Biomedical subjects

Gerald J August

Publications and source records attributed to Gerald J August.

12 recordsLinked to original sources

PubMed2006

Can evidence-based prevention programs be sustained in community practice settings? The Early Risers' Advanced-Stage Effectiveness Trial.

This study evaluated institutional sustainability of the Early Risers "Skills for Success" conduct problems prevention program. In a previous early-stage effectiveness trial Early Risers had been successfully implemented by a nonprofit community agency with guidance, supervision, technical assistance and fiscal support/oversight provided by program developers. The current advanced-stage effectiveness trial applied a randomized, control group design to determine whether this community agency could replicate earlier positive findings with a new cohort of participants, but with less direct involvement of program developers. An intent-to-intervene strategy was used to compare children randomly assigned to Early Risers or a no-intervention comparison group. Compared to results obtained in an early-stage effectiveness trial, program attendance rates were much lower and only one positive outcome was replicated. Failure to replicate program effects was not attributed to poor program implementation, because data collected pertaining to exposure, adherence and quality of delivery were acceptable, and a participation analysis showed that families who attended at higher levels did benefit. It was difficulties that the community agency experienced in engaging families in program components at recommended levels that primarily accounted for the results. Possible organizational barriers that impeded sustainability included unreliable transportation, poor collaboration between the agency and the local public school system, high staff turnover, agency downsizing, and fiduciary responsibility and accountability. It was concluded that both program developers and program providers need to be proactive in planning for sustainability.

Child↗

PubMed2006

Implementing an evidence-based preventive intervention in neighborhood family centers: examination of perceived barriers to program participation.

: This study examined parents' perceived barriers to participation in a multicomponent prevention program implemented by a community agency serving culturally diverse urban neighborhoods. The Early Risers Participation Interview (ER-PI), modeled after Kadzin et al.'s (1997) Barriers to Treatment Participation Scale, was administered to parents (N = 138) of children who were screened for disruptive behavior and were randomized into a two-year intervention condition. Results showed that the perceived barriers score provided significant information in differentiating low and high participators after controlling for child, parent, and family characteristics. Early identification and resolution of parents' perceived barriers to participation may be key to implementing multifaceted preventive programs successfully in inner-city neighborhoods. EDITOR'S STRATEGIC IMPLICATIONS: The authors present promising practices for client engagement and retention. The experimental, longitudinal design is notable, especially in the evaluation of a community-run prevention program.

Adult↗

PubMed2006

Prospective study of adolescent drug use among community samples of ADHD and non-ADHD participants.

OBJECTIVE: To describe the late adolescent drug use outcomes from a relatively large, community-identified sample of children with attention-deficit/hyperactivity disorder (ADHD) who have been assessed longitudinally from childhood through late adolescence. METHOD: Adolescent drug use outcomes were compared between ADHD-only (n = 27), ADHD-externalizing (mostly oppositional defiant disorder) (n = 82), and normal control (n = 91) groups. RESULTS: The ADHD-externalizing group revealed significantly worse drug use outcomes (drug use frequency and substance use disorders) compared to the other two groups, and the ADHD-only group showed outcomes comparable to the community control group. CONCLUSIONS: ADHD without a comorbid externalizing disorder is not associated with an increased risk of drug abuse. ADHD with a comorbid externalizing disorder, primarily oppositional defiant disorder, is associated with an elevated risk of drug use, particularly with respect to marijuana and tobacco involvement.

Adolescent↗

PubMed2004

Moving evidence-based drug abuse prevention programs from basic science to practice: "bridging the efficacy-effectiveness interface".

This article examines the challenges faced by developers of youth drug abuse prevention programs in transporting scientifically proven or evidence-based programs into natural community practice systems. Models for research on the transfer of prevention technology are described with specific emphasis given to the relationship between efficacy and effectiveness studies. Barriers that impede the successful integration of efficacy methods within effectiveness studies (e.g., client factors, practitioner factors, intervention structure characteristics, and environmental and organizational factors) are discussed. We present a modified model for program development and evaluation that includes a new type of research design, the hybrid efficacy-effectiveness study that addresses program transportability. The utility of the hybrid study is illustrated in the evaluation of the Early Risers "Skills for Success" prevention program.

Adolescent↗

PubMed2004

Testing the goodness-of-fit of a multifaceted preventive intervention for children at risk for conduct disorder.

OBJECTIVE: To determine the importance of parents' global adaptive functioning as a predictor of participation rate and subsequent child social competence outcome in 3 program components of an evidence-based, multifaceted, preventive intervention for at-risk children. METHOD: Families of program children (n = 124, mean age 6.6 years at recruitment) were offered 3 program components that continued for 3 years: a 6-week summer program, a biweekly family program that included concurrent parent and child education and skills training groups, and a flexibly tailored home visitation family support program. We used structural equation modelling to test hypotheses about the effects of parental characteristics on program attendance in each of the program components over 3 years, as well as their relation to children's social competence. RESULTS: Predictors of attendance included child IQ, socioeconomic status (SES), and single-parent status for some components but not others, depending on parents' global adaptive functioning. Predictors of child social competence outcome were mediated by attendance in specific program components and were dependent on parent global adaptive functioning. Some components contributed decisively to social competence outcomes, and others did not, despite subjects' participation. CONCLUSIONS: Common family characteristics (that is, child IQ, SES, and single-parent status) predict program attendance differently, depending on parents' global adaptive functioning. Parents' global adaptive functioning determined whether attendance in specific program components mediated children's social competence. In this preventive intervention, as in clinical practice, only knowledge of the goodness-of-fit between participant characteristics and program attributes can ensure optimum benefit.

Adaptation, Psychological↗

PubMed2003

Effects of pairing aggressive and nonaggressive children in strategic peer affiliation.

Examined the behavior of 118 second graders who participated in a 6-week summer school program that incorporated strategic peer affiliation (a "buddy system"). Moderately aggressive children (the targets of the intervention) were paired with nonaggressive peers throughout the program. All participants were observed playing foosball with their buddies and with aggressive and nonaggressive nonbuddies as teammates. Aggressive children had lower levels of disruptive behavior when their teammate was nonaggressive, regardless of whether the teammate was a buddy. Nonaggressive children showed elevated disruptive behavior when playing with an aggressive nonbuddy, but not when playing with an aggressive buddy. The highest level of aggressive behavior was seen in pairs of aggressive teammates who were friends. One year later, no increase in peer-rated aggressive behavior was found in either group. Results suggest that unidirectional peer influence is possible and that strategic peer affiliation can be an effective intervention that does not put nonaggressive children at risk for acquiring undesired behaviors.

Aggression↗

PubMed2003

Parceling component effects of a multifaceted prevention program for disruptive elementary school children.

This study examined predictors and outcomes of attendance in two standard components of a multifaceted preventive intervention aimed at children with early-onset disruptive behavior after 3 years of intervention. Mean rate of attendance in the Family Program, but not the Summer School Program, differed by level of child disruptiveness (grouping variable). Although predictors of attendance (SES, single-parent status, child IQ) did not differ across high- and low-disruptive groups, predictors of outcome were moderated by level of child disruptiveness for academic achievement and aggression outcomes, but not for social competence. Higher attendance in the Summer Program was associated with higher child social competence at Year 3 for all children. For academic achievement, higher attendance in the Summer Program was associated with higher scores for mild/moderately disruptive children and lower scores for highly disruptive children in Year 3. Higher attendance in the Family Program was associated with lower aggression scores for mild/moderately disruptive children. Findings highlight the importance of matching intervention components to the assessed or expressed needs of client subgroups.

Aggression↗

PubMed2003

Dissemination of an evidence-based prevention innovation for aggressive children living in culturally diverse, urban neighborhoods: the Early Risers effectiveness study.

