Moderated Mediation of the eCHECKUP TO GO College Student Cannabis Use Intervention.

Background: Cannabis use rates are rising among college students, creating a need for effective and accessible intervention options. One such intervention, the Marijuana eCHECKUP TO GO (eCTG) program, has relatively few studies investigating mechanisms of change and related outcomes. This intervention provides users with personalized normative feedback to adjust user's normative perceptions and use patterns. The current study tested moderated mediation of program effects between the eCTG intervention condition and a healthy stress management (HSM) control condition in a college student sample of near-daily cannabis users. Protective behavioral strategies (PBS) were measured among the eCTG conditionMethods: Data were analyzed from a sample of 227 students who were randomly assigned to the eCTG intervention condition or HSM control condition. Change in cannabis use frequency was measured by re-administering the baseline survey at a six-week follow-up. Multi-group moderated mediation path analysis tested the effects of the eCTG intervention on change in cannabis use frequency through PBS, descriptive norms, and injunctive norms, with multi-group categories defined by sex.Results: Direct effects indicated the intervention predicted reduced descriptive norm perceptions and cannabis use frequency. An indirect effect was found for the intervention condition on reducing cannabis use frequency through change in descriptive norms in males. Similarly, an indirect effect was seen for intervention condition on reducing cannabis use frequency through change in injunctive norms for females.Conclusions: Findings suggest changes in descriptive norms played a sex-specific mediating role in the mechanisms of change for the eCTG intervention on reductions in cannabis use frequency.

Mechanisms of change in an adapted marijuana e-CHECKUP TO GO intervention on decreased college student cannabis use.

The objective of this study was to test indirect effects of the Marijuana e-CHECKUP TO GO program on college students' frequent marijuana use through decreased use in specific social and academic activities. This study randomly assigned college students who reported frequent marijuana use (i.e., approximately five times per week) in fall 2016 to receive Marijuana e-CHECKUP TO GO or healthy stress management (HSM) strategies. The final baseline sample included 298 participants. Path analyses tested direct program effects on marijuana use at six-week posttest, as well as the indirect effect via use within four activities frequently participated in by college students: socializing, being physically active, studying, and being in class. Direct Marijuana e-CHECKUP TO GO effects on reductions in frequent use were transmitted by decreased marijuana use while studying and no use while socializing, being physically active, or in class. Marijuana e-CHECKUP TO GO may be most effective at reducing use of marijuana among college students while studying.

Marijuana eCHECKUPTO GO: Effects of a personalized feedback plus protective behavioral strategies intervention for heavy marijuana-using college students.

BACKGROUND: Marijuana use is common among U.S. college students. Liberalization of marijuana use policies is hypothesized to decrease social norms discouraging use, which protects against marijuana use. This may increase the importance of protective behavioral strategies (PBS) to reduce marijuana use harm. METHODS: This study tested direct and moderated (by sex) program effects of an adapted version of the Marijuana eCHECKUPTO GO, a web-based marijuana use intervention providing university-specific personalized feedback (PF) with normative information and PBS to students attending a university in a state with legalized adult recreational marijuana. Participants were 298 heavy-using college students randomly assigned to receive Marijuana eCHECKUPTO GO or strategies for healthy stress management (HSM). General linear models (GLMs) tested direct program effects on proximal intervention targets, marijuana use, and use consequences. Multi-group GLMs then tested the moderating effect of sex on direct intervention effects. RESULTS: Marijuana eCHECKUPTO GO participants reported decreases in estimated use prevalence (i.e., descriptive norms), self-reported hours high per week, days high per week, periods high per week, and weeks high per month. Sex moderated intervention effects on the use of PBS such that females in the PF condition increased their use of PBS more than males. CONCLUSION: Results demonstrate preliminary support for the adapted Marijuana eCHECKUPTO GO in reducing marijuana use for "heavy college-aged users". Future research should test adapted Marijuana eCHECKUPTO GO sustained effects over time, and examine whether program effects on harm reduction manifest after sustained (e.g., booster) program implementation.

Predictors of Group Leaders' Perceptions of Parents' Initial and Dynamic Engagement in a Family Preventive Intervention.

Attendance and participant engagement are two consistent predictors of the efficacy of preventive interventions. Although both are typically measured and analyzed as static factors, evidence indicates patterns of attendance and participant engagement change over the course of intervention. Understanding parent characteristics that predict engagement may inform strategies to maximize parents' involvement thereby increasing intervention uptake and improving effects. This study examined whether parents' baseline characteristics predicted their engagement in a family-based intervention. The study was conducted with 515 caregivers participating in a randomized comparative trial testing the efficacy of The Mindfulness-Enhanced Strengthening Families Program 10-14 (MSFP 10-14) and The Strengthening Families Program: For Parents and Youth 10-14 (SFP 10-14). Facilitator ratings were used to measure parent engagement. Results indicated generally high levels of initial engagement with small, but a significant linear increase across the intervention. Parental education level and involvement with their youth predicted engagement in the first session, while parents' marital/relationship status, avoidance of conflict with their youth, involvement with their youth, and perceived parent-youth relationship quality at baseline predicted change in engagement. Results highlight engagement as a dynamic construct that changes over time and indicates potential variables that may help identify parents that may need support engaging in this intervention.

Are there individual and sibling differences in appraisals of interparental conflict?

