Family Intervention for Children and Crack-Using Mothers

对儿童和吸食可卡因的母亲的家庭干预

• 批准号: 6944331
• 负责人: Antonio Morgan-Lopez
• 金额: $ 20.2万
• 依托单位: RESEARCH TRIANGLE INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6944331
• 关键词: AIDS education /prevention; African American; academic achievement; adolescence (12-20); age difference; behavioral /social science research tag; child behavior disorders; clinical research; crack cocaine; disease /disorder proneness /risk; drug abuse; drug abuse prevention; family structure /dynamics; family therapy; gender difference; human subject; medical outreach /case finding; middle childhood (6-11); parents; religion; sex behavior; social behavior

DESCRIPTION (provided by applicant): This developmental (R21) study will address an unmet need among preteen youths and their African-American mothers who abuse crack cocaine. The strong link between adolescent substance use and high-risk sexual behaviors makes adolescent children of African-American drug abusers one of the highest risk groups for substance abuse and HIV. The social contexts of maternal drug use and its associations with potentially neglectful and aggressive parenting may lead to poor child outcomes through negative influence on family dynamics. Research shows that family factors influence substance use, HIV-related risk, and protective factors in the long term. Short-term effects of substance use and HIV risk-reduction interventions with youth may diminish over time because of the lack of family or parent involvement. Selective family-skills interventions that target drug-using mothers, their preadolescent children, and their dyadic interactions may be a more-durable approach to prevent youth drug abuse and HIV risk factors through adolescence and adulthood. To break potential intergenerational patterns of drug use and HIV risk among families with maternal drug use, there is a critical need to identify risks and protective mechanisms operating for the children of these families, and to adapt and test a family-skills intervention that targets these factors among youths at an especially vulnerable stage of pre-adolescence. Because target mothers and children are hard to reach and retain in interventions, the proposed study will be conducted in two phases: formative and experimental. The formative phase will adapt and refine recruitment and retention strategies and the intervention with community input; the experimental phase will examine the outcomes of the adapted family-skills intervention delivered in a multicomponent format (maternal, youth, and mother-child sessions) to prevent drug abuse and HIV among children (aged 10 to 14 years) of African-American mothers who abuse crack and are not in treatment. The specific aims of the proposed developmental study are as follows: Specific Aims: Formative Phase. Aim 1) To develop and refine effective strategies to reach, recruit, and retain African-American mothers who use crack and their children (aged 10 to 14 years) in a multicomponent family-skills intervention to prevent youth drug abuse and HIV. Aim 2) To revise, adapt, and tailor relevant family interventions to reduce risk factors for substance abuse and prevent HIV among the targeted preteen children (aged 10 to 14 years) of African-American mothers who use crack and are not in treatment. Specific Aims: Experimental Phase. Aim 3) To describe individual, maternal, and familial risk and protective factors in children (aged 10 to 14 years) of African-American mothers who use crack and are not in treatment. Aim 4) To examine the outcomes (family environment, youth social skills and problem behaviors, substance use, and sexual risk) of a family-skills intervention adapted for drug abuse and HIV prevention among African-American mothers who use crack and their children relative to a no-intervention control group at 3- and 6-month follow-ups. Aim 5) To explore mediating (e.g., maternal and adolescent self-efficacy, perceived risk, and maternal drug use) and moderating factors (youth age, gender, school performance, religiosity) of intervention effectiveness on substance use, sexual intentions and risk behaviors among children of African-American mothers who use crack and are not in treatment.

描述（由申请人提供）： 这项发展性 (R21) 研究将解决滥用强效可卡因的青春期前青少年及其非洲裔美国母亲未得到满足的需求。青少年药物滥用与高风险性行为之间的密切联系使非裔美国药物滥用者的青少年子女成为药物滥用和艾滋病毒的最高风险群体之一。孕产妇吸毒的社会背景及其与潜在的忽视​​和攻击性养育方式的联系可能会对家庭动态产生负面影响，从而导致不良的儿童结局。研究表明，从长远来看，家庭因素会影响物质使用、艾滋病毒相关风险和保护因素。由于缺乏家庭或父母的参与，物质使用和艾滋病毒风险降低干预措施对青少年的短期影响可能会随着时间的推移而减弱。针对吸毒母亲、青春期前儿童及其二元互动的选择性家庭技能干预措施可能是预防青少年吸毒和整个青春期和成年期艾滋病毒危险因素的更持久方法。为了打破孕产妇吸毒家庭中潜在的吸毒和艾滋病毒风险代际模式，迫切需要确定针对这些家庭儿童的风险和保护机制，并调整和测试针对处于青春期前特别脆弱阶段的青少年中的这些因素的家庭技能干预措施。由于干预措施很难接触到并保留目标母亲和儿童，因此拟议的研究将分两个阶段进行：形成阶段和实验阶段。形成阶段将调整和完善招聘和保留策略以及社区投入的干预措施；实验阶段将检查以多组成部分（孕产妇、青少年和母子会议）形式提供的家庭技能干预的结果，以防止滥用可卡因且未接受治疗的非裔美国母亲的儿童（10至14岁）吸毒和感染艾滋病毒。拟议发展研究的具体目标如下： 具体目标：形成阶段。目标 1) 制定和完善有效的策略，以通过多组成部分的家庭技能干预措施接触、招募和留住使用可卡因的非裔美国母亲及其子女（10 至 14 岁），以预防青少年吸毒和艾滋病毒。目标 2) 修订、调整和定制相关的家庭干预措施，以减少使用可卡因且未接受治疗的非裔美国母亲的目标青春期前儿童（10 至 14 岁）的药物滥用风险因素并预防艾滋病毒。具体目标：实验阶段。目标 3) 描述使用快克且未接受治疗的非洲裔美国母亲所生的儿童（10 至 14 岁）的个人、母亲和家庭风险和保护因素。目标 4) 在 3 个月和 6 个月的随访中，检查吸毒非裔美国母亲及其子女相对于无干预对照组的药物滥用和艾滋病毒预防家庭技能干预的结果（家庭环境、青少年社交技能和问题行为、物质使用和性风险）。目标 5) 探讨使用可卡因且未接受治疗的非洲裔美国母亲的孩子的物质使用、性意图和危险行为的干预效果的中介（例如，母亲和青少年的自我效能感、感知风险和母亲吸毒）和调节因素（青少年年龄、性别、学校表现、宗教信仰）。