This study evaluated the effectiveness of the Early Risers "Skills for Success" Program when implemented by neighborhood family resource centers available to urban children and their families. Kindergarten and first-grade children (n = 327) enrolled in 10 schools were screened for aggressive behavior, and randomized to two model variations of the Early Risers Program or a no-intervention control condition. The full-strength model (CORE + FLEX) included child and parent/family components whereas the partial model (CORE-only) offered only the child component. The intervention was delivered over two continuous years. CORE + FLEX children showed higher levels of program attendance than their CORE-only counterparts but no differences on outcomes measures were observed between models. When both program models were collapsed and compared to controls, program children showed significant gains on measures of school adjustment and social competence, the most aggressive program children showed reductions in disruptive behavior, and program parents reported reduced levels of stress.

Aggression↗

PubMed2002

Gender differences in psychiatric comorbidity among adolescents with substance use disorders.

The authors examined gender differences in rates of comorbid psychiatric disorders among adolescents with I or more psychoactive substance use disorders. Baseline diagnostic data were obtained from 135 adolescents, ages 12 to 19, and their parents-guardians, who participated in a study to develop and efficacy test Integrated Family and Cognitive-Behavioral Therapy. Rates of attention-deficit/hyperactivity disorder and conduct disorder were higher among drug-abusing male adolescents compared with drug-abusing female adolescents. However, high rates of disruptive behavior disorders also characterized drug-abusing female adolescents. Similarly, drug-abusing female adolescents exhibited a higher rate of major depression compared with drug-abusing male adolescents. However, rates of dysthymia, double depression (i.e., major depression and dysthymia), and bipolar disorder were equivalent between genders.

Adolescent↗

PubMed2002

The early risers longitudinal prevention trial: examination of 3-year outcomes in aggressive children with intent-to-treat and as-intended analyses.

The effects of participation following a 3-year preventive intervention trial targeting elementary school children with early-onset aggressive behavior were evaluated. Intent-to-treat analyses revealed that program participants, compared with controls, showed greater gains in social skills, academic achievement, and parent discipline, with mean scores in the normative range on the latter two constructs. As-intended participation in the Family Program, which included separate parent and child education and skills-training groups, was associated with improved parent discipline practices and gains in children's social skills, with level of child aggression moderating gains in academic achievement. Recommended level of FLEX family support contact time was associated with gains in academic achievement, concentration problems, and social skills, with parents of severely aggressive children showing greater reductions in parent distress.

Achievement↗

PubMed1998

Diagnosing attention deficit disorders with the Behavioral Assessment System for Children and the Child Behavior Checklist: test and construct validity analyses using optimal discriminant classification trees.

The usefulness of the Behavioral Assessment System for Children (BASC) and Child Behavior Checklist (CBCL) Parent scales was examined with respect to (a) differentiating students with attention deficit-hyperactivity disorder (ADHD) from non-ADHD students and (b) discriminating between the predominantly inattentive-type and combined-type ADHD-afflicted students. For both the BASC and the CBCL, a different optimal discriminant classification tree analysis (CTA) model was developed for each of the 2 diagnostic predictions. For distinguishing ADHD students from non-ADHD students, the BASC model was more parsimonious and accurate than the CBCL model. Toward the goal of differentiating between primarily inattentive and combined types, the CBCL's model was superior for predicting primarily inattentive students. The results demonstrate the diagnostic utility of the BASC and CBCL and describe salient behavioral dimensions associated with subtypes of ADHD.

Attention Deficit Disorder with Hyperactivity↗

PubMed1992

Attention deficit hyperactivity disorder: an epidemiological screening method.

Multistage identification, an epidemiological screening method of diagnostic assessment, was used to identify attention-deficit hyperactivity disorder (ADHD) in 1,490 elementary-school students. Children diagnosed with ADHD exhibited more impairment on adjustment measures and were more likely to have coexisting disruptive behavior disorders than were children diagnosed as subclinical non-ADHD.

Achievement↗