Despite decades of empirical literature documenting the harmful effects of frequent, intense, violent, and unresolved interparental conflict on children's adjustment, there is considerable variability in the extent to which marital conflict contributes to the development of children's emotional and behavioral problems. Past research has documented links between properties of interparental conflict itself (e.g., intensity, frequency), children's appraisals of conflict, and children's outcomes, yet less is known about the role of individual and family characteristics in predicting children's conflict appraisals. Sibling studies may be especially helpful in understanding these individual differences yet are notably lacking in marital conflict research. The current study examines individual- and family-characteristic predictors of adolescents' appraisals of conflict in a study of 153 adolescents as well as sibling similarities in conflict appraisals in a subsample of 50 pairs of siblings. Controlling for parent reports of the frequency, intensity, and resolution of interparental conflict, parent-child relationship quality and stressful life events predicted conflict appraisals. In addition, there was nonindependence of sibling appraisals of conflict properties, but self-blame and threat appraisals appeared independent across siblings. Greater discrepancies in siblings' conflict appraisals were related to more negative marital conflict and discrepancies in parent-child relationship quality, and were found in mixed-sex sibling dyads. Implications for future studies on factors that impact children's appraisals of conflict and in particular making use of sibling studies to examine shared environmental and individual influences on appraisals is highlighted. (PsycINFO Database Record

Advancing Evidence-Based Assessment in School Mental Health: Key Priorities for an Applied Research Agenda.

Evidence-based assessment (EBA) is a critically important aspect of delivering high-quality, school-based mental health care for youth. However, research in this area is limited and additional applied research on how best to support the implementation of EBA in school mental health (SMH) is needed. Accordingly, this manuscript seeks to facilitate the advancement of research on EBA in SMH by reviewing relevant literature on EBA implementation in schools and providing recommendations for key research priorities. Given the limited number of published studies available, findings from child and adolescent mental health and implementation science research are also included to inform a robust and comprehensive research agenda on this topic. Based on this literature review, five priorities for research on EBA in SMH are outlined: (1) effective identification of assessment targets, (2) appropriate selection of assessment measures, (3) investigation of organizational readiness for EBA, (4) study of implementation support for EBA, and (5) promotion of EBA data integration and use. Each priority area includes recommended directions for future research. A comprehensive and robust research agenda is warranted to build the science and practice of implementing EBA in SMH. Specific directions for this agenda are offered.

Trust: An innovative tool for investigating marital conflict in response to a novel stressor.

The goal of this study was to investigate an innovative approach to elicit marital conflict behaviors in response to a novel stressor. Past research has relied exclusively on assessments of marital conflict that measure reoccurring or past conflict. Couples engaged in 2 interactions: (a) a standardized conflict discussion and (b) the Timed Reconstruction of Unseen Structures Together (TRUST) task, in which couples worked together to solve an unfamiliar problem. Results indicated that the TRUST task was effective at eliciting both positive and negative conflict behaviors and explained unique variance in self-reports of marital conflict and resolution after controlling for behavior during the standardized conflict discussion. Couples on average displayed more positive and fewer negative conflict behaviors during the TRUST task relative to the conflict discussion task and also rated the novel task as more difficult and stressful. In bivariate analyses, negative behaviors during the TRUST task were related to self-reports of marital conflict and resolution in expected directions for both men and women. In contrast, men who displayed more positive behaviors during the TRUST task self-reported more frequent and intense marital conflict; positive behaviors during the TRUST task were unrelated to women's self-reports of marital conflict or resolution. Implications and directions for future research are discussed. (PsycINFO Database Record

Exploring the impact of a pre-service interprofessional educational intervention for school mental health trainees.

With collaborative interprofessional teams integral to school mental health (SMH) service delivery, pre-service educational strategies are needed to promote interprofessional collaboration among SMH trainees. The current study evaluated the effectiveness, feasibility, and acceptability of a pre-service, interprofessional SMH educational intervention focused on promoting the cross-disciplinary competencies essential for SMH practice. Eight SMH trainees participated in the study. Using a mixed-method design, quantitative pre/post competency data were collected via trainee self-report. Qualitative data were collected through a focus group and reflection journals. Results indicate that the intervention promoted competency in all areas, with significant growth in the provision of learning supports to youth. Key factors influencing intervention feasibility included time/scheduling, changing school team composition, and project coordination. Trainees' perceptions of the educational intervention were related to buy-in, clinical experience, and role flexibility. Implications for the design of pre-service interprofessional SMH education strategies are discussed.

Marital conflict in early childhood and adolescent disordered eating: emotional insecurity about the marital relationship as an explanatory mechanism.

Disordered eating behaviors, including frequent dieting, unhealthy weight control behaviors (e.g., vomiting and skipping meals for weight loss) and binge eating are prevalent among adolescents. While negative, conflict-ridden family environments have long been implicated as problematic and a contributing factor to the development of disordered eating, few studies have examined the influence of marital conflict exposure in childhood to understand the development of these behaviors in adolescence. The current study investigates the impact of marital conflict, children's emotional insecurity about the marital relationship, and disordered eating behaviors in early adolescence in a prospective, longitudinal study of a community sample of 236 families in Midwest and Northeast regions of the U.S. Full structural mediation analyses utilizing robust latent constructs of marital conflict and emotional insecurity about the marital relationship, support children's emotional insecurity as an explanatory mechanism for the influence of marital conflict on adolescent disordered eating behaviors. Findings are discussed with important implications for the long-term impact of marital conflict and the development of disordered eating in adolescence.

Feasibility and preliminary outcomes from a pilot study of an integrated health-mental health promotion program in school mental health services.

The prevalence of unmet health and mental health needs among youth has spurred the growing consensus to develop strategies that integrate services to promote overall well-being. This pilot study reports on the feasibility and outcomes of a theory-driven, family-focused, integrated health-mental health promotion program for underserved adolescents receiving school mental health services. Parent and adolescent assessments conducted prior to and following the brief, 6-session promotion program showed significant improvements in family support, youth self-efficacy, health behaviors, and mental health outcomes. Clinician reports contributed to a characterization of the feasibility, acceptability, and future recommendations for the integrated program.