Intervention Programs For Youth Research Articles

Community stakeholder feedback for development of a volunteer-coached behavioral activation for youth in a low-resource community

Youth in low-resource communities have limited access to mental health (MH) services. This exploratory study reports community stakeholder feedback for stressors affecting youth MH and development of a volunteer-coach provided behavioral activation (BA) program for youth in a low-resource community. Eight focus groups with youth (n = 7) and adults (n = 35) were conducted during January-September 2023. Data analysis followed the inductive thematic analysis steps. Participants attributed the high prevalence of youth MH problems to high-pressure environment, lack of support, hopelessness about the future, and negative impact of social media. Youth participants expressed mistrust of MH professionals and were hesitant to endorse a volunteer-coached BA program. They stated the non-professionals will be better than professional therapists but mentioned the stigmatization of mental-health help-seeking and related fear of bullying. Adults were more supportive of the program but pointed out such practical barriers as lack of parental support and availability of youth time due to after-school extracurricular activities. Participants also provided suggestions to increase parents’ buy-in of the program. Stakeholder feedback illustrated multiple challenges for developing and implementing an evidence-based MH intervention program for youth in a low-resource community. MH literacy education and alleviation of stigma about MH help-seeking are essential steps.

'Do it afraid': An arts-based reflexive collective case study exploring youth responses to post-concussion communication changes in daily life.

Concussion and communication researchers have yet to study how post-concussion communication changes affect youths' daily lives. The lack of attention paid to how young people respond to communication changes during concussion recovery constitutes a significant gap in current concussion management research and practices. To explore how youth respond to the effects of post-concussion communication changes in their daily life, including (1) daily routines, (2) relationships with family members, (3) relationships with peers and (4) participation in school/work and community activities. Five youths (16-25 years) and three family members participated in this arts-based reflexive collective case study. Ecocultural theory provided the theoretical framework for study design, data collection and analysis. Cases consist of (1) pre-interview demographic information, (2) three 60-90-min virtual interviews, (3) optional family member interviews, (4) multi-media arts-based participant-generated materials representing participants' experiences of communication change and concussion, and (5) researcher observations, discussions and reflexive journal entries. Reflexive thematic analysis was used to analyse the data. Analysis yielded four themes that illustrate the ways youth navigated and adapted to post-concussion communication changes: (1) navigating changes in communication tasks, daily roles, and identity; (2) re-negotiating relationships and emotional reactions; (3) seeking control and learning to let go during recovery; and (4) helping youth adapt to post-concussion communication changes. The study findings deepen our understanding of the impact of post-concussion communication changes on youths' daily lives and underscore considerations critical to the development ofcommunication-focused concussion education programs and interventions tailored specifically for youth. What is already known on the subject Youth is a critical period of social and emotional development. Communication is integral to identity, relationships, participation in daily activities and well-being. Concussions can affect speech clarity, fluency, understanding and use of language, and social interactions. Re-engaging in routine activities and pre-injury roles can be challenging for youth experiencing communication changes as part of complex concussion recoveries. What this paper adds to the existing knowledge Findings from this research illuminate how youth navigate and adapt to communication changes post-concussion and support the development of youth-focused communication education programs, assessments and interventions. Youth participants actively managed their recoveries by developing innovative strategies to support their communication during daily activities, learning about communication, practicing communication tasks sequentially, and facing fears. Youth also reframed and challenged narrow views of 'normal communication'. What are the potential or actual clinical implications of this work? Findings highlight the need for more youth- and communication-focused education materials and programs within youth concussion management protocols. Information about the specific ecological and sociocultural factors youth encounter during concussion recovery is needed to develop targeted communication-focused education and intervention programs for youth and their families to mitigate risks of isolation, loneliness, and mental health concerns and increase youths' participation in family, community and cultural life. By learning from youth about how communication changes affected their participation in daily activities, identity and relationships, clinicians can provide information and interventions to reduce adverse listener reactions and help young people feel supported and understood.

