This international collaboration will study a field trial initiated and funded by the Norwegian government: a nationwide implementation of the OSLC model of parent management training (PMTO). PMTO is an efficacious theory-based intervention that teaches parents child-rearing strategies that prevent deviant child behavior and promote healthy family development. The Norwegian goal is to have trained PMTO interventionists available in every municipality (435) to intervene at the earliest stages of deviant child behavior, thus preventing later substance abuse, school failure, and delinquency. This proposal details the research describing the processes and mechanisms associated with successful PMTO implementation. The project is a collaboration among 3 centers: OSLC, the Norwegian Center for the Study of Behavioral Problems and Innovative Practice in Oslo, and the Institute for Social Research. NIDA support will enable us to map onto work in progress funded by two Norwegian Ministries (Children & Family Affairs and Social & Health Affairs). We propose to study factors contributing to the adoption, adaptation, and implementation of PMTO in Norwegian communities. Adoption will be studied across successive generations of trainees. Generation 1 (G1) consists of a cohort of Norwegian professionals recently certified by OSLC professionals as PMTO Specialists. In 2002, G1 began training the second generation of Norwegian professionals (G2). Late in 2003, Norwegian PMTO specialists will begin training G3. We will study fidelity to and adaptation of PMTO procedures through generations of training using repeated multiple method assessments and direct observation of intervention sessions. We hypothesize successful intervention for those who retain fidelity to the core PMTO parenting practices and this will prevent negative child outcomes like substance abuse. We also expect to find additions to PMTO that are relevant to Norwegian culture but do not destroy PMTO integrity. We hypothesize that such additions will enhance adoption and sustainability of the program. Factors that contribute to fidelity, adaptation, and drift from fidelity will be evaluated, hypothesizing increasing drift with time and ensuing generations of trainees, and that fidelity drift will be correlated with reduced efficacy. To better understand the adoption and rejection of PMTO by agencies, professionals, and families, we will analyze already collected field notes and retrospective accounts from the recruitment and participation of G1 agencies and trainees. These data can be compared with prospective and concurrent data collected during the recruitment and training of G2 and G3 agencies and trainees. Annual surveys will be conducted to study beliefs and attitudes within experimental and control community agencies throughout Norway.
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