower odds of membership in the polysubstance use class. Our analysis also revealed sociodemographic differences in class membership. These findings highlight potential mechanisms for intervention to reduce polysubstance use among LGBTQ + youth.

多种物质的使用与多种短期和长期健康后果相关。尽管之前的研究已经证明了女同性恋、男同性恋、双性恋、跨性别者、同性恋者/质疑者和其他性与性别少数群体(LGBTQ +)青少年与异性恋/同性别青少年之间以及 LGBTQ + 青少年亚群体之间在多种物质使用方面的差异,但目前还不清楚个人、家庭和学校因素与 LGBTQ + 青少年的物质使用模式有何关联。通过对全国 9646 名 13-17 岁的 LGBTQ + 青少年进行大规模抽样调查,我们使用潜类分析法研究了酒精、烟草和大麻的使用模式,并确定了个人、家庭和学校因素是否会预测类别成员资格。我们确定了五种物质使用类别:多种物质使用、多种物质尝试、酒精和大麻双重使用、酒精使用和不使用。抑郁程度越高、LGBTQ + 受害程度越高以及在学校中的自我表现能力越强,则加入多种物质使用类别的几率越大;而家庭联系程度越高以及在学校中拥有性别性别联盟(GSA),则加入多种物质使用类别的几率越小。我们的分析还揭示了班级成员的社会人口学差异。这些发现凸显了减少 LGBTQ + 青少年使用多种药物的潜在干预机制。
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引用次数: 0
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Prevention Science
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