Suchergebnisse

Olsson TM. Intervening in youth problem behavior in Sweden: a pragmatic cost analysis of MST from a randomized trial with conduct disordered youthInt J Soc Welfare 2010: 19: 194–205 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare.Within the context of a randomized trial, this study assessed the costs of treating conduct disorder with multisystemic therapy (MST) or treatment as usual (TAU) for 156 youth in Sweden. From the perspective of the municipal Social Welfare Administration, all intervention costs were collected for the 6‐month period starting at randomization. MST was found to cost, on average, US$8,847 per youth. A course of intervention including MST was found to cost significantly more (US$5,038 per youth) than TAU. Although MST was found to reduce the use of and costs associated with non‐placement interventions, MST was not found to reduce the use of or costs associated with placement interventions. This is contrary to findings reported from studies undertaken in the USA. Intent‐to‐treat (ITT) and treatment‐of‐treated (TOT) analyses are presented.

Objectives: The purpose of this study was to investigate the costs and benefits associated with multisystemic therapy (MST) for conduct disordered youth, 2 years following intake. Methods: The study employed a secondary analysis of 156 youth enrolled in a randomized trial assessing the psychosocial and behavioral outcomes of MST. Results: MST cost on average 105,400 SEK per youth. MST was associated with a direct benefit to participants of 1,000 SEK per youth and positively impacted the use of nonplacement downstream interventions for a benefit of 62,100 SEK per youth. These benefits did not offset the cost of MST. Conclusions: MST was associated with a net loss to society after 2 years of 44,500 SEK per youth.

English
This article uses programme theory reconstruction to investigate three conceptualisations of evidence-based practice (EBP). The first two are taken directly from the literature and contrasted with a third taken from a relevant policy programme. The article argues that 'evidence-based practice' is not a homogeneous concept, and that interested parties within research, practice and policy may not have a shared vision of EBP even though they may use the same terminology. It is important for the successful implementation of EBP within practice and policy that there is a clear understanding of what EBP is and how EBP is supposed to work if research, policy and practice are to work together toward common goals.

Solving individual, group, or societal problems through social intervention in practice settings is a complex task. The extent to which this end is achieved depends heavily on the effectiveness of the change strategies in use. Increased understanding of how these change strategies work to impact outcomes is at the forefront of the science of social intervention. In this special issue, we have gathered a collection of seven articles that present central issues related to program theory in social interventions developed in practice setting. Our goal is to advance the knowledge of how an understanding of theory in practice can advance social intervention research.

Commentators interested in school‐based prevention programs point to the importance of economic issues for the future of prevention efforts. Many of the processes and aims of prevention science are dependent upon prevention resources. Although economic analysis is an essential tool for assessing resource use, the attention given economic analysis within school‐based prevention remains cursory. Largely, economic analyses of school‐based prevention efforts are undertaken as secondary research. This limits these efforts to data that have been collected previously as part of epidemiological and outcomes research. Therefore, economic analyses suffer from gaps in the knowledge generated by these studies. This chapter addresses the importance of economic analysis for the future of school‐based substance abuse prevention programs and highlights the role of prevention research in the development of knowledge that can be used for economic analysis.

Program theory reconstruction is an often-overlooked aspect of social intervention research. In this paper, we argue that intervention research benefits if the research design is informed by the specific intervention's program theory (i.e., the idea of how the intervention is supposed to lead to the intended outcomes). The purpose of this paper is to offer a comprehensive and accessible guide to program theory reconstruction in research on social interventions and to provide arguments as to how program theory reconstruction can be used to benefit intervention studies. First, we summarize what program theory is and its role in intervention research. Second, we provide a direct "how-to" for researchers, practitioners, and students who may be unfamiliar with the methods of program theory reconstruction but are interested in undertaking a program theory reconstruction. Finally, we conclude with how program theory reconstruction can benefit intervention research.

Background A challenge to implementation is management of the adaptation-fidelity dilemma or the balance between adopting an intervention with fidelity while assuring fit when transferred between contexts. A prior meta-analysis found that adapted interventions produce larger effects than novel and adopted interventions. This study attempts to replicate and expand previous findings. Methods Meta-analysis was used to compare effects across a whole-population of Swedish outcome studies. Main and subcategories are explored. Results The 523 studies included adapted (22%), adopted (33%), and novel (45%) interventions. The largest effect was found for adapted followed by novel and adopted interventions. Interventions in the mental health setting showed the highest effects, followed by somatic healthcare and social services. Conclusions These results replicate and expand earlier findings. Results were stable across settings with the exception of social services. Consistent with a growing body of evidence results suggest that context is important when transferring interventions across settings.

The preschool edition of Promoting Alternative THinking Strategies (PATHS(®)) is a school-based, teacher implemented universal intervention developed in the United States designed to promote social emotional competence (SEC) in children as a foundation for improved mental health. PATHS is delivered as a curriculum and it is based on theories and research regarding SEC, brain development, and optimal school environments. A majority of children in Sweden attend preschool, which is government-subsidized and follows a national curriculum focusing on both academic and social emotional learning. However, there is not so much focus on formal instruction nor manual-based lessons. The purpose of this study was to assess the short-term (pre- to post-test) effects of PATHS in the Swedish preschool setting. Using a two-wave cluster randomized trial with multi-method and informant assessment (N = 285 4 and 5-year-old Swedish children; n = 145 wait-list control; n = 140 intervention; K = 26 preschools; k = 13 intervention; k = 13 control) we assessed changes in child emotional knowledge, emotional awareness, social problem solving, prosocial play, inhibitory control, and working memory using structural equation modeling (SEM). We included schools with at least one classroom of 4–5-year-old children from three municipalities. We excluded open preschools, parent cooperative preschools, and family day homes. After random assignment, schools were informed of condition assignment. Research team members were not blind to assignment. We hypothesized that relative to children in control schools, children in intervention schools would evidence improvements in social emotional competence as well as other outcomes. Children in PATHS, relative to children in the control, evidenced improvements in working memory and prosocial play, but also showed an increase in hyperactive behaviors. Girls in PATHS, relative to girls in the control, showed improvement in emotional knowledge and reduced anxiety. These results are considered in light of ...