Increasing resilience among LGBTQ youth: The protective role of natural mentors

Based on the minority stress model, which emphasizes the unique risk stressors that impact LGBTQ youths’ lives, and the resilience perspective, which emphasizes the interaction between protective and promotive factors in youth and their surroundings, we investigated in this exploratory study the mechanism by which natural mentoring relationships contribute to LGBTQ youths’ hope. A web sampling of LGBTQ youth aged 12–25 (N = 198) was used, and participants answered a self-report questionnaire to assess their hope, mentor support, risk factors (i.e., internalized homophobia, anti-LGBTQ harassment, level of outness, gender identity and sexual orientation) and personal characteristics. Findings showed that the support of mentors, particularly mentors as autonomy promoters, contributed significantly to LGBTQ youths’ hope. Results also revealed that transgender youth had lower levels of hope than did LGBQ cisgender youth. The mediation analysis revealed that the support of mentors mediated the link between risk factors (e.g., antigay harassment, internalized homophobia) and higher levels of hope. The discussion suggests considering both risk and protective factors as an integral part of LGBTQ youth intervention programs in the contexts of their lives (e.g., school). Also discussed are the possible explanations for the contribution of natural mentoring and the mechanism involved in risk and protective factors. Implications for practice emphasize the importance of increasing LGBTQ youths’ hope via their social ties with mentors in their environments.

Rethinking narratives about youth experiencing homelessness: The influence of self-determined motivation and peer relations on coping.

Using the cognitive appraisal theory of coping and the self-determination theory of motivation, we examined the shared variance of motivational orientations, attachment relationships, and gender on adaptive and maladaptive coping among youth experiencing homelessness. Several scales including The Global Motivation Scale (assessing motivational orientations; i.e., autonomous and controlled motivation), the Brief Cope (adaptive and maladaptive coping strategies), and the Inventory of Parent and Peer Attachment (self-perceptions of relationships with mothers, fathers, and peers) were administered to 102 youth aged between 16 and 24 (Mage = 20, SD = 2.07) years recruited from an evening program for youth experiencing homelessness in Montreal, Canada. Autonomous motivation was positively associated with engagement in effective coping strategies, while controlled motivation was positively linked to maladaptive coping. Moderation analyses were used to examine whether gender and relationships with attachment figures moderated the relationship between motivation and coping. A significant main effect of peer attachment on adaptive coping emerged, in which greater peer attachment was related to more adaptive coping among the youth. No interaction effects resulted. Although no significant moderating effects were associated with essential relationships and gender, further research implementing a more nuanced approach to assessing the interaction between these constructs may be warranted. Overall, the findings highlight the importance of intervention programs for youth experiencing homelessness, that focus on enhancing autonomous motivation and utilizing peer support to optimize the use of adaptive coping strategies.

Feasibility and acceptability of a peer provider delivered substance use screening and brief intervention program for youth in Kenya

BackgroundYouth in sub-Saharan Africa are at high risk of substance use yet lack access to substance use interventions. The goal of this project was to evaluate the feasibility and acceptability of a peer-delivered, single-session substance use screening and brief intervention program for youth in Kenya.MethodsThis was a convergent parallel mixed methods study utilizing both quantitative and qualitative approaches. Two trained peer providers administered the screening and brief intervention program to 100 youth aged 15–24 years. To evaluate the implementation of the intervention, we collected quantitative and qualitative data. Feasibility and acceptability were quantitatively assessed using the Dissemination and Implementation Measures. Fidelity was assessed by rating all 100 audio-recorded sessions using a checklist. To obtain qualitative feedback on the intervention, we conducted five focus group discussions with 25 youths and six semi-structured interviews with two peer providers and four clinic leaders. The semi-structured interviews were guided by the Consolidated Framework for Implementation Research. Quantitative data was analyzed via descriptive statistics using STATA. Qualitative data was analyzed using thematic analysis with NVIVO.ResultsThe lifetime prevalence of any substance use was 50%. The mean level of acceptability of the intervention from the perspective of the youth was 3.53 (SD 0.15), meaning that the youth found the intervention to be acceptable “a lot” of the time. Mean levels of implementation outcomes (acceptability, adoption, Acceptability, Appropriateness, Feasibility, Reach/access, Organizational climate, General leadership skills, and Sustainability) as rated by peer providers and clinic staff ranged between 2.61 (“a moderate amount”) and 4.0 (“a lot”). In qualitative data, youth reported that the intervention was helpful and useful in enabling them to stop or reduce substance use. The peer providers felt that the intervention was easy to implement, while the clinic leaders felt that available resources were adequate, and that the intervention aligned well with the goals of the clinic.ConclusionOur findings suggest that the peer-delivered screening and brief intervention program was perceived as acceptable to the youth and feasible to implement.Trial registrationNCT04998045 Registration date: 10/08/2021.

