AbstractThis study evaluated direct and indirect effects of the Family Check-Up Online (FCU-O) across two distinct randomized trials with middle school youth and families. The FCU-O is a digital health adaptation of the Family Check-Up that is delivered in a brief, online format with supportive coaching. The FCU-O was delivered to parents of middle school youth with a focus on targeting both proximal and distal outcomes that impact the development of conduct problems, including a range of parenting skills, effortful control, and youth emotional problems. Participants were primary caregivers of children aged 10 to 14 years. Eligibility varied across the trials and included endorsing depression or significant stress, or having a child enrolled in a school with limited resources. A total of 374 participants across trials were included in the analysis and were randomly assigned to receive the intervention or control. Using Integrative Data Analytic techniques, we examined the effects of random assignment on a range of outcomes, including emotional and behavior problems, parenting skills, parenting confidence, and effortful control. We examined the indirect effects of the FCU-O on changes in conduct problems from baseline to 6 months via changes in mediator variables at the first follow-up assessment (2–3 months). The FCU-O improved emotional problems, effortful control, parenting confidence, and parent sense of importance at the first follow-up. Mediation analyses suggested indirect effects on conduct problems at 6-month follow-up via improvements in effortful control and emotional problems, but not via improvements in parenting confidence or sense of parenting importance. Results indicate the FCU-O has potential as a public health intervention for families with middle school youth to reduce behavioral risk. ClinicalTrials.gov Identifier: NCT 03060291; NCT 05117099.

This study evaluated a classroom program to address Intolerance of uncertainty (IU) in secondary school students in Australia. IU is a transdiagnostic vulnerability factor for a range of psychological difficulties. A universal classroom program aimed to increase student understanding of feelings of uncertainty and explored socioemotional factors that could influence behaviors when facing uncertainty. Classroom teachers in two high schools were trained to deliver an 18-lesson program under naturalistic classroom conditions. Relative to the control group, the intervention lowered IU at post-test, but not at a later follow-up. The only socioemotional outcome measure to demonstrate a concurrent change was social media use. Limitations of the study were associated with the naturalistic classroom intervention, including the high level of attrition. Future studies may need to address broader factors in the students’ context that could influence intolerance of uncertainty.

Home visiting programs for new parents have a broad range of goals, including improvements in maternal and child health, reductions in child maltreatment, and improvements in child development. Before 2020, few home visits were conducted through phone or video encounters, i.e., telehealth home visiting (teleHV). However, rapid adoption of teleHV was required by the coronavirus disease 2019 (COVID-19) pandemic. To understand how conducting initial visits via teleHV was associated with outcomes, we performed a secondary data analysis to make use of the natural experiment created by COVID-19. Utilizing data from the Nurse-Family Partnership, a US national evidence-based model, we compared outcomes for families whose initial home visits were in person (enrolled 10/2019 to 1/2020; n = 7066) to those whose first visits were through teleHV (enrolled 4/2020 to 12/2020; n = 14,587). TeleHV at intake was associated with a higher likelihood of elevated depressive symptoms at 12 months (OR = 1.37; 95% CI 1.07, 1.76), a lower likelihood of retention to child’s age 12 months (OR = 0.67; 95% CI 0.58, 0.78), a higher likelihood of early drop from the program (OR = 1.77; 95% CI 1.48, 2.12), and fewer screening assessments completed (b = − 0.06; 95% CI − 0.07, − 0.04). No differences were detected between groups for the likelihood of breastfeeding at child’s age 6 months, elevated intimate partner violence (IPV) risk, 90% of attempted visits completed, or time to attrition. COVID-19 may have led families in different groups to have different experiences during key points of child development; however, as both groups’ involvement in the program occurred primarily during the pandemic, they were both subject to comparable influences. These findings suggest that in-person visits have some advantages in the first months of program involvement.

