Adaptive Intervention Strategies in Conduct Problems Prevention
Condition: Conduct Problems
Study type: Interventional

Summary: 
      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.
    

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.
    

Intervention name(s): Youth Behavioral Intervention; Parent Education
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Teen Intervene is an early intervention program for 12-19 year olds.; Everyday Parenting is a parent training curriculum.
Other intervention name(s): Teen Intervene; Everyday Parenting
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Prevention