Adapting a substance use screening and brief intervention for peer-delivery and for youth in Kenya

BackgroundSubstance use is a major problem among youth in sub-Saharan Africa, yet interventions that address this problem are scarce within the region. Screening and brief intervention is a cost-effective, efficacious, and easy to scale public health approach to addressing substance use problems. We conducted a pilot study to evaluate the feasibility of implementing a peer delivered screening and brief intervention program for youth in Kenya. The goal of this paper is to report on the process of adapting the Alcohol Smoking and Substance Involvement Screening Test for Youth-linked Brief Intervention (ASSIST-Y-linked BI) program for peer delivery and for the Kenyan context prior to the pilot. MethodsThe adaptation process was led by a multi-disciplinary team comprised of psychiatrists, pediatricians, and psychologists. We utilized the ADAPT-ITT framework to adapt the ASSIST-Y-linked BI. The ADAPT-ITT framework consists of 8 phases including Assessment, Decision making, Adaptation, Production, Topical Experts, Integration, Training, and Testing the evidence-based intervention. Here, we report on phases 1–7 of the framework. The results of the pilot testing will be out in 2023. ResultsOverall, we made surface level adaptations to the ASSIST-Y-linked BI program such as simplifying the language to enhance understandability. We maintained the core components of the program i.e., Feedback, Responsibility, Advice, Menu of Options, Empathy, Self-efficacy (FRAMES). ConclusionsOur paper provides information which other stakeholders planning to implement the ASSIST-Y-linked BI for youth in sub-Saharan Africa, could use to adapt the intervention.

Barriers and facilitators to scaling up Healthy Choices, a motivational interviewing intervention for youth living with HIV

BackgroundThis study included Community Health Workers and their supervisors from HIV clinical care teams who participated in the Healthy Choices intervention program. Healthy Choices is a Motivational Interviewing-based intervention aimed at improving medication adherence and reducing alcohol use for adolescents and emerging adults ages 16—24 living with HIV. In this study, the intervention was “scaled up” for delivery by local HIV care providers in real-world clinic settings.MethodsProviders (N = 21) completed semi-structured interviews (N = 29) about their experiences with intervention scale-up. Rigorous thematic analyses were conducted within discussions of barriers and facilitators of intervention implementation.ResultsThree dominant thematic areas emerged from the data: (1) perceptions of the Healthy Choices intervention, (2) engaging high risk YLH in in-person behavior interventions, and (3) perspectives on implementation of the intervention using local staff. Results offer insights into implementation of MI-based interventions for adolescents and emerging adults in clinic settings using local clinical staff instead of dedicated research staff.ConclusionsOverall, scaled-up intervention programs for youth are challenged to maintain scientific rigor, provide rigorous training and supports, and offer an attractive and engaging program.

Evaluation of a Health Navigator Pilot Program for Youth in Foster Care

The Health Navigator Program (HNP) was a pilot health mentor intervention program for youth in British Columbia, Canada, with connections to the provincial child welfare system. In this article, youth participants are referred to as “independent youth” as they are independent of traditional familial care. Children and youth in the foster care system face increased prevalence and risk of physical and mental health challenges with lasting implications throughout adulthood. The cumulative effect of childhood trauma, lack of connections to supportive adults, and structural obstacles such as poverty, racism, and sexism all contribute to creating significant barriers for independent youth navigating the health care system. The HNP was created to address these obstacles and facilitate improved health outcomes for independent youth. Youth from 2 program sites were paired with medical student volunteers who provided advocacy and mentorship. A qualitative process evaluation was undertaken to assess the effectiveness of the HNP in achieving the intended program outcomes. Findings revealed that the independent youth participants increased awareness of their own health needs, gained confidence in navigating the health care system, and had improved short-term health outcomes. Relationship building with a caring adult, outside of a paid professional role, was shown to be the most significant factor in achieving these positive outcomes.