Youth violence is a national public health concern in USA, especially in resource-constrained urban communities. Between 2018 and 2021, the Healthy Communities for Youth (HCFY) program addressed youth violence prevention in select economically marginalized urban communities, with the HCFY program reducing the likelihood of youth-involved violent crime. Leveraging costs from program expense reports, this study analyzes the costs of the HCFY program in order to inform policymaking and the program’s future ongoing implementation. Total HCFY program costs were $821,000 ($290,100 annually including program start-up costs) over the 34-month project period. Operationalization costs contributed the largest share (64.8%), with 45% attributable to intervention coordinators. In the intervention community, the program costs $100 per capita, $1100 per youth-involved crime case, and $8100 per youth-involved violent crime case. Findings were sensitive to the number of youth-involved crime or violent crime cases and costs of high-level program leadership and self-evaluation analysts, with the per youth-involved violent crime case cost ranging between $700 and $1600 over the program period. Analysis of HCFY program costs is an important step in determining the affordability of a community-level program to prevent youth violence in resource-limited urban communities.

This study aimed to examine the efficacy of school-based e-cigarette preventive interventions via a systematic review and meta-analysis. We searched Medline, Embase, PsycINFO, Scopus, CINAHL, Cochrane, and clinical trial registries for studies published between January 2000 and June 2023 using keywords for e-cigarettes, adolescents, and school. Of 1566 double-screened records, 11 met the criteria of targeting adolescents, evaluating an e-cigarette preventive intervention, being conducted in a secondary school, using a randomized controlled trial (RCT), cluster RCT, or quasi-experimental design, and comparing an intervention to a control. Pre-specified data pertaining to the study design, outcomes, and quality were extracted by one reviewer and confirmed by a second, and where necessary, a third reviewer. Meta-analyses found no evidence that school-based interventions prevented e-cigarette use at the longest follow-up, which ranged between 6 and 36 months post-intervention (OR = 0.43, 95% CI = 0.16, 1.12; p = 0.09). However, subgroup analyses identified significant effects at post-test and when studies with < 12-month follow-up were omitted. No effect was found for tobacco use at the longest follow-up (OR = 1.01, 95% CI = 0.65, 1.59, p = 0.95); however, reductions in past 30-day tobacco use (OR = 0.59, 95% CI = 0.39, 0.89, p = 0.01) which encompassed e-cigarettes in some studies were identified. Narrative synthesis supported these mixed results and found some school-based interventions prevented or reduced e-cigarette and/or tobacco use; however, some increased use. School-based interventions were also associated with improved knowledge (SMD = − 0.38, 95% CI = − 0.68, − 0.08, p = 0.01), intentions (SMD = − 0.15, 95% CI = − 0.22, − 0.07, p = 0.0001), and attitudes (SMD = − 0.14, 95% CI = − 0.22, − 0.06; p = 0.0007) in the short term. Overall, the quality of evidence was low-to-moderate. School-based interventions hold the potential for addressing e-cigarette use, however, can have null or iatrogenic effects. More high-quality research is needed to develop efficacious interventions, and schools must be supported to adopt evidence-based programs. This is the first systematic review and meta-analysis to examine the efficacy of school-based preventive interventions for e-cigarette use. It provides crucial new knowledge about the efficacy of such interventions in preventing e-cigarette use and improving other outcomes (e.g., tobacco use, knowledge, intentions, attitudes, and mental health) among adolescents and the key characteristics associated with efficacious interventions. Our findings have important practical implications, highlighting future research directions for the development and evaluation of e-cigarette preventive interventions, along with the need to provide support to schools to help them identify and adopt evidence-based programs.

Heterogeneous effects from interventions often remain hidden in between-group analyses, risking overgeneralized conclusions of treatment effects. In this exploratory study, we performed latent profile analysis to unveil differential treatment effects among children in The Incredible Years Teacher Classroom Management Programme (IY TCMP). This program has previously been shown to reduce behavioral problems in preschools and schools in total samples and subgroups. A total of 726 children (48.7% girls; Mage = 4.21 years; SDage = 0.86) from 92 childcare centers in Norway participated in either the intervention (n = 338) or the matched control condition (n = 388). First, by conducting latent profile analysis on baseline levels of child-teacher relationship (closeness, conflict), behavioral problems, and social competence, three distinct profiles were identified: High Risk (26.4%), Moderate Risk (42.8%), and Low Risk (30.7%) – each profile with unique characteristics. Second, we tested for within-profile, condition-by-time interactions following the intervention, showing distinct treatment responses for each profile. High-risk profiles profited most from the IY TCMP, with a substantial decrease in externalizing problems, more teacher closeness, and less teacher conflict. Moderate-risk profiles also gained better teacher-child relationships and improved social competence. The Low-Risk profiles showed no effects from the intervention. It is argued that latent profile analysis presents a feasible approach for examining within-sample heterogeneity in intervention research. It also reveals crucial information on treatment variability, as demonstrated in the Incredible Years Programme.

