OBJECTIVE Although the literature on treatment engagement varies in its characterization and enumeration of the relevant dimensions, the dimensionality of treatment engagement has yet to be tested empirically using a uniform measurement approach. We therefore examined the structural validity of a hypothesized five-factor model, using a confirmatory factor-analytic approach applied to youth and caregiver reports of their own perceived level of engagement. METHOD Data were obtained from 1,807 primarily Hispanic American (56.0%) and African American/Black (26.3%) youth (Mage = 12.7; 46.8% female) and/or their caregivers participating in school mental health services in Los Angeles, California, and rural South Carolina. Participants (N youth records = 1,415; N caregiver records = 1,361) rated 35 self-report indicators of treatment engagement, hypothesized to represent five REACH dimensions (Relationship, Expectancy, Attendance, Clarity, and Homework), approximately 4 weeks following an intake assessment. RESULTS Results uniformly supported the hypothesized five-factor models relative to one-factor, youth χdiff(10)² = 2,092.96, p < .001; caregiver χdiff(10)² = 4,570.93, p < .001, and four-factor, youth χdiff(4)² = 225.15, p < .001; caregiver χdiff(4)² = 843.06, p < .001, alternative models. Modification indices and expected change coefficients did not indicate substantive points of strain in the five-factor models, and tests of model invariance uniformly supported the REACH structure across youth age, youth race, region, and caregiver language. CONCLUSIONS Findings supported a five-factor structure that appears to generalize well across multiple groups, and they set the stage for advances in measurement and improved conceptualization of treatment engagement in research and clinical care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

中文翻译：

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青少年和看护者参与治疗的维度：REACH 框架的结构有效性。

目标 尽管关于治疗参与的文献在其表征和相关维度的列举方面各不相同，但治疗参与的维度尚未使用统一的测量方法进行经验测试。因此，我们使用验证性因素分析方法检验了假设的五因素模型的结构有效性，该方法适用于青年和照顾者关于他们自己感知参与水平的报告。方法 数据来自 1,807 名主要是西班牙裔美国人 (56.0%) 和非裔美国人/黑人 (26.3%) 的青年（法师 = 12.7；46.8% 的女性）和/或其在加利福尼亚州洛杉矶市参加学校心理健康服务的看护人，以及南卡罗来纳州农村。参与者（N 条青年记录 = 1,415；N 条护理人员记录 = 1,361）对 35 个治疗参与的自我报告指标进行评分，假设代表五个 REACH 维度（关系、期望、出勤、清晰度和家庭作业），大约在摄入评估后 4 周。结果 结果一致支持假设的五因素模型相对于一因素，青年 χdiff(10)² = 2,092.96，p < .001；看护者 χdiff(10)² = 4,570.93，p < .001，四因素，青年 χdiff(4)² = 225.15，p < .001；看护者 χdiff(4)² = 843.06, p < .001, 替代模型。修正指数和预期变化系数并未表明五因素模型中的实质性应变点，并且模型不变性测试一致支持跨青年年龄、青年种族、地区和照顾者语言的 REACH 结构。结论 调查结果支持一个似乎可以很好地概括多个群体的五因素结构，它们为研究和临床护理中治疗参与的测量和改进概念化奠定了基础。（PsycInfo 数据库记录 (c) 2022 APA，保留所有权利）。