Dark Triad: Associations with juvenile delinquency, conduct disorder and trauma

The Dark Triad (DT) consists of three personality traits (machiavellianism, narcissism, and psychopathy). This is considered relevant for understanding the development of undesirable characteristics for society, frequently observed in young people and adults with antisocial and delinquent behaviours. Aversive personality traits have only recently aroused interest in researchers as a cohesive set of factors. The aim of this study was to analyse the associations of the DT (machiavellianism, narcissism, and psychopathy) with juvenile delinquency, conduct disorder (CD), and trauma. For this, a total sample of Portuguese adolescents (n=601; Mage=15.95 years, SD=1.05 years, range=13-18 years) was used, subdivided into a male forensic group, male school group, and female school group. After the elaboration of multiple linear regression models, the results indicated that the psychopathy dimension was the one with the greatest association with juvenile delinquency and CD, while the narcissism dimension was the one with the greatest association with trauma. In future studies, the associations of the DT with juvenile delinquency, CD, and trauma in Portuguese adolescents should continue to be explored in the forensic and school contexts, to further clarify these relationships and contribute to the development and implementation of prevention and intervention programs for Youth with these characteristics.

Manuscript: Defining Quality Standards for Intensive Home Based Treatment Programs for Youth with Serious Emotional Disorders

Intensive Home Based Treatment (IHBT) is a critical component of the continuum of community-based behavioral healthcare for youth with serious emotional disorder (SED) and their families. Yet despite being used nationwide at costs of over $100 million annually in some states, a well-vetted, research-based set of quality standards for IHBT has yet to be developed. The current project aimed to define program and practice standards for IHBT, drawing upon literature review, expert interviews, and a systematic Delphi process engaging over 80 participants, including IHBT developers, experts in evidence-based youth mental health, youth and family advocates, IHBT providers, and state policymakers. After two rounds of quantitative and qualitative input, adequate consensus was achieved on 32 IHBT Program Standards and 43 IHBT Practice Standards. These standards hold potential for informing efforts such as development of state regulations, provider contracts, memoranda of agreement, and training and workforce development initiatives. Translation of the quality standards into measurement strategies holds potential for providing a method of continuous quality improvement across multiple levels as well as use in research on IBHT.

A randomized controlled trial of a new intervention in early symptomatic syndromes eliciting neurodevelopmental clinical examinations: PR-ESSENCE

The need for effective intervention programs for youth with neurodevelopmental problems (ESSENCE) and challenging behaviour is great. This study examines Problem Resolution in ESSENCE (PR-ESSENCE), a newly developed model in which children and parents develop mutual problem resolution strategies. Ten-week randomized controlled trial of PR-ESSENCE for children and adolescents aged 5–18 years, compared to treatment as usual. Outcomes were assessed at baseline and randomized period endpoint. Primary outcome was the Clinical Global Impression—Improvement scale (CGI-I) rated by blinded assessors. Secondary outcomes were rated by parents—SNAP-IV, Eyberg Child Behavior Inventory (ECBI), Relationship Problems Questionnaire, Family Burden of Illness Module, and children—Beck Youth Inventories (BYI). ClinicalTrials.gov identifier: NCT03780413. The study enrolled 108 participants (active n = 72; controls n = 36, randomized 2:1), of whom 95 completed the randomized period. No clinically significant group differences were found in baseline characteristics. More than half had autism and 80% had ADD or ADHD. Large treatment effects were seen on CGI-I (ITT analysis, Effect Size 1.48). Treatment responders, much/very much improved on CGI-I, were 51.4% in active group and 5.6% of controls. Effect sizes were medium to large in parent ratings on SNAP-IV (ODD and ADHD symptoms), ECBI (behaviour problems), and in BYI child self-ratings of disruptive behaviour. PR-ESSENCE treatment improved global symptoms and functioning (CGI-I), behaviour problems, ADHD and ODD symptoms, and disruptive behaviour. Treatment effects were at least equivalent to those in previous studies of well-established Parent Management Training and Collaborative Problem Solving programs.

Cognitive-Behavioral Skills Building to Alleviate the Mental Health Effects of Bullying Victimization in Youth.

Bullying is a long-standing problem with relatively few intervention options for individual youth who have experienced it and have adverse mental health concerns. Depression, anxiety, and suicidal ideation are major consequences of bullying victimization. Although few evidence-based interventions have been put forth to address bullying victimization at the individual level, cognitive-behavioral therapy (CBT) and cognitive-behavioral skills building (CBSB) have been well researched for mental health concerns in youth. The purpose of the current article is to examine the theoretical framework of cognitive theory for individuals who have experienced bullying. Previous work that has addressed CBT for bullying interventions is described. Specific examples of how CBSB components could be applied to a bullying intervention program for youth are discussed. Ultimately, providing a theoretical framework to address this public health concern sets the stage for future intervention research. [Journal of Psychosocial Nursing and Mental Health Services, 59(5), 15-20.].

Efficacy of a computer-assisted cognitive-behavior therapy program for treating youth with anxiety and co-occurring autism spectrum disorder: Camp Cope-A-Lot

BackgroundIn a crossover design the current study describes the efficacy of a computer-assisted intervention program for youth with autism spectrum disorder (ASD) who also experience co-occurring anxiety. MethodsThe computer-assisted cognitive behavior therapy (CBT) program for treating anxiety, Camp Cope-A-Lot (CCAL) was compared to control intervention, another computer-assisted program, The Social Express (TSE), that does not employ CBT nor is targeted for the treatment of anxiety. TSE is designed to improve social skills in youth with ASD. Participants had a principal anxiety disorder and a current diagnosis of ASD. Participants received 12-sessions of CCAL or 12-sessions of TSE. Outcome measures were obtained at intake, upon completion of the first intervention of the trial and upon completion of the second intervention of the trial. ResultsCCAL was efficacious for treating anxiety. Participants who completed CCAL demonstrated significant and clinical reductions in anxiety when compared to participants who completed TSE. Both interventions, CCAL and TSE, resulted in some limited improvement in social skills. ConclusionsThe current study showed that anxiety symptoms in youth with ASD and co-occurring anxiety disorders can benefit from computer-assisted CBT employing CCAL. This expands previous literature employing computer-assisted CBT interventions in youth, and more specifically, youth with ASD.

Determinants of attrition in a pediatric healthy lifestyle intervention: The CIRCUIT program experience

IntroductionAttrition in pediatric weight management programs is notoriously high. Greater understanding of its determinants is needed to inform retention strategies. We identified determinants of attrition in CIRCUIT, a healthy lifestyle intervention program for youth at risk of cardiovascular disease. MethodsA one-arm intervention study of children aged 4-18 years who initiated the CIRCUIT program in the first five years of its existence (N = 403). We defined attrition as attending the baseline visit but ceasing attendance prior to the 1-year follow-up. Potential determinants of dropout included the child’s age, sex, ethnicity, body mass index (BMI) z-score, family socio-demographic characteristics, and estimated driving time to the program, all measured at baseline. Associations were estimated bivariately, using chi-squared- and t-tests, and simultaneously in a multivariable logistic regression model. ResultsOf the 403 participants who started the program, 198 (49%) dropped out within 12 months of enrollment. Youth who dropped out were older (mean age 12.8y vs. 11.3y; p < 0.01), were less likely to live with both parents (62% vs. 71%; p = 0.05), and to have mothers who had completed high school (79% vs. 88%; p = 0.01). No group differences were observed for sex, ethnicity, baseline BMI z-score, fathers’ education, or driving time to the program. In multivariate models, only older age at initiation of the intervention (OR: 1.2; CI: 1.1,1.3) and lower maternal education (OR: 2.0; CI: 1.0,3.8) were associated with dropout. ConclusionImproved tailoring of interventions to older pediatric participants and to families of lower maternal education may help reduce attrition in CIRCUIT and similar lifestyle intervention programs.