Parenting programs aim to improve parenting quality, which may, in turn, support various aspects of child development, including behavior and mental health. However, parenting interventions show considerable heterogeneity in response patterns across different families, demonstrating that they are not one-size-fits-all programs. This variability points to a need for greater understanding of which families benefit most from these interventions and how to improve response among those who do not. Following this literature gap, this study employed a person-centered approach to identify different parenting profiles associated with heterogeneity in treatment responses to a family-based prevention interventions adapted for military families. This study used data from a randomized controlled trial of the ADAPT intervention for 336 US military families in which at least one parent had deployed to war. Latent profile analyses revealed three unobserved parenting profiles among mothers and fathers, reflecting High positive, Moderate positive, and Coercive parenting styles. Latent transition analysis (LTA) suggested that the ADAPT program led to improvements in parenting, particularly among mothers who began the program with moderate or typical levels of parenting skills, and that these positive changes in parenting may help to decrease child externalizing problems. For fathers, the ADAPT program was most effective in preventing declines in positive parenting among those with initially typical levels of positive parenting. Overall, study findings demonstrate considerable heterogeneity in parenting behavior among a sample of military families that is associated with variability in parent responses to the evidence-based parenting program.

Beginning with the successful sequencing of the human genome two decades ago, the possibility of developing personalized health interventions based on one’s biology has captured the imagination of researchers, medical providers, and individuals seeking health care services. However, the application of a personalized medicine approach to emotional and behavioral health has lagged behind the development of personalized approaches for physical health conditions. There is potential value in developing improved methods for integrating biological science with prevention science to identify risk and protective mechanisms that have biological underpinnings, and then applying that knowledge to inform prevention and intervention services for emotional and behavioral health. This report represents the work of a task force appointed by the Board of the Society for Prevention Research to explore challenges and recommendations for the integration of biological and prevention sciences. We present the state of the science and barriers to progress in integrating the two approaches, followed by recommended strategies that would promote the responsible integration of biological and prevention sciences. Recommendations are grounded in Community-Based Participatory Research approaches, with the goal of centering equity in future research aimed at integrating the two disciplines to ultimately improve the well-being of those who have disproportionately experienced or are at risk for experiencing emotional and behavioral problems.

Substance use-related problems continue to be a national public health crisis despite years of prevention efforts. Community anti-drug coalitions are well positioned to address substance use at local levels. Coalitions often rely on their members to connect to resources they need to address community issues and plan for sustainability over time. Such capacity building occurs through voluntary cooperation among members, making it essential to understand the role network connections play. This study sought to determine whether structural characteristics of coalitions’ resource sharing networks impact members’ perceptions of community improvement and coalition sustainability. Surveys at two timepoints collected data from 68 coalitions in Pennsylvania and Missouri on members’ connections or ties to share information, personnel, money, or other types of collaboration. Analyses examined how coalition-level measurements of sectoral diversity, density, and resource sharing centralization, respectively, were associated with members’ perceptions of community improvement, sustainability planning, and coalition sustainability. Sectoral diversity and centralization were unrelated to study outcomes. Density was also unrelated with perceived community improvement and sustainability planning. However, two facets of cooperative density were positively associated with perceived coalition sustainability: the density of ties to share information and the density of multiple types of collaborative ties. This study suggests that both information and other collaborative ties foster perceived coalition sustainability, although not community improvement.

In a group randomized trial of 45 elementary schools, a whole-child health and wellness curriculum introduced as a regular part of the educational programming was compared to education as usual over 2 years with a 2-year follow-up. The curriculum focused on integrating multiple SEL skills—mindfulness, compassion, and physical awareness—with the intent to advantage developmental patterns for these skills, academic engagement, personal well-being, and student behavior. The program design and trial implementation were launched with end-use delivery and long-term sustainability as integral considerations. Effects were shown for several SEL skills and behavioral indicators previously robustly correlated to long-term outcomes. Effects were demonstrated more broadly in schools serving high-poverty communities, suggesting the impact was stronger where the need was greater. Results are interpreted regarding supporting school-based SEL, the potential of applying group randomized trials with end-use conditions of implementation, and the value of fitting innovation efforts to school system operations, mandates, and priorities for promoting sustainability.