Prevention Science最新文献

Parental emotional socialization (PES) has been recognized as a critical mechanism in parenting programs to enhance children's well-being, especially following adversity. However, few studies have examined the potential moderating effect of baseline PES levels. This study aimed to examine whether supportive and unsupportive PES can mediate the intervention effects of a parenting program on child adjustment (Aim 1), and whether baseline PES can moderate the effect (Aim 2). This study utilized data from two randomized controlled trials for post-deployed military families (N = 335, Mage = 8.25, 54% girls). Families were either assigned to in-person intervention condition (n = 226) or a treatment-as-usual condition (n = 109). Baseline-targeted moderation mediation (BTMM) models were conducted for mothers and fathers separately, with child age, child sex, child minority status, family household income, and deployment length included as covariates. The parenting program had an indirect effect on child internalizing and externalizing problems 1-year post-baseline through reduced maternal unsupportive PES at post-intervention, while no indirect effect was found through supportive PES. Additionally, baseline PES moderated the impact of the ADAPT program on maternal supportive and unsupportive PES post-intervention, such that mothers who reported less supportive PES or more unsupportive PES at baseline benefited more. No intervention effect was found through fathers' PES. The findings underscore the crucial role of baseline PES in shaping behavioral parenting intervention effectiveness. The study highlights that one size does not fit all and future research and practice should consider the diverse needs and responses of families, emphasizing the delivery of personalized interventions to best meet parents' needs and maximize support.

Image-based sexual abuse is an increasingly prevalent form of technology-facilitated harm, yet disclosure rates remain low. Understanding why youth do not disclose image-based sexual abuse is critical for developing effective prevention and intervention strategies. This paper examined the reasons youth do not disclose image-based sexual abuse incidents and identified incident- and person-level characteristics associated with different nondisclosure motives. Participants were recruited online to this US-based cross-sectional study between June 28, 2023, and April 1, 2024, using social media advertisements targeting individuals aged 18-28. A total of 6204 individuals completed the survey; 2854 (46.0%) reported experiencing image-based sexual abuse before age 18. The analytic sample included 2522 incidents reported by 1551 participants that were not disclosed. The most frequently cited reasons for nondisclosure were fear of getting in trouble with family (53.9%), embarrassment (52.9%), and the belief that they could handle the incident alone (45.2%). Reasons varied by image-based sexual abuse subtype. Longer incident duration and explicit content were related to fear of getting into trouble with their family or the police, and having multiple people responsible was related to many reasons for nondisclosure (i.e., fear of getting in trouble, fear the person would find out, embarrassment, and feeling like no one could help) ,. Female participants and sexual/gender minority youth were more likely to report barriers specific to fear and shame. Prior victimization was associated with a greater belief that no one could help and fear of getting in trouble or the person finding out. Prevention should address common fears, challenge stigma and self-blame, and ensure youth have access to trusted adults and non-punitive disclosure options. These findings support clinical efforts to reduce barriers and promote safe disclosure pathways for these survivors.

This study examines changes in the conditions for social and emotional learning (SEL) implementation in California over the 2023-2024 school year, following approximately 3.5 years of CalHOPE Student Support. Grounded in the SHIFT-SEL model, CalHOPE aims to build statewide SEL infrastructure through a nested implementation support system, with County Offices of Education (COEs) positioned as key intermediaries. Educational leaders (507 in Fall 2023 and 386 in Spring 2024) reported on their well-being, workplace climate, and SEL implementation conditions. This study builds on prior work by including county, district, and school site SEL leaders in the analysis, enabling a broader examination of change across multiple levels of the education system. Cross-sectional comparisons showed that COE leaders reported more favorable conditions than district and school leaders, particularly in the extent of the supports they provided. Longitudinal analyses revealed small but significant improvements among district/school leaders in well-being, implementation supports, leadership capacities, and SEL structures and routines, while conditions at the COE level remained favorable. These findings suggest progress in infrastructure for SEL implementation support statewide and illustrate the potential of regional intermediaries for scaling prevention practice.