The role of natural mentoring and sense of belonging in enhancing resilience among youth in care

• We examined adolescent's resilience as manifested by their hope and current life skills. • We examined the role of mentoring and sense of belonging as promotive factors. • Mentoring relationships were positively correlated with better economic status. • Sense of belonging mediated the association between mentoring and resilience. Based on resilience and ecological perspective models, which emphasize the interaction between protective and promotive factors in youth and in their surroundings, this study explored the mechanism by which natural mentoring relationships and sense of belonging contribute to youths' life skills and hope. The participants comprised 213 adolescents in out-of-home placement placements in Israel (16–19 years old). Structural equation modelling revealed sense of belonging mediated the association between youths’ mentoring relationships and youths' resilience as manifested by their hope and current life skills. The discussion suggests considering these factors as an integral part of youth intervention programs in the context of residential care. Also discussed are the possible explanations for the mechanism linking youths' life skills, hope, and sense of belonging, in relation to which mentoring relationships operate. Implications for practice emphasize the importance of considering instrumental aspects as well as mental and motivational aspects to enhance youths' resilience in their transition to adulthood.

Steadfast benevolence: A new framework for understanding important adult-youth relationships for adolescents in care

Abstract Positive relationships with parents, caregivers and other adults are shown as critically important in supporting child and adolescent development. One consequence for youth of being involved in the child welfare system is the disruption of these relationships. Youth in care often lack relational permanence or meaningful bonds to sustain them in their transition to adulthood. Relationship-based interventions for youth in care, such as kinship care and mentoring, are poised to improve on youths’ relationships with adults, though many intervention programs for youth in care are skills-based. This study is based on interviews with 17 adolescents in care (88% African–American, 12% Latinx, 14–19 years old, from a large urban center) who were part of a program aimed at supporting high-school aged youth in care in their transition to adulthood. Through iterative coding of all interviews, adult-adolescent relationships facilitated by the program emerged as a strong area of focus within the data. Data reflecting this focus were further analyzed using an interpretivist thematic approach. Findings reveal that adolescents experienced the program-based relationships in family terms, which were further classified by attributes captured by the central conceptual framework reflected in the data, identified as steadfast benevolence. Findings point to steadfast benevolence as an umbrella for multiple positive and instrumental relational qualities. This article concludes with discussion of implications of this concept for practice and future research.

1306-P: Impacting Youth with Poorly Controlled Type 1 Diabetes

Background: Youth with poorly controlled type 1 diabetes (T1D) are at increased risk for morbidity yet very few interventions have targeted this vulnerable population. The purpose of this study was to test the feasibility, acceptability and preliminary efficacy of an intensive, team-based intervention program for youth with HbA1c ≥ 9.5%. Methods: Forty patients (age 14.1±2.3 years, 53% male) with T1D (duration 6.5±4.3 years) were enrolled in an intensive, 4-month team-based intervention that included a visit with their primary endocrinologist and a pediatric psychologist at baseline as well as up to 6 encounters (in-person visits and calls) with a Certified Diabetes Educator (CDE). The CDE encounters were designed to establish goals, support behavior changes, review glucose logs, and make interim dose adjustments as needed. Feasibility was measured by the number of patients approached and the number of patients who ultimately agreed to participate, acceptability was measured by attendance and attrition rates, and preliminary efficacy was assessed by changes in HbA1c and diabetes-related Quality of Life (QoL). Data were collected at baseline and 4 months. Results: Of the 42 patients who were approached, 40 agreed to participate, and 35 (87.5%) completed the 4-month program. CDE engagement with patients included an average of 3 phone calls and 3 in-person visits. Compared to baseline, HbA1c reduced from 12.0%±1.6 at baseline to 11.0%±1.9 at the 4 month visit (p&amp;lt;0.001) and QoL increased from 61.0±12.3 to 64.7±11.0 (P&amp;lt;0.05). Conclusion: Intensive team-based interventions in pediatric patients with poorly controlled T1D can improve glycemic control and QoL. Disclosure M. Chambers: None. G.Q. Shaibi: None. C.R. Kapadia: None. F. Hoekstra: None. S.S. Puffenberger: None. L. Touger: None. I.K. Radcliffe: None. L. Holzmeister: None. K.A. Olsen: None. Funding Thomas J. Beatson, Jr. Foundation

