Adaptive Intervention Strategies in Conduct Problems Prevention

This pilot study conducts feasibility research to develop adaptive intervention strategies for conduct problems prevention. The adaptive model will stipulate for whom only brief prevention strategies are sufficient and for whom more intensive strategies are necessary. The research will involve youth (10-17 years of age) identified by law enforcement as early offenders and who are referred for pre-court juvenile diversion programming.

Study Overview

• Status: Completed
• Conditions: Conduct Problems
• Intervention / Treatment: Behavioral: Youth Behavioral Intervention; Behavioral: Parent Education

Detailed Description

This project proposes to conduct feasibility research to inform implementation of a future full-scale SMART design (i.e., sequential, multiple assignment, randomized trial) that will be used to construct adaptive intervention strategies (AIS) for conduct problems prevention. AIS individualize treatment via decision rules that specify how the type (youth-focused or parent focused) or intensity (low dosage or high dosage) of an intervention should be formulated prior to the beginning of treatment based on youth and family characteristics and/or repeatedly adjusted over time based on proximal outcomes collected during treatment. AIS are needed in conduct problems prevention to address the heterogeneity of at-risk youth and the variability in response to conventional fixed-type preventive interventions. With the present SMART trial each participant will progress through two stages of intervention using a stepped-care framework. In the first stage participants will be randomized to one of two 'brief-type' intervention options, either the youth-focused Teen Intervene-Brief program (TI-B; Winters & Leitten, 2007) or the parent-focused Everyday Parenting-Brief program (EP-B; Dishion et al., 2003, 2010). Responders to either program will be stepped down and monitored over time for maintenance. Non-responders to either program will be stepped up and randomized to one of two second stage 'intensive-type' intervention options that feature either (1) continuation of the first stage option with increased dosage (EP-Expanded or TI-Expanded), or (2) switching to the alternative expanded intervention modality. This feasibility study will enroll high risk youth (10-17 years of age) who have been arrested for status or misdemeanor offenses and referred for pre-court juvenile diversion programming. The aims of this feasibility research are to (1) develop practice infrastructure for implementing a SMART design and assess practitioner adherence to the various intervention sequences, (2) roll out the stepped-care intervention sequences and obtain estimates of recruitment into SMART, attrition at both stages, and overall response rate to first-stage intervention options, (3) describe the demographic and clinical characteristics of the sample of diversion-referred youth who are enrolled in the study, (4) create a latent construct for conduct problems that will be used as the distal outcome, and (5) explore the utility of incorporating secondary tailoring variables (e.g., child and family risk characteristics) in the adaptive intervention model.

• Study Type: Interventional
• Enrollment (Actual): 200
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Minnesota
    • Minneapolis, Minnesota, United States, 55415
      • Center for Personalized Prevention Research in Children's Mental Health

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 10 years to 17 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Youth ages 10-17
• Juvenile diversion referral (to community partner agency)

Exclusion Criteria:

• Pervasive developmental disabilities
• Serious psychiatric disorders requiring specialized mental health treatment (e.g. psychosis, bipolar disorder, etc.)
• Substance dependence

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Youth Behavioral Intervention; Teen Intervene Program	Behavioral: Youth Behavioral Intervention; Teen Intervene is an early intervention program for 12-19 year olds.; Other Names: Teen Intervene
Other: Parent Education; Everyday Parenting Program	Behavioral: Parent Education; Everyday Parenting is a parent training curriculum.; Other Names: Everyday Parenting

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Peer Delinquency Scale	Youth Report	9 months
Family Check-Up Youth Questionnaire - Adolescent	Youth Report	9 months
Personal Experiences Screening Questionnaire-Adolescent	Youth Report	9 months
Self-Reported Delinquency Scale-Adolescent (SRD)	Youth Report	9 months
Inventory of Callous-Unemotional Traits-Youth (ICU)	Youth Report	9 months
Delayed Discounting Task	Youth Computer Task	9 months
Dimensional Change Card Sort Task (DCCS)	Youth Computer Task	9 months
Flanker Task	Youth Computer Task	9 months
Iowa Gambling Task	Youth Computer Task	9 months
Family Check-Up Caregiver Questionnaire-Adolescent	Parent Report	9 months
Behavior Assessment System for Children (BASC-2)	Parent Report	9 months
Delis Rating of Executive Functions (D-REF)	Parent Report	9 months
Family Check-Up Caregiver Questionnaire-Family	Parent Report	9 months
Early Adolescent Temperament Questionnaire-Revised (EAT-Q)	Parent Report	9 months
Disruptive Behavior Rating Scale (DBRS)	Parent Report	9 months
Parenting Relationship Questionnaire (PRQ)	Parent Report	9 months
Inventory of Callous-Unemotional Traits-Parent (ICU)	Parent Report	9 months

Collaborators and Investigators

• Sponsor: University of Minnesota
• Collaborators: National Institute of Mental Health (NIMH); St. Paul Youth Services
• Investigators: Principal Investigator: Gerald August, Ph.D., University of Minnesota

Study record dates

Study Major Dates

• Study Start: June 1, 2013
• Primary Completion (Actual): December 1, 2016
• Study Completion (Actual): December 1, 2016

Study Registration Dates

• First Submitted: April 3, 2015
• First Submitted That Met QC Criteria: April 7, 2015
• First Posted (Estimate): April 10, 2015

Study Record Updates

• Last Update Posted (Actual): November 1, 2019
• Last Update Submitted That Met QC Criteria: October 30, 2019
• Last Verified: October 1, 2019

More Information

Terms related to this study

• Other Study ID Numbers: 1304S30941; R34MH097832 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO