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Disruptive behavior disorders in childhood are increasingly pervasive and associated with numerous, negative long-term outcomes. The current study examined whether adding a brief, home-visitation intervention to an existing, multi-component (child and teacher) intervention, would improve social-emotional and behavioral outcomes for young children with challenging behavior in home and school settings who required intensive support. A total of 379 teacher-parent-student triads were screened for elevated levels of behavioral risk in school and home settings and then randomly assigned to school only intervention (i.e., teacher and student components), home only intervention (i.e., parent), both combined, or business-as-usual control conditions. We examined baseline and posttest outcomes across prosocial behavior, problem behavior, and academic domains. The results demonstrated substantial support for the teacher and child-focused condition and combined conditions, and modest support for the parent-focused condition. The study advances the literature by increasing the knowledge base related to these interventions implemented alone and in combination.

BackgroundPostpartum depression (PPD)—the most common complication of childbirth—is a significant and prevalent public health problem that severely disrupts family interactions and can result in serious lasting consequences to the health of women and the healthy development of infants. These consequences increase in severity when left untreated; most women with PPD do not obtain help due to a range of logistical and attitudinal barriers. ObjectiveThis pilot study was designed to test the feasibility, acceptability, and potential efficacy of an innovative and interactive guided Web-based intervention for postpartum depression, MomMoodBooster (MMB). MethodsA sample of 53 women who satisfied eligibility criteria (

BackgroundPhysical activity (PA) for older adults has well-documented physical and cognitive benefits, but most seniors do not meet recommended guidelines for PA, and interventions are lacking. ObjectivesThis study evaluated the efficacy of a 12-week Internet intervention to help sedentary older adults over 55 years of age adopt and maintain an exercise regimen. MethodsA total of 368 sedentary men and women (M=60.3; SD 4.9) were recruited, screened, and assessed online. They were randomized into treatment and control groups and assessed at pretest, at 12 weeks, and at 6 months. After treatment group participants rated their fitness level, activity goals, and barriers to exercise, the Internet intervention program helped them select exercise activities in the areas of endurance, flexibility, strengthening, and balance enhancement. They returned to the program weekly for automated video and text support and education, with the option to change or increase their exercise plan. The program also included ongoing problem solving to overcome user-identified barriers to exercise. ResultsThe multivariate model indicated significant treatment effects at posttest (P=.001; large effect size) and at 6 months (P=.001; medium effect size). At posttest, intervention participation showed significant improvement on 13 of 14 outcome measures compared to the control participants. At 6 months, treatment participants maintained large gains compared to the control participants on all 14 outcome measures. ConclusionsThese results suggest that an online PA program has the potential to positively impact the physical activity of sedentary older adult participants. More research is needed to replicate the study results, which were based on self-report measures. Research is also needed on intervention effects with older populations.

BackgroundPostpartum depression is a significant public health problem affecting approximately 13% of women. There is strong evidence supporting Cognitive Behavioral Therapy (CBT) for successful psychosocial treatment. This treatment model combines cognitive and behavioral strategies to address pessimism, attributions for failure, low self-esteem, low engagement in pleasant activities, social withdrawal, anxiety, and low social support. Encouraging results have been reported for using Web-based CBT interventions for mental health domains, including the treatment of panic disorder, post-traumatic stress disorder, and complicated grief and depression. To date, however, Web-based interventions have not been used and evaluated specifically for the treatment of postpartum depression. ObjectiveWe describe the formative work that contributed to the development of our Web-based intervention for helping to ameliorate symptoms of postpartum depression, and the design and key components of the program. MethodsA total of 17 focus group participants and 22 usability testers, who shared key characteristics with the participants of our planned feasibility study, took part. ResultsThe qualitative and quantitative data gathered in the focus groups and usability sessions reported here suggest that the new mothers involved had largely positive reactions to the major features of the program and that those program features performed well in terms of usability. ConclusionsAn overview of the eventual design, architecture, and key program ingredients of the MomMoodBooster program is provided including innovative features supplementing 6 core CBT sessions, which include a partner’s website, a library, and individual feedback by a personal coach.

Early intervention efforts have been effective in reducing disruptive behaviors and the probability of poor developmental outcomes. Early interventions include common practice elements to improve social functioning and decrease problem behaviors that disrupt the teaching-learning process. The First Step Next intervention has been well validated across early childhood and early elementary settings. In the present article, we provide a best-evidence synthesis of five randomized controlled replication studies between 2009 and 2021. Collectively, these studies show the intervention has resulted in small to large effect sizes and statistically significant improvements, compared with students randomized to control conditions, on multiple indicators of prosocial and problem behavior. The current synthesis focuses on a range of outcomes across elementary and preschool populations, as well as implementation fidelity and social validity ratings, to help school professionals in determining whether First Step Next might be useful in their efforts to support students at risk of school failure.

Background Concurrent with their enrollment in Web-based Randomized Controlled Trials (RCTs), participants can easily choose to use treatment programs that are not assigned in the study. The prevalence of using non-assigned treatments is largely unknown although it is likely to be related to the extent to which non-assigned treatments are: (a) easy to find and use, (b) low in cost, (c) well publicized, and (d) available from trusted sources. The impact of using other programs—both beneficial and detrimental—warrants additional research investigation. Objective The aim of this report is to explore the extent to which participants enrolled in a Web-based intervention for smoking cessation used treatment methods that were not explicitly assigned (“non-assigned treatment”). In addition to describing the relation between using non-assigned treatments and smoking cessation outcomes, we also explore the broader issue of non-assigned program use by RCT participants in Web-based behavioral interventions, generally. Methods We describe the use of other programs (as measured by self-report at the 3-month follow-up assessment) by 1028 participants who were randomized to the Web-based SHIP (Smokers’ Health Improvement Program) RCT which compared the Quit Smoking Network (QSN) treatment program and the Active Lives control condition. We examine the extent to which pharmacotherapy products were used by participants in the QSN condition (which explicitly recommended their use) and the Active Lives condition (which purposefully omitted mention of the use of pharmacotherapy). We also test for any between-condition impact of using non-assigned treatments and pharmacotherapy products on smoking cessation outcomes. Results A total of 24.1% (248/1028) participants reported using one or more smoking cessation treatment programs that were not explicitly recommended or assigned in their treatment protocol. Types of non-assigned treatments used in this manner included individual counseling (1.7%), group counseling (2.3%), hypnotherapy/acupuncture (4.5%), pamphlets/books (12.6%), and other Web-based smoking cessation programs (9.0%). Participants who used non-assigned treatments were more likely to be female and have at least a high school education. Use of non-assigned Web programs was related to greater levels of self-reported smoking cessation measured at the 3-month assessment (OR = 2.63, CI = 1.67 - 4.14, P < .001) as well as the combined 3- and 6-month assessments (OR = 2.09, CI = 1.11 - 3.91, P = .022). In terms of reported medication use, there were no differences between conditions in the number of pharmacotherapy products used. However, more participants in the QSN condition used at least one pharmacotherapy product: 50.0% (262/524) vs 43.8% (221/504); χ2 (1, N = 1028) = 3.90, P = .048. The use of pharmacotherapy and non-assigned treatment types showed a small but marginally significant correlation: r1028 = .061, P = .05. Conclusions A noteworthy proportion of individuals recruited via the Internet to participate in a Web-based intervention used treatment programs and tools not formally assigned as a part of their research protocol. We consider factors likely to influence using non-assigned treatments and suggest ways that future research can begin to study more fully this important phenomenon which is likely to be found in any type of research, but may be particularly pronounced in minimal contact, Web-based intervention trials.