Addressing socio-demographic differences that affect mental health service encounters is crucial for ethical practice and enhancing therapeutic alliances. Yet discussing personal perceptions of socio-demographic influences within a large healthcare system can be challenging due to discomfort among staff and the need for engagement at both interpersonal and organizational levels. The SITE project sought to intervene on one healthcare system's mental health providers' willingness to discuss patient background during care coordination. An internal workgroup used intervention mapping enhanced with frameworks from socio-demographic-focused literature and implementation science. Data collection included surveys, interviews, and a participatory consensus process. The results were two multi-component intervention packages designed to address interpersonal and organizational barriers, each targeting providers' willingness and psychological safety in addressing patient-specific background factors with colleagues. The interventions were adopted by the setting and then later dissolved due to administrative shifts. While the resultant interventions are unique to this setting, we demonstrate a repeatable process for adapting a well-known intervention development method (intervention mapping (IM)) informed by theory and implementation science. This process can be applied in other healthcare systems for discerning multi-level interventions appropriate to different contexts.

Adverse childhood experiences (ACEs) are preventable, potentially traumatic events that can predict a wide range of short- and long-term negative health outcomes. More research is needed on policies that may reduce ACEs. Paid Family Leave (PFL) is a state-level policy that provides economic support for employees to care for a newborn or a recently adopted child. This study evaluated effects of PFL on reduction in household challenge ACEs. To investigate whether PFL implementation reduced the occurrence of household challenge ACEs among young children in Rhode Island and New York relative to other states without PFL implementation. This study used 2011-2019 population-based National Survey of Children's Health (NSCH) data to compare the proportion of household challenge ACEs experienced in intervention versus control states. Bayesian Additive Regression Tree (BART) and two-way fixed effects (TWFE) methods estimated post-intervention average treatment effects. United States (U.S.) Census covariates controlled for variation between states. Placebo checks bolstered the robustness of inference. Rhode Island and New York (intervention states) implemented PFL in 2014 and 2018, respectively. Control states included states that did not implement PFL as of 2019. The NSCH surveys included a 9-item ACEs questionnaire in which caregivers reported on whether their children ages 0-2 experienced various forms of abuse, and potentially traumatic household challenges (i.e., caregiver divorce, domestic violence, caregiver incarceration, caregiver mental health problems, caregiver substance use). This study focused on five household challenge ACEs and the occurrence of any household challenge ACE as primary outcomes. A treatment indicator identified intervention and control states. State-level covariates were median household income, unemployment rate, and percent uninsured.  Results suggest that PFL implementation was associated with significant 4% reduction in caregiver separation and 2% reduction in caregiver incarceration ACEs in the intervention states post-PFL adoption and a significant 4% reduction in the proportion of young children experiencing any household challenge ACE relative to no PFL implementation in control states. This study adds rigorous scientific support for the public health benefits of PFL for young children and their families. Existing evidence indicates caregiver incarceration and separation may affect children's short- and long-term mental health, substance use, and school related outcomes. Support through PFL may help reduce the occurrence of household challenge ACEs and promote children's well-being.

Children's mental health disorders are rising, underscoring the need to implement behavioral parent training (BPT) programs. However, wide variability in BPT effectiveness often reflects inconsistencies in implementation fidelity. This study examines test-retest reliability of the GenerationPMTO model's Fidelity of Implementation Rating System (FIMP) over a 17-year period. Seven coders provided ratings of 34 video segments from families participating in the Marriage and Parenting in Stepfamilies (MAPS) intervention, coded at two time points (2004, 2021) using first and third iterations of the FIMP manual. Variance decomposition analyses determined how much variability in scores was attributable to the interventionist, the observational coder, the session, and the year the data were coded. Test-retest intraclass correlation coefficients (ICCs) examined reliability across FIMP domains (knowledge, structure, teaching, process, and overall). Therapist differences accounted for the largest variance (38.1%), followed by coders (14.1%) and session (10.7%). Year did not significantly contribute, indicating that FIMP revisions have not undermined earlier fidelity metrics. Reliability analyses showed acceptable-to-excellent ICCs (range = 0.73-0.92), supporting the comparability of historical and current ratings. These findings indicate that GenerationPMTO's FIMP refinements maintain core fidelity metrics. By demonstrating stable fidelity data over time, the study bolsters confidence in both historical results and current coding practices. These outcomes reinforce the utility of long-standing training materials and support the use of stable fidelity tools in ongoing implementation and training contexts. Such synergy between fidelity measurement and adaptation fosters sustained program effectiveness across service contexts, allowing providers to align newer fidelity protocols with established best practices.

