Scaling evidence-based interventions (EBIs) in public education systems remains a persistent challenge in prevention science. Although many interventions demonstrate impact in efficacy trials, they are often underused or fail to achieve intended benefits when introduced in routine practice without sufficient implementation support. Research-practice partnerships (RPPs) offer a promising approach for bridging research, policy, and practice; however, few published examples describe how RPPs can support district-wide scale-up and sustainment of EBIs. This article describes an RPP formed to scale ParentCorps—a family-centered EBI developed through community-engaged research—within New York City’s universal pre-kindergarten initiative, Pre-K for All. ParentCorps is designed to strengthen family-school partnerships and reduce racial and income disparities in children’s educational and mental health outcomes. The partnership brought together the Center for Early Childhood Health and Development (the intervention developer), the NYC Public Schools Division of Early Childhood Education (the implementing system), and the Research Alliance for New York City Schools (a research intermediary). Guided by implementation science frameworks, partners co-designed a series of pragmatic, cluster randomized studies conducted under routine district conditions. We present findings from a pragmatic hybrid type 3 implementation-effectiveness trial that compares two levels of implementation support for ParentCorps. Primary outcomes included pre-K program family engagement practices, assessed using the district’s annual system-wide survey; secondary outcomes included parent and child outcomes. We conclude by highlighting the RPP structures, processes, and design choices that enabled rigorous evaluation at scale and discussing implications for how RPPs can build implementation capacity to support district-wide scale-up and sustainment of family-centered EBIs in public education systems.
Caregiver-mediated interventions for preventing child mental and behavioral health problems depend in part on caregivers’ use of intervention skills outside of sessions, termed home practice. Strategies to improve home practice engagement and follow through should be based on caregiver needs and input. Parents (225 mothers, Mage = 39.1; 80 fathers, Mage = 41.0) participating in a randomized controlled trial of a family-based preventive intervention wrote in responses to questions about what would help them engage in home practice of skills. Guided by previous research and the COM-B model, we coded responses for common themes, termed promoters of home practice or simply promoters. After calculating the prevalence of each promoter, we conducted a set of multilevel logistic regressions to determine whether specific promoters corresponded to the caregivers’ reports of common challenges to home practice, reported in a previous study (Kim et al., 2021). The most common promoters were caregiver attunement (to their or their child’s behaviors, cognitions, and emotions), practicing more, and planning-related strategies. When caregivers expressed daily stressors, they were more likely to report planning and less likely to report attunement promoters. When challenges arose related to caregivers’ cognitions about the program or home practice, they were more likely to report attunement promoters. Caregiver wellness and self-regulation challenges were also related to higher likelihood of attunement promoters. Caregivers who chose to receive the program in Spanish reported attunement promoters more often than those who received the program in English. Home practice promoters related to caregivers’ internal and external contexts, and most promoters centered around modifying caregiver behavior, cognitions, or emotions rather than relying on outside resources. Some promoters corresponded to specific types of challenges to home practice. Findings can guide program providers in developing supports to enhance caregiver home practice, increasing program impact. ClinicalTrials.gov NCT03125291, registered 4/13/2017 https://clinicaltrials.gov/study/NCT03125291
This study aimed to identify and prioritize sustainability factors and strategies and to explore their relationships based on expert-informed concept mapping analysis. Three rounds of consultation were conducted sequentially among a total sample of 44 experienced experts in childhood obesity intervention. Experts first rated the importance and feasibility of factors and strategies related to program sustainability and then completed a card sorting task to group factors and strategies according to whether the same strategies could address them. Inter-rater agreement was assessed using the Average Deviation index. A go-zone plot was generated to visualize strategy priorities by importance and feasibility. Multidimensional scaling and hierarchical cluster analysis were used to identify clusters of sustainability factors and strategies. The results showed that “matching stakeholders’ perceived needs” was rated as the most important factor, and 12 strategies were rated as both highly important and feasible in the go-zone plot. Six clusters of sustainability factors and strategies emerged: (1) alignment and collaboration, (2) workforce engagement, (3) capacity building, (4) resource security, (5) sustainability-focused enhancement, and (6) streamlining and optimization. This assessment and categorization of factors and strategies can help practitioners prioritize practices based on their specific needs and contextual conditions to sustain childhood obesity prevention programs.
Family-centered prevention programs improve youth self-regulation, yet intervention effects are heterogeneous, and the mechanisms underlying differential response remain poorly understood. Identifying neural metrics that shape responsiveness to prevention may advance theory and inform program refinement. This study examined whether baseline brain structure moderated response to a telehealth adaptation of the Strong African American Families program (T-SAAF), a prevention intervention targeting self-regulation among Black preadolescents. Youth ages 11–12 and their caregivers (N = 170 families) were recruited in North Georgia and randomly assigned to T-SAAF or a no-treatment control condition. Allocation was 1:1 in a two-group parallel design evaluated within a superiority framework, and we generated the allocation sequence using statistical software. Because randomization followed the pretest assessment, allocation was concealed from participants and from pretest assessors, and condition was revealed only after pretest data collection was complete. Thereafter, families, facilitators, and posttest assessors could not be masked to condition, as T-SAAF is a group-based family program delivered by facilitators. We conducted no interim analyses and used no stopping guidelines; the trial completed as planned. They were assessed at baseline and approximately nine months later. A neuroimaging subsample completed structural MRI prior to intervention exposure. Analyses focused on whether cortical and subcortical structural metrics moderated changes in parent-reported youth self-control. To account for differential engagement, the intervention main effect was tested in a propensity score–matched sample of youth who received the intervention and comparable controls (n = 130); brain by intervention interactions were tested in the neuroimaging subsample (n = 105). Assignment to T-SAAF was associated with a modest increase in self-control (F[1,124] = 4.28, p = .04). Baseline anterior cingulate cortex (ACC) structure moderated this effect. The clearest and most consistent evidence was for rostral ACC thickness and caudal ACC thickness; caudal ACC volume showed the same pattern with weaker but convergent support. Across these metrics, thinner or smaller ACC at baseline was associated with greater intervention-related gains in self-control, whereas youth with higher ACC structural values showed little differential benefit. No moderation was observed for rostral ACC volume, amygdala volume, or nucleus accumbens volume. Findings provide preliminary evidence that individual differences in neural structure, particularly within the ACC, may shape responsiveness to family-centered preventive intervention during preadolescence. By extending neural prediction approaches from adult treatment to developmental prevention, this study indicates that neurodevelopmental markers can clarify mechanisms of differential response and inform program refinement. Confirmation in adequately powered, preregistered research is needed. ClinicalTrials.gov NCT05253235 ( https://clinicaltrials.gov/study/NCT05253235 ); registered February 22, 2022.
Sexual minority youth (SMY) scholarship has lagged in its attention to the conceptual and practical distinctions between peer victimization and bullying. The current study includes five population-based samples from the Youth Risk Behavior Survey (n = 68,285). We used the Karlson, Holm, and Breen (KHB) method to test whether school-based victimization and bullying differentially account for sexual identity differences in substance use and mental health. Results showed that school-based victimization and bullying were weakly correlated; each was a robust independent factor in the association between sexual orientation and health outcomes. Victimization emerged as a robust factor that attenuated sexual identity differences in substance use among SM girls, but not for SM boys, accounting for 40–96
