Preventing substance misuse among Latino youth: A study of mediating processes

描述(由申请人提供)：研究表明，以学校为基础的药物滥用预防计划能够防止药物滥用。然而，预防计划影响物质滥用的机制总体上仍不清楚。虽然与从初中向高中过渡有关的因素可能会使高中生面临物质滥用的风险，但很少有研究投资于为高中生制定的预防方案及其干预过程。此外，尽管一些调查表明，预防方案通过与黑人和白人青年相似的过程影响拉美裔青年，但有一些证据表明，预防方案如何影响拉美裔青年存在差异。特别是，研究表明，文化适应程度可能在这些年轻人对预防计划的反应中发挥重要作用，特别是当考虑到性别时。为了扩大我们对以高中为基础的预防计划的干预机制以及它们如何影响拉美裔青年的理解，拟议的研究将检查能力的提高和风险因素的减少是否预示着拉丁裔高中生样本中物质使用的增长减少。这项研究的目的是：1)考察以学校为基础的九年级预防计划-同伴团体联系(PGC)-在三年内对学生酒精和大麻使用的影响；2)检查对同龄人酒精或大麻使用的反对、对酒精或大麻使用的信念、个人和社会能力以及学校联系作为计划效果的潜在中介；以及3)检查性别和文化适应作为计划效果的潜在调节因素。2005年，269名九年级学生(92%是拉丁裔)被随机分为对照组(n=175)和计划(n=94)，进行了一项随机对照试验，以检验PGC的效果。在训练有素的导师的监督下，训练有素的学长在每周40分钟的课程中向一小群新生讲授PGC为期一年的以活动为基础的课程。共收集了四波调查数据：基线、后测、一年随访和两年随访。将使用潜在增长曲线分析来分析数据，以模拟潜在结果和中介因素中的个体变化。更好地理解预防方案如何有助于减少拉美裔青年药物滥用的发生率和进展，可能会对未来的预防方法产生影响。因此，这项研究与NIDA的目标一致，即防止已经开始使用药物的人开始使用药物并升级为成瘾。 与公共健康相关：在美国，未成年人饮酒每年造成的公共健康成本超过600亿美元，其中包括每年因交通事故、暴力犯罪、自杀未遂和其他相关负面后果造成的54亿美元的医疗成本(Miller，Levy，Spicer等人，2006年)。如果将高中年龄青年中与毒品有关的事件包括在内，公共卫生成本将大幅增加。有必要审查拉丁裔/a青年的药物滥用预防方案，因为他们比黑人和白人青年更有可能与饮酒的司机一起乘车，在学校场地饮酒，以及使用可卡因、海洛因或摇头丸(CDC，2008年)。

DESCRIPTION (provided by applicant): Research has shown that school-based drug abuse prevention programs are able to prevent substance misuse. The mechanisms through which prevention programs impact substance misuse, however, remain generally unclear. While it is likely that factors related to the transition from middle school to high school place high school youth at risk for substance misuse, few studies have invested prevention programs developed for high school youth and their intervening processes. Moreover, although a few investigations suggest that prevention programs impact Latino youth via similar processes as Black and White youth, there is some evidence to suggest that there are differences in how prevention programs influence Latino youth. In particular, research suggest that level of acculturation may play an important role in how these youth respond to prevention programs, especially when gender is considered. To broaden our understanding of the intervening mechanisms of high school-based prevention programs and how they influence Latino youth, the proposed study will examine whether increased competencies and reduced risk factors predict reduced growth in substance use in a Latino sample of high school students. This study aims to: 1) examine the impact of a school-based ninth grade prevention program, Peer Group Connection (PGC), on students' alcohol and marijuana use over three years, 2) examine disapproval of peers' alcohol or marijuana use, beliefs about alcohol or marijuana use, personal and social competencies, and school bonding as potential mediators of program effects, and 3) examine gender and acculturation as potential moderators of program effects. In 2005, 269 ninth grade students (92% Latino) were randomized to the control (n = 175) and program (n = 94) conditions of a randomized controlled trial examining the effects of PGC. Under the supervision of trained advisors, trained upperclassmen delivered PGC's year-long, activity-based curriculum to small groups of freshmen during weekly forty-minute sessions. Four waves of survey data were collected: baseline, post-test, one-year follow-up, and two-year follow-up. Data will be analyzed using latent growth curve analysis to model individual change in the potential outcomes and mediators. An improved understanding of how prevention programs contribute to reductions in the incidence and progression of Latino youth's substance abuse may have implications for future preventative approaches. Thus, this study is in line with NIDA's goal "to prevent the initiation of drug use and the escalation to addiction in those who have already initiated use." PUBLIC HEALTH RELEVANCE: In the Unites States, underage drinking accounts for over $60 billion in public health costs each year, including $5.4 billion a year in medical care costs due to traffic crashes, violent crime, suicide attempts and other related negative outcomes (Miller, Levy, Spicer et al, 2006). The public health costs increase substantially when drug related incidents among high school age youth are included. There is a need to examine drug abuse prevention programming among Latino/a youth, because they are more likely than Black and White youth to have ridden with a driver who had been drinking alcohol, to have drunk alcohol on school grounds, and to have used cocaine, heroin or ecstasy (CDC, 2008).