This project responds to the need for (1) affordable and sustainable 'indicated' preventive interventions for young children already showing emerging mental health problems, and for (2) interventions that can be delivered effectively in accessible, 'real-world' settings. This proposal seeks RO1 funding for a randomized controlled trial (RCT) to evaluate the efficacy of the Promoting Resilient Children Initiative (PRCI) in Deducing mental health problems among urban, minority children and in preventing future disorders and costly services. The PRCI is a second-generation adaptation of the Primary Mental Health Project (PMHP). The school-based PMHP was developed 40 years ago by Cowen and colleagues and has been disseminated to 1,500 schools in the U.S. The PMHP program's strengths include ecological validity for schools and moderate cost.. PRCI significantly modifies both the intervention content and method of implementation used in PMHP. In PRCI children learn behavioral and cognitive skills for emotion regulation and for coping in 24 sessions with school-based Mentors. In 10 home visits the Mentors teach parents to assist their children in developing skills. A preliminary trial of PRCI suggests that the intervention reduces children's problems in the short-term and has a larger impact than PMHP on targeted behavioral and emotional outcomes. This trial is needed to determine the longer-term efficacy of the PRCI intervention. For the proposed 5-year study, 200 children will be randomly assigned to PRCI intervention and 200 to control conditions from 75 classrooms in 5 urban schools. (1)""""""""We will compare intervention and control levels of externalizing and internalizing problems, need for services, and indices of family functioning over 30 months to assess program efficacy. (2) We will seek to determine levels of implementation fidelity required to achieve positive outcomes. (3) We will test hypotheses about mechanisms that govern the impact of PRCI on children's development. This project can have a positive public health impact through the potential to expand an improved intervention to more than 1,000 schools currently implementing PMHP and to other schools in the U.S. From the standpoint of advancing prevention science, the proposed study can contribute to knowledge needed to improve interventions in communities and the effective use of specially trained non-professional intervenors.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH068423-01A2
Application #
6919365
Study Section
Psychosocial Development, Risk and Prevention Study Section (PDRP)
Program Officer
Vitiello, Benedetto
Project Start
2005-09-01
Project End
2010-06-30
Budget Start
2005-09-01
Budget End
2006-06-30
Support Year
1
Fiscal Year
2005
Total Cost
$507,817
Indirect Cost
Name
University of Rochester
Department
Psychiatry
Type
Schools of Dentistry
DUNS #
041294109
City
Rochester
State
NY
Country
United States
Zip Code
14627
Cross, Wendi; West, Jennifer; Wyman, Peter A et al. (2015) Observational measures of implementer fidelity for a school-based preventive intervention: development, reliability, and validity. Prev Sci 16:122-32
Wu, Pan; Gunzler, Douglas; Lu, Naiji et al. (2014) Causal inference for community-based multi-layered intervention study. Stat Med 33:3905-18
Cross, Wendi F; West, Jennifer C (2011) Examining implementer fidelity: Conceptualizing and measuring adherence and competence. J Child Serv 6:18-33
Wyman, Peter A; Cross, Wendi; Hendricks Brown, C et al. (2010) Intervention to strengthen emotional self-regulation in children with emerging mental health problems: proximal impact on school behavior. J Abnorm Child Psychol 38:707-20
Wyman, Peter A; Gaudieri, Patricia A; Schmeelk-Cone, Karen et al. (2009) Emotional triggers and psychopathology associated with suicidal ideation in urban children with elevated aggressive-disruptive behavior. J Abnorm Child Psychol 37:917-28
Brown, C Hendricks; Ten Have, Thomas R; Jo, Booil et al. (2009) Adaptive designs for randomized trials in public health. Annu Rev Public Health 30:1-25
Brown, C Hendricks; Wang, Wei; Kellam, Sheppard G et al. (2008) Methods for testing theory and evaluating impact in randomized field trials: intent-to-treat analyses for integrating the perspectives of person, place, and time. Drug Alcohol Depend 95 Suppl 1:S74-S104