Background Smoking cessation remains a significant public health problem. Innovative interventions that use the Internet have begun to emerge that offer great promise in reaching large numbers of participants and encouraging widespread behavior change. To date, the relatively few controlled trials of Web-based smoking cessation programs have been limited by short follow-up intervals. Objective We describe the 6-month follow-up results of a randomized controlled trial in which participants recruited online were randomly assigned to either a Web-based smoking cessation program (Quit Smoking Network; QSN) or a Web-based exercise enhancement program (Active Lives) adapted somewhat to encourage smoking cessation. Methods The study was a two-arm randomized controlled trial that compared two Web-based smoking cessation programs: (1) the QSN intervention condition presented cognitive-behavioral strategies, and (2) the Active Lives control condition provided participants with guidance in developing a physical activity program to assist them with quitting. The QSN condition provided smoking cessation information and behavior change strategies while the Active Lives condition provided participants with physical activity recommendations and goal setting. The QSN condition was designed to be more engaging (eg, it included multimedia components) and to present much greater content than is typically found in smoking cessation programs. Results Contrary to our hypotheses, no between-condition differences in smoking abstinence were found at 3- and 6-month follow-up assessments. While participants in the QSN intervention condition spent more time than controls visiting the online program, the median number of 1.0 visit in each condition and the substantial attrition (60.8% at the 6-month follow-up) indicate that participants were not as engaged as we had expected. Conclusions Contrary to our hypothesis, our test of two Web-based smoking cessation conditions, an intervention and an attention placebo control, failed to show differences at 3- and 6-month assessments. We explored possible reasons for this finding, including limited engagement of participants and simplifying program content and architecture. Future research needs to address methods to improve participant engagement in online smoking cessation programs. Possible approaches in this regard can include new informed consent procedures that better explain the roles and responsibilities of being a research participant, new program designs that add more vitality (changing content from visit to visit), and new types of reminders pushed out to participants to encourage return visits. Simplifying program content through a combination of enhanced tailoring and information architecture also merits further research attention.

The purpose of this study was to examine whether seventh-grade positive peer affiliation and conduct problems mediated the relationship between sixth-grade parental monitoring of behavior and eighth-grade school participation and grades among students with elevated behavior ratings (EBR; n = 821) and students with unelevated behavior ratings (UBR; n = 3,779). Conduct problems and peer affiliation mediated the relationship between parental monitoring and school participation as well as grades in the overall sample (n = 4,600). A multiple-group mediation model suggested that these effects did not significantly differ across students with EBR and UBR, though the mediation estimates were smaller in magnitude and not statistically significant among students with EBR. Implications for the role of parental monitoring as an intervention target within a multitiered system of support for social and behavioral skills in middle school, as well as limitations and future directions are discussed.

Background: Mental health conditions are common among individuals with intellectual disability. Under recognition of mental health disorders leading to unmet treatment needs is common in this population. This article addresses one major contributing factor, the lack of cognitively accessible self-report measures for individuals with intellectual disability. Method: In this literature-informed overview of the state of the field, we discuss the need for, and complexities of, including individuals with intellectual disability in mental health assessments. Results: With appropriate supports, many individuals with intellectual disability can respond to mental health questions. We discuss evidence-based strategies to make mental health assessments more accessible. Conclusion: We highlight the need to engage individuals with intellectual disability to provide first-hand information about their health and well-being. New instruments and research procedures should be developed in partnership with individuals with intellectual disability. Self-report may be essential to advancing the science of mental health research. [This article was co-authored by the Nisonger Center RRTC on Health and Function.]

The present study examined influences of sixth-grade student-reported parent educational involvement on early adolescent peer group affiliations at seventh and eighth grade. In addition, student gender and ethnicity were explored as possible moderators. Drawn from a large effectiveness trial, participants in this study were 5,802 early adolescents across 20 middle schools in the northwest region of the United States. Findings suggested that specifically parent's educational involvement in sixth grade predicted increases in positive peer affiliation, when controlling for a general score of parent monitoring practices. The relation between parent educational involvement and peer affiliation varied by student ethnicity but not by gender. Findings suggest the social benefits of parent's engagement with the school context on early adolescent development.