5 Clinical Trials for Various Conditions
This study is a two-armed randomized controlled trial of the eNew Beginnings Program (eNBP)'s effects on children's mental health problems as well as interparental conflict, parent-child relationship quality and effective discipline. The eNBP is an asynchronous, fully web-based program that was based on the in-person, group NBP, which has been found to strengthen parent-child relationship quality and effective discipline and reduce children's mental health problems in three randomized controlled trials of the NBP involving over 1,800 children. The investigators hypothesized that parents in the eNBP intervention condition would have less interparental conflict and higher parent-child relationship quality and effective discipline than those in the wait-list control condition. The investigators also expected the children whose parents were in the eNBP intervention condition would have fewer internalizing problems and externalizing problems and higher prosocial skills than those with parents in the wait-list control.
The project is a 15-year follow-up of 240 young adults whose families participated in an experimental evaluation of the New Beginnings Program (NBP), a preventive intervention for divorced families. The NBP was provided in late childhood; the follow-up occurred in young adulthood. Families were randomly assigned to one of three conditions: mother program (MP), dual-component mother and child program (MPCP), or literature-control (LC) condition. Programs were designed to change several putative mediators of children's post-divorce mental health problems using empirically-supported change strategies. The investigators expected that the NBP would have either main or risk by program interactive effects on mental health and substance use problems and disorders, developmental tasks, parent-young adult relationships, physical health problems, and competencies, such that YAs who participated in NBP will have better functioning than YAs in the control condition. The investigators expected that the NBP will have either main or risk by program interactive effects on mothers' mental health; those in the NBP are expected to have fewer mental health problems than those in the control condition.
This application requests funding to conduct a randomized effectiveness trial of The New Beginnings Program (NBP) delivered through a partnership of domestic relations courts, community service providers and the NBP research team. This is the first attempt to offer the population of families seeking divorce an evidence-based prevention program shown to have long-term effects on youth problem outcomes. It is estimated that over a third of U.S. children experience parental divorce, which confers elevated risk for multiple problems in childhood and adulthood including substance use and abuse, smoking, mental health problems, high risk sexual behavior, and physical health problems. Efficacy trials of the NBP found positive effects at post-test, 6-year and 15-year follow-ups. For example, at 6-year follow-up the participation in NBP led to reductions in marijuana, drug and alcohol use and a 37% reduction in prevalence of diagnosed mental disorder; and reductions in externalizing problems, internalizing problems and high risk sexual behavior. Positive effects also occurred for grade point average (GPA) and self esteem. For many of the effects of the NBP, the effects were stronger for youth who were at higher risk at program entry. Many of the program effects were mediated through the program effects to strengthen parenting. Funded by an Advanced Center for Intervention and Services Research grant (NIMH P30 MH068685) the investigators modified the NBP to translate it from a prototype tested in efficacy trials into a program that can be effectively delivered by community service providers and one that is appropriate across diverse cultural groups, and fathers as well as mothers. Pilot testing of the modified NBP and training and monitoring systems has demonstrated that they are highly acceptable to parents and providers. The investigators also developed and experimentally tested a system of parent recruitment that was found to be effective in getting parents to enroll (sign up to participate) in the NBP but, similar to other prevention parenting programs, initiation (attendance at one or more sessions) in the NBP in the pilot was low.
Because parental divorce has been linked to a significant increase in mental health diagnoses among children, it is important to develop effective interventions that reduce the negative impact of divorce on children. This study assesses the efficacy of the Co-Parenting for Resilience (CPR) resilience program by randomly assigning divorcing individuals to three different forms of the intervention to test whether one or both of versions of CPR are better than reading a self-help book, and whether an in-person version of CPR is more effective than an online version. The three conditions or versions are: 1) an in-person version of CPR taught by a trained non-clinician, 2) an asynchronous fully online version of CPR, and 3) a group that simply reads a self-help book and responds to a knowledge check to ensure the material was read.
This study will identify components for inclusion in a coping intervention package to reduce mental health problems among children exposed to high interparental conflict after parental separation/divorce. Reappraisal, distraction, and relaxation coping strategies are related to fewer mental health problems among children, making intervention components based on these strategies key candidates for inclusion in an optimized coping intervention. The primary aim is to experimentally assess the main and interactive effects of three digital intervention coping components (reappraisal, distraction, relaxation) on children's coping efficacy, emotional security, and internalizing and externalizing problems. Secondary aims are to assess indirect effects of the intervention components on children's coping efficacy, emotional security, and internalizing and externalizing problems through their cognitive, emotional, and behavioral reactions to post-separation/divorce interparental conflict events.