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Predictors of program response to a child anxiety indicated prevention and early intervention protocol

Description
The purpose of this study was to examine if certain child demographics and risk modifiers of the child (i.e., anxiety sensitivity, depressive symptoms, anxiety control, and social competence) predict program response to a Child Anxiety Indicated Prevention and Early Intervention protocol (Pina, Zerr, Villalta, & Gonzales, 2012). This anxiety protocol…

The purpose of this study was to examine if certain child demographics and risk modifiers of the child (i.e., anxiety sensitivity, depressive symptoms, anxiety control, and social competence) predict program response to a Child Anxiety Indicated Prevention and Early Intervention protocol (Pina, Zerr, Villalta, & Gonzales, 2012). This anxiety protocol focused on cognitive behavioral techniques (e.g., systematic and gradual exposure) that used culturally responsive implementation strategies (Pina, Villalta, & Zerr, 2009). The current study aims to investigate specific predictors of program response to this anxiety protocol. First, it was of interest to determine if child demographics and risk modifiers of the child at baseline would predict program response to the early anxiety intervention protocol. Second, it was of interest to see if an interaction with one of the four risk modifiers at baseline and sex or protocol condition would predict program response to the early anxiety intervention protocol. This study included 88 youth (59.14% Hispanic/Latino and 40.9% Caucasian) who were recruited through referrals from public schools and randomized to one of two protocol conditions (i.e., child-only or the child-plus-parent protocol), which had varying levels of mothers’ participation within the Child Anxiety Indicated Prevention and Early Intervention protocol (Pina et al., 2012). Participants ranged from 6 to 17 years of age (M = 10.36, SD = 2.73), and 48.9% were boys. The four risk modifiers were assessed using the Childhood Anxiety Sensitivity Index (CASI; Silverman, Fleisig, Rabian, & Peterson, 1991), Children's Depression Inventory (CDI; Kovacs, 1981), Anxiety Control Questionnaire for Children-Short Form (ACQ-C-S; Weems, 2005), and Social Competence scale from the Child Behavior Checklist (CBCL; Achenbach & Resorla, 2001). Program response was measured by pre-to-posttest changes in anxiety outcomes. Regarding the first aim, each of the four risk modifiers was related to pre-to-posttest changes in program response outcomes. Regarding the second aim for interactions between each of the four focal predictors, sex and protocol condition emerged as moderators. These results have potential implications for clinicians and researchers interested in understanding why some children might experience more or less change when participating in an early intervention protocol for anxiety.
ContributorsWynne, Henry (Author) / Pina, Armando (Thesis advisor) / Luthar, Suniya (Committee member) / Enders, Craig (Committee member) / Wolchik, Sharlene (Committee member) / Arizona State University (Publisher)
Created2017
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Reach for success: an initial evaluation of implementation quality in school settings

Description
Anxiety is one of the most common psychiatric disorders among children yet characterized by lower use of mental health services. Preventive efforts have demonstrated promise in the ability to reduce anxiety symptoms. However, as evidence-based interventions move into real-world settings, there is a need to systematically examine potential implementation factors…

Anxiety is one of the most common psychiatric disorders among children yet characterized by lower use of mental health services. Preventive efforts have demonstrated promise in the ability to reduce anxiety symptoms. However, as evidence-based interventions move into real-world settings, there is a need to systematically examine potential implementation factors that may affect program outcomes. The current study investigates the relations between different aspects of implementation and their effect on outcomes of a school-based preventive intervention targeting anxiety symptoms. Specifically, the study examines: (1) the measurement of quality of delivery, (2) specific relations among implementation components, (3) relations between these facets and anxiety program outcomes. Implementation data were collected from nine school-based mental health staff and observer ratings. Program outcomes (pretest and immediate posttest) were measured from 59 participants and their parents (mostly mothers) in the intervention condition. Implementation components included adherence, quality of delivery, time spent, participant responsiveness, and perceived usefulness of program materials. Program outcomes included child-reported emotional expressivity, physiological hyperarousal, negative cognitions, social skills, self-efficacy, and child and parent reported levels of child anxiety. Study findings indicated that quality of delivery was best captured as two facets: skillful presentation and positive engagement. Adherence and quality of delivery were associated with greater participant responsiveness, although time spent was not. Significant relations were found between some implementation components and some program outcomes. Further efforts can be used to optimize the translation of evidence-based programs into real-world settings.
ContributorsChiapa, Amanda (Author) / Pina, Armando (Thesis advisor) / Dishion, Thomas (Committee member) / Wolchik, Sharlene (Committee member) / Grimm, Kevin (Committee member) / Berkel, Cady (Committee member) / Arizona State University (Publisher)
Created2017