Although mindfulness-based interventions show initial positive results on a range of substance use behaviors, evaluations of mindfulness-based interventions would benefit from state-of-the-art alternative approaches to the ubiquitous use of sum or total scores. Sum scores do not reflect "true" underlying mindfulness as they do not consider differences in the relative weight of each item and/or the possibility that measurement may differ across groups. The purpose of this study was to identify measurement noninvariance/differential item functioning (MNI/DIF) across racial and ethnic groups, age groups, and those with PTSD diagnoses and differences in inferences on the factors of the Five Facet Mindfulness Questionnaire between scale scores estimated using moderated nonlinear factor analysis (MNLFA) and a total score analog model (TSA). Age, PTSD diagnosis, non-Hispanic Black race/ethnicity, Hispanic race/ethnicity, and other race/ethnicity showed statistically significant MNI/DIF. In the MNLFA model, PTSD diagnosis and Hispanic race/ethnicity contributed to significant MNI/DIF on the "true" acting with awareness, describing, and observing latent factors such that Hispanic participants were higher on average on acting with awareness scores and lower on average on describing and observing scores. The TSA model failed to estimate significant differences on acting with awareness score for participants with PTSD diagnosis. Additionally, in the TSA model, there was an increase in the effect size of Hispanic participants' baseline describing and observing estimates, thus overestimating differences in respective scores for Hispanic participants. Failing to correct for MNI/DIF in mindfulness scale scores can impact inferences and effect sizes for group differences in mindfulness thus creating bias in characterizing mindfulness, particularly for Hispanic individuals and those with PTSD diagnoses.

Effective early school-based prevention programs can shift behavioral outcomes, not just across the life course, but across generations; however, few studies have sufficient follow-up to test this. Here, we assess the impact of an early preventive intervention on later parenting practices. Participants were part of a randomized trial of two elementary school prevention programs to prevent aggressive and disruptive behavior in first grade, who were followed into adulthood. Participants who became parents (52%) participated in additional data collection about parenting at ages ~ 31-34. Results generally suggest null findings between elementary school-based prevention programming and parenting in adulthood. However, females who received a classroom-based intervention had significantly higher levels of constructive parenting as compared to females in the control condition. These findings suggest that the benefits of early prevention programming may accrue across multiple generations.

Students of color are disciplined for behavioral infractions at higher rates than white students in K-12 schools in the USA. The consequences of racism in K-12 schools include mental health problems, school dropout, and disproportionate disciplinary practices, leading to the school-to-prison pipeline. Many school personnel implement interventions to address student behavior rather than racism and other implicit biases. Furthermore, culturally relevant practices are imperative to address the root causes of racial disparities in student discipline. For these reasons, a systematic and comprehensive review of the published literature on school-based interventions in the USA (including public and private K-12 schools) was conducted to identify interventions to remedy racial disparities in school discipline, as well as the research designs used to test their efficacy. The final sample includes 48 studies that directly or indirectly attempt to address the race discipline gap. There were only three studies that reduced race disparities in school discipline with a culturally relevant intervention. Future researchers may consider the importance of the school's cultural context and intervention audience when developing and testing efforts to reduce racial disproportionality.

Asian American and Pacific Islanders (AAPI) youth report a high prevalence rate of youth violence. Logic models that guide violence prevention programming are often not culturally specific and may not address the unique structural/social drivers of youth violence in minoritized communities. Monsoon has received Rape Prevention and Education (RPE) funding from the Iowa Department of Health and Human Services (Iowa HHS) since 2007 through a competitive application process. The specific aim of Monsoon's Youth Sexual Violence Prevention Program (YVPP) is to "prevent gender-based violence by educating and empowering peers through outreach and workshops." In response to growing awareness at Iowa HHS about the limitations of the State RPE programmatic logic model in addressing AAPI-specific context for youth violence, Monsoon received additional RPE funds to establish the first culturally specific RPE logic model in Iowa. This initiative aims to fill a gap in culturally relevant evaluation resources. This paper describes the academic-community partnership initiated in 2023 that guided the participatory development of the culturally specific logic model and evaluation plan, for youth violence prevention in AAPI communities. Monsoon partnered with staff and faculty from the Center for Disease Control and Prevention (CDC)-funded Prevention Research Center for Rural Health (PRC-RH) in this work. PRC-RH faculty and staff reviewed documents and interviewed Monsoon leaders and youth staff. An AAPI-specific youth staff logic model and evaluation research questions were developed using a community-based research approach. Based on these, a mixed-methods evaluation plan was outlined. This case study highlights the critical importance of community-engaged research and practice to develop culturally specific logic models and evaluation designs for youth sexual violence prevention in the AAPI community.