Computerized intervention to prevent drug use among at-risk adolescents in Central Asia: Preliminary family-level findings from a pilot mixed methods trial.
Computerized intervention to prevent drug use among at-risk adolescents in Central Asia: Preliminary family-level findings from a pilot mixed methods trial.
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防止中亚高危青少年吸毒的计算机干预：混合方法试点试验的家庭层面初步结果。
DOI：
10.1016/j.drugpo.2019.03.022
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Rozental,Yelena
中科院分区：
文献类型：
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作者：
Ismayilova,Leyla;Terlikbayeva,Assel;Rozental,Yelena
背景哈萨克斯坦艾滋病毒感染率的迅速增长主要是由注射毒品造成的。这项研究适应了以家庭为中心的循证艾滋病毒和物质使用预防干预的风险青少年从社区在阿拉木图，已大大影响海洛因贸易和use.MethodsThis NIDA资助的试点可行性试验包括181名高危青少年（14-17岁）通过当地学校和181他们的父母或其他成年家庭成员招募。要获得资格，青年必须居住在药物暴露高的城市地区，并且至少有一个个人或家庭风险因素（例如，使用药物的家庭成员或朋友，父母的犯罪史）。除了关于药物使用和艾滋病毒的标准校本健康教育方案外，干预组的儿童-照顾者二人组还接受了三次试点计算机化课程，重点是儿童-青少年沟通、支持和监测。青少年和照顾者完成ACASI调查在俄罗斯在基线，3- 6个月的后续行动和治疗组（n = 24二人组）的子样本也参加了干预后的焦点小组interviews.ResultsAt 6个月的后续行动，小的影响大小被检测到为父母的做法作为关键的理论中介变量。干预组的参与者报告说，严厉的纪律做法减少了（科恩的d=-0.35，p = 0.026），积极和支持性的养育方式增加了（d = 0.26，p = 0.042），不良监控减少了（根据照顾者d =-0.23，p = 0.137和青少年d =-0.25，p = 0.113）。干预后焦点小组提供了干预内容如何让照顾者与他们的孩子重新联系并更多地参与彼此生活的例子。结论在哈萨克斯坦等中等收入国家，结合家庭参与方法和利用互动技术的干预措施可能是一种具有吸引力和潜在有效的工具，具有高度的保真度和易于扩展性，可减少药物使用和其他风险，在高危青少年中采取行动。
BackgroundThe rapidly growing rates of HIV infection in Kazakhstan are largely driven by injection drug use. The study adapts a family-focused evidence-based HIV and substance use prevention intervention for at-risk adolescents from communities in Almaty that have been greatly affected by heroin trade and use.MethodsThis NIDA-funded pilot feasibility trial included 181 at-risk adolescents (ages 14–17) recruited through local schools and 181 of their parents or other adult family members. To be eligible, youth had to reside in city areas with high drug exposure and have at least one personal or family risk factor (e.g., substance-using family members or friends, parental criminal history). In addition to the standard school-based health education program on drug use and HIV, intervention arm adolescent–caregiver dyads received three pilot computerized sessions focused on caregiver-adolescent communication, support and monitoring. Adolescents and caregivers completed ACASI surveys in Russian at baseline, 3- and 6-month follow-ups and a subsample from the treatment group (n = 24 dyads) also participated in post-intervention focus group interviews.ResultsAt 6-month follow-up, small effect sizes were detected for parenting practices as the key theoretical mediating variable. Intervention arm participants reported a reduction in harsh discipline practices (Cohen’s d= −.35, p = .026), an increase in positive and supportive parenting (d = 0.26, p = .042), and a decline in poor monitoring (according to caregivers d = −0.23, p = .137 and adolescents d = −0.25, p = .113). Post-intervention focus groups provided examples of how the intervention content allowed caregivers to reconnect with their children and get more involved in each other's lives.ConclusionIn middle-income countries like Kazakhstan, interventions that integrate family involvement approaches and utilize interactive technologies may represent an engaging and potentially effective tool with high fidelity and easy scalability to reduce substance use and other risk-taking behaviors among at-risk youth.