PROSPER delivery of universal preventive interventions with young adolescents: long-term effects on emerging adult substance misuse and associated risk behaviors
PROSPER delivery of universal preventive interventions with young adolescents: long-term effects on emerging adult substance misuse and associated risk behaviors
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DOI：
10.1017/s0033291717000691
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发表时间：
2017-10-01
影响因子：
6.9
通讯作者：
Trudeau, L.
中科院分区：
文献类型：
--
作者：
Spoth, R.;Redmond, C.;Trudeau, L.
背景物质滥用和相关的健康风险行为在成年初期很普遍。对于在青少年时期实施的基于社区的普及预防干预措施的交付系统对高中毕业后的影响，存在着知识差距。本研究报告了PROSPER输送系统对19岁患者的影响，超过基线7.5年。队列顺序设计包括28个公立学区随机分配到PROSPER伙伴关系交付系统或通常的编程条件。PROSPER社区小组在六年级实施了以家庭为重点的干预措施，在七年级实施了以学校为基础的干预措施。19岁高中后报告的结果包括一生、当前和药物滥用频率，以及反社会和危及健康的性行为。对时间点结果的协方差进行意向治疗、多水平分析，沿着风险相关的干预效果适度分析。结果显示，来自PROSPER社区的新兴成年人报告了一系列物质类型的物质滥用显着降低，相对减少率高达41.0%。未观察到相关的反社会和危害健康的性行为指数或性传播感染的终生发生率的显著结果。与风险相关的调节效应不显著，表明新生儿高风险和低风险亚组的结果大致相当。PROSPER提供系统用于简短的普遍预防干预措施，通过减少长期药物滥用，具有潜在的公共卫生影响，其积极成果延伸到高中以上。
Background. Substance misuse and associated health-risking behaviors are prevalent in emerging adulthood. There is a knowledge gap concerning the post-high school effects of community-based delivery systems for universal preventive interventions implemented during young adolescence. This study reports effects of the PROSPER delivery system through age 19, 7.5 years past baseline.Methods. A cohort sequential design included 28 public school districts randomly assigned to the PROSPER partnership delivery system or usual-programming conditions. PROSPER community teams implemented a family-focused intervention in 6th grade and a school-based intervention in 7th grade. Outcomes for the age 19, post-high school report included lifetime, current, and frequency of substance misuse, as well as antisocial and health-risking sexual behaviors. Intent-to-treat, multi-level analyses of covariance of point-in-time outcomes were conducted, along with analyses of risk-related moderation of intervention effects.Results. Results showed emerging adults from PROSPER communities reported significantly lower substance misuse across a range of types of substances, with relative reduction rates of up to 41.0%. No significant findings were observed for associated antisocial and health-risking sexual behavior indices; or for lifetime rates of sexually transmitted infections. Risk-related moderation effects were non-significant, suggesting generally comparable outcomes across higher-and lower-risk subgroups of emerging adults.Conclusions. The PROSPER delivery system for brief universal preventive interventions has potential for public health impact by reducing long-term substance misuse, with positive results extending beyond high school.