Preventive Effects of Treatment for Childhood Mental Illness on Adolescent Substance Use

儿童精神疾病治疗对青少年药物使用的预防作用

• 批准号: 10180930
• 负责人: Andrea S Young
• 金额: $ 15.45万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10180930
• 关键词: Address; Adolescence; Adolescent; Adolescent Development; Adult; Adverse event; Affect; Age; Aggressive behavior; Alcohols; Attention deficit hyperactivity disorder; Award; Behavior; Behavioral; Caring; Cessation of life; Characteristics; Child; Child Development; Childhood; Clinic; Clinical; Communities; Complement; Data; Data Analyses; Development; Dose; Emotional; Emotions; Epidemiology; Etiology; Family; Focus Groups; Follow-Up Studies; Frequencies; Future; Goals; Guidelines; Health; Health Personnel; Health Policy; Health Services; Health Services Research; Hyperactivity; Improve Access; Injury; Intervention; Interview; K-Series Research Career Programs; Manic; Marijuana; Mediating; Mediation; Mediator of activation protein; Mental Health; Mental Health Services; Mental disorders; Mentored Patient-Oriented Research Career Development Award; Mentors; Methodology; Methods; Minority; National Institute of Drug Abuse; Neuropsychology; Outcome; Parents; Patients; Pattern; Patterns of Care; Performance; Pharmaceutical Preparations; Practice Guidelines; Preventive; Psychiatry; Psychologist; Public Health; Quality of Care; Race; Randomized Controlled Trials; Reading; Recording of previous events; Regulation; Research; Research Methodology; Research Personnel; Research Project Grants; Risk; Risk Factors; Role; Sampling; Services; Severities; Strategic Planning; Substance Use Disorder; Suicide; Symptoms; Time; Training; Work; Youth; adolescent substance use; base; behavioral outcome; biopsychosocial; career; child mental health service; cohort; community setting; comorbidity; cost; disorder risk; evidence base; experience; follow-up; health service use; high risk population; improved; individualized medicine; innovation; longitudinal analysis; low socioeconomic status; meetings; patient oriented; patient oriented research; peer; preventive intervention; programs; prospective; protective factors; psychiatric symptom; psychosocial; recruit; sexual risk behavior; skills; social disadvantage; substance use; substance use prevention; symposium; treatment as usual; treatment effect; twelfth grade; underage drinking

Project Summary/Abstract This revised K23 Mentored Career Development Award will support the candidate in developing an independent research career to investigate determinants of children’s mental health services use in usual care settings and the long-term preventive effects of children’s mental health services use on adolescent behavioral outcomes including psychosocial functioning and substance use. This award will provide the candidate with extensive training in substance use epidemiology, health policy, health services research, advanced longitudinal data analysis and latent variable analysis, and mixed-methods research. This training will permit the candidate to expand understanding of how evidence-based mental health services impact later substance use, an important public health outcome, and inform more individualized targeted mental health services and substance use prevention. This K23 Award will provide the candidate the methodological and analytical skills needed to reach a long-term career goal of developing and implementing a patient-centered research program focused on improving youths’ substance use outcomes and access to quality care. Randomized controlled trial follow-up studies suggest that treatment for childhood mental disorders (CMD) reduces risk of substance use; however, these studies cannot elucidate how patterns of children’s use of mental health services in the community affect later substance use. Further, research identifying moderators and mediators of the association between treatment for childhood mental illness and later substance use is lacking. Thus, the proposed research project will examine treatment patterns for primary CMD, associated substance use outcomes in adolescence, and potential mediating and moderating factors of the association. Additionally, a mixed methods approach, including focus group data from key stakeholders (adolescents, their parents, and mental health care providers), will further elucidate barriers and facilitators to evidence-based mental health services and other treatment challenges. Specific aims include: 1) Characterize children’s patterns of mental health service use in usual care settings; identify demographic and clinical factors associated with continuity of service use and receipt of guideline concordant care; 2) Determine the effects of usual care on proximal risk factors for SUD and subsequent problematic substance use; assess whether proximal risk factors mediate the effect of usual care for CMD on problematic substance use in adolescence. 3) Assess whether early SUD risk factors moderate the effect of usual care for CMD on problematic substance use in adolescence. 4) Assess the reciprocal effects of substance use/SUD and CMD over the course of child and adolescent development. 5) Conduct focus groups with key stakeholders to gain a deeper understanding of barriers to guideline-concordant care and aid in developing strategies to optimize access to quality care and decrease substance use risk among vulnerable youth. This project’s innovative focus on examining long-term public health impacts of children’s mental health services within the developmental context, analysis of longitudinal data from an at-risk sample, and use of mixed methods will contribute to understanding of adolescent SUD risk and protective factors and barriers and facilitators of evidence-based services.

项目摘要/摘要 经过修订的K23指导职业发展奖将支持候选人开发独立研究 调查儿童精神卫生服务决定者在通常的护理环境中使用的职业和长期 儿童精神卫生服务使用对青少年行为结果的预防作用，包括社会心理 功能和药物使用。该奖项将为候选人提供广泛的药物使用培训 流行病学，卫生政策，卫生服务研究，高级纵向数据分析和潜在变量分析以及 混合方法研究。这项培训将使候选人能够扩展对循证基于循证的心理的理解 卫生服务影响后来的药物使用，这是一个重要的公共卫生结果，并告知更多个性化的目标 心理健康服务和药物使用预防。该K23奖将为候选人提供方法论和 达到发展和实施以患者为中心的研究所需的分析技能才能达到长期职业目标 计划致力于改善青年的物质使用结果和获得优质护理的机会。随机对照试验 后续研究表明，儿童精神障碍（CMD）的治疗可降低使用药物的风险。然而， 这些研究无法阐明儿童在社区中使用心理健康服务的模式如何影响 使用物质。此外，研究识别童年治疗之间关联的主持人和介体的研究 缺乏精神疾病和后来的药物使用。拟议的研究项目将检查 初级CMD，青少年中相关的物质使用结果，以及潜在的介导和调节因素 协会。此外，混合方法方法，包括关键利益相关者（青少年，， 他们的父母和心理保健提供者）将进一步阐明障碍和促进者 卫生服务和其他治疗挑战。具体目的包括：1）表征儿童的心理健康模式 在通常的护理环境中使用服务；确定与服务使用的连续性相关的人口和临床因素 收到指南和协和的护理； 2）确定通常护理对SUD近端风险因素的影响 随后的有问题的药物使用；评估近端危险因素是否介导了对CMD的常规护理的影响 青春期中有问题的物质使用。 3）评估早期SUD危险因素是否适应通常护理的影响 CMD关于青少年有问题的物质使用。 4）评估物质使用/SUD和CMD的相互影响 儿童和青少年发展的过程。 5）与主要利益相关者进行焦点小组，以更深入 了解准则协议护理的障碍，并帮助制定策略以优化获得优质护理的机会 并降低弱势青年的药物使用风险。该项目的创新专注于研究长期公众 儿童心理健康服务在发育环境中对健康的影响，分析纵向数据 处于危险的样本和使用混合方法将有助于理解青少年的SUD风险和保护因素 以及循证服务的障碍和促进者。