RESUMEN

Despite the important increase in the prevalence of depression during adolescence, a low proportion of adolescent presenting elevated depressive symptoms receive school-based mental health services. Moreover, programs implemented in school settings often suffer of a less rigorous implementation, thus limiting their potential effectiveness. The identification of factors influencing implementation fidelity is essential to improve the quality of services. Guided by a theory-driven evaluation model, we assessed the quality of implementation of the Pare-Chocs program and the factors that affected this quality with the elements of action model of Chen (2005). Participants were 15 professionals that implemented Pare-Chocs with six groups of adolescents exhibiting high depressive symptoms. A mixed-method approach was used to collect quantitative data on implementation fidelity in the six groups and qualitative data on action model components. Our results suggest that adherence, dose and participant responsiveness were high. Time constraints and lack of previous education linked to program theory limited the fidelity of implementation, but training, supervision and program guide enhanced it. These findings confirm that prevention programs disseminated in school settings could be implemented with a high level of fidelity, although some challenge must be considered in treatment planning to contribute to higher program effects. Moreover, fidelity should be systematically evaluated in this setting.

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RESUMEN

Contemporary studies suggest that most of the children who manifest conducts disorder also present personal as well as family problems. This is particularly true for children whose disorder is precocious. The identification of personal characteristics as well as social and family risk and protection factors associated with children with such problems are of great use for intervention planning and service organization for them and their families in Québec. In consequence, the objectives of this study are to identify the social, family and psychological factors that characterize children presenting conducts disorder. To do so, 62 children in treatment between the ages of 7 and 12 and with a diagnosis of conducts disorder are compared with 36 children of the same age without such diagnosis. Results show that children with conduct problems come from less stable and cohesive families as well as a lower socio-economic level. Moreover, their network of social support is less developed. The study reveals that the parents of children with conducts disorder use punishment more often. Finally, the research demonstrates that the children of this group have a much higher probability of presenting an exteriorized disorder (66 %) than the children of the other group (8 %). All these distinctive characteristics allows to correctly classify 93,8 % of the children of this study in the 2 groups. The results indicate the need to improve the parents'educational practices, increase the child's social network as well as reduce the conducts of opposition and inattention of the child. Finally, the complexity of the problems raised with the child and families commands a concerted professional intervention.