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. 2018 Sep:72:62-72.
doi: 10.1016/j.cct.2018.07.011. Epub 2018 Jul 18.

Steps to Effective Problem-Solving in group homes

Sarah H Ailey  1 , Arlene M Miller  2 , Olimpia Paun  2 , Michael Schoeny  2 , Tricia Johnson  2 , Teresa Moro  2 , Arthur Nezu  3 , Tamar Heller  4 , Janet Melby  5
Affiliations

Steps to Effective Problem-Solving in group homes

Sarah H Ailey et al. Contemp Clin Trials. 2018 Sep.

Abstract

Aggressive/challenging behaviors (A/CB) are a major public health problem for individuals with intellectual disabilities (ID). A leading reason for psychiatric hospitalizations and incarcerations, such behaviors are costly to the health care system, agencies, and families. Social problem-solving (SPS) training programs for individuals with ID have had positive behavioral results, but most were conducted in clinical or forensic settings. None was a community-based preventive intervention, none examined whether the behaviors decreased in residential and work settings, and none addressed cost-effectiveness. In preliminary work, we modified an effective SPS training program (ADAPT: Attitude, Define, Alternatives, Predict, and Try out), using input from individuals with ID and residential staff, as a community-based preventive intervention that we delivered in group homes (STEPS: Steps to Effective Problem-solving). Individuals with ID have high rates of obesity, and our attention-control condition is a nutrition intervention: Food for Life. We describe the protocol for a randomized clinical trial to: (1) test the efficacy of the STEPS intervention for improving SPS skills and reducing A/CB compared to an attention-control nutrition intervention in group homes; (2) assess the mediating effect of residential staff SPS skills, group-home level SPS skills, and group cohesiveness on the improvement of SPS skills and reductions in A/CB; and (3) evaluate the cost-effectiveness of STEPS. We expect to show that STEPS is a preventive strategy to reduce A/CBs among individuals with ID and improve the cost-effectiveness of their care.

Keywords: Aggressive and challenging behaviors; Community preventive interventions; Group homes; Intellectual disability; Social problem-solving.

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Figures

Figure 1:
Figure 1:
Steps to Effective Problem-Solving (STEPS) Framework
Figure 2.
Figure 2.
CONSORT Flow Diagram for STEPS
See this image and copyright information in PMC

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