School-level predictors of conduct problems in adolescence: a longitudinal analysis of UK data

BackgroundConduct problems, which include aggression, lying, and stealing, can differ in terms of continuity and desistence across different stages of life, such as childhood and adolescence. Although several research efforts have investigated individual-level factors associated with continuity and desistence of conduct problems in adolescence, less is known about school-level factors that might underlie such patterns. MethodsWe undertook longitudinal latent class analysis to identify trajectories of conduct problems across adolescence (age 11–15 years) using the Learning Together study dataset (n=3901, 50·7% female), which includes adolescents in 40 state schools within Greater London, UK. We then investigated the role of several school-level factors (such as Ofsted rating, gender of students, school deprivation, school type, and school atmosphere, according to information gathered through the government website or through self-reported questionnaire) in predicting class membership using multinomial logistic regression. On the basis of the Bayesian Information Criterion and entropy, we selected the best fit model with two classes of conduct problems using three data points: a stable low and a moderate-high class across male and female students. A multi-level model was employed to account for school-level clustering. FindingsSeveral school-level factors predicted persistent patterns of conduct problems in male and female students separately, even after controlling for family-level confounders such as socio-economic status and family structure. However, positive school atmosphere was the factor that was most strongly associated with reduced risk of persistent conduct problems across male and female students. More specifically, a better school atmosphere at baseline was associated with lower risk of being in the moderate-high class for conduct problems in both female (OR 0·365, 95% CI 0·253–0·527) and male students (0·290, 0·186–0·451). InterpretationRelationships between teachers and students, sense of belonging to the school, and participation in school activities are aspects that researchers and schools should consider when implementing prevention and intervention programs for youth with conduct problems and antisocial behaviour. A strength of this study was that it included a large sample of adolescents. A limitation was that we did not investigate causality, which should be addressed in future research. FundingPartly supported by the NIHR through a funded intervention study called Learning Together (ISRCTN10751359).

Preliminary Findings of KINNECT: A Psychosocial Intervention for Youth in Residential Treatment

ABSTRACT Early intervention programs for youth in residential treatment can have a positive impact on numerous outcomes, including health, educational performance, and reduced prevalence of high-risk behaviors. Yet, there is currently a limited number of evidenced-based interventions that treat youth in these settings. This paper presents preliminary findings of a new psychosocial treatment for adolescents in residential treatment that can be implemented by front-line youth professionals. A 20-session multimodal group social skill building intervention, called KINNECT, was developed to address numerous health-risk behaviors through movement-based psychosocial skill building. A quasi-experimental post-test only design using non-equivalent groups was used on 63 participants from two residential treatment facilities in the Midwest. The findings of this study found a reduced likelihood of non-emergency medical visits and self-harming behavior in those who participated in the KINNECT intervention. The authors provide a discussion of these findings along with recommendations for future research.

Evaluating the Effects of an Adolescent Family Violence Intervention Program on Recidivism among Court-Involved Youth

Child to family violence is a significant problem, and research on effective programs is lacking. The current study evaluates Step Up, a group intervention program for youth and parents to address youth-initiated patterns of violence. In this retrospective evaluation, we compared 115 court-involved youth who participated in Step Up between 2006 and 2015 to a propensity score weighted group of court-involved youth who had never participated in the program on three outcomes: general recidivism, assault-related recidivism, and domestic violence (DV)-related recidivism. The two groups were adequately balanced on 13 variables capturing background risk prior to outcome analyses. After propensity score weighting, the treatment group showed a significantly lower risk of general recidivism within 12 months, regardless of program completion (21.7% versus 30.9% for the comparison group). Program completion appeared to further boost positive results, as the risk of general recidivism was 14.7%, compared to 27.3% for the weighted comparison sample. However, program participation was not significantly related to either assault-related recidivism or DV-related recidivism, after controlling for background risk. The results of this study indicate that Step Up shows some promise as an effective program to reduce recidivism for youth engaged in child to family violence. However, the results are somewhat mixed, given the lack of effect on future assault-related and DV-related court referrals. Implications for policy and practice are discussed.