In-home prevention of SA risks for Native teen families

本土青少年家庭的 SA 风险家庭预防

• 批准号: 7486101
• 负责人: John T. Walkup
• 金额: $ 5万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-30 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7486101
• 关键词: Accident and Emergency department; Adolescent; Age; American Indians; Apache Indians; Attitude; Birth Intervals; Caring; Child; Child Abuse and Neglect; Child Rearing; Childhood; Classification; Communities; Competence; Drug abuse; Drug usage; Education; Emotional; Extended Family; Face; Family; Funding; Future; Gap Junctions; Goals; Health; Health Promotion; Health Resources; Health behavior; Home environment; Home visitation; Hospitalization; Hospitals; House Call; Indian reservation; Individual; Ingestion; Injury; Intervention; Interview; Learning; Legal; Life Experience; Low income; Measurement; Measures; Mediator of activation protein; Medical; Mental Health; Methods; Mothers; Navajo; Nexus (resin cement); Nurses; Office Visits; Outcome; Parenting behavior; Parents; Patient Self-Report; Poverty; Pregnancy; Prevention; Public Health Schools; Randomized; Rate; Recording of previous events; Reporting; Research Support; Risk; Schools; Score; Social Work; Standards of Weights and Measures; Symptoms; Teenagers; Time; Training; Transportation; Tribes; Unemployment; United States Substance Abuse and Mental Health Services Administration; Visit; Writing; base; child neglect; day; depressive symptoms; early childhood; prenatal; prevent; programs; reservation-based; response; social; teenage mother

is study will assess the efficacy of a prenatal and early childhood home visiting intervention, delivered by American Indian (Al) paraprofessionals, to Al teen mothers and their children. The goal of the intervention- Family Spirit-is to reduce risks and promote protective factors that will decrease drug abuse and related health and behavior problems over the lifetime of the mothers and children served. Expectant, reservation- based Al teens face multigenerational challenges, including geographic isolation, history of oppression, poverty, unemployment, limited education, poor access to health and mental health resources, high rates of drug use and fragmented families. These forces are countered by unique protective factors in Native communities including traditions that promote strong extended family networks and emphasis on family as the nexus of strength for individuals. Two decades of research support the efficacy of prenatal and early childhood home visiting programs to prevent health and behavior problems for low income, teen mothers and their children. Home-visiting interventions have not yet been evaluated for Al teens. Although the efficacy of nurse home visiting programs has been proven/the shortage of Al nurses and potential cultural barriers associated with non-Indian home visitors limits the feasibility of this approach for reservation-based teen mothers. Eligible expectant Al teens (N=320), ages 12-19 from four reservation communities will be randomized (1:1) to the Family Spirit Intervention (FS) + Optimized Standard Care vs. Optimized Standard Care (OSC) alone. Parental competence and maternal and child outcomes will be assessed at multiple time points until the child is 36 months old and will include self-reports; interviews; medical, social service and legal record reviews; and observations of the home environment. Study methods and assessments have been piloted since 1998 in previous studies funded by SAMHSA. We propose to assess the efficacy of an American Indian (Al) paraprofessional delivered, home visiting program for reservation-based Al teen mothers and their children. The proposed intervention will: 1) train Navajo and Apache paraprofessionals to implement and assess an evidence-based home-visiting intervention, 2) combine traditional and western understanding of the power of healthy family formation to protect adolescent parents and their children from future risks, and 3) offer new systematic approaches for reducing the burden of drug abuse in Al communities.

IS研究将评估产前和幼儿家庭参观干预措施的功效， 美国印第安人（AL）少年母亲及其子女。干预的目标 - 家庭精神 - 降低风险并促进保护因素，以减少药物滥用及相关因素 在母亲和儿童的一生中，健康和行为问题。预期，保留 - 基于AL青少年面临多代挑战，包括地理隔离，压迫历史， 贫困，失业，受教育程度有限，获得健康和心理健康资源的机会不佳，高率 吸毒和分散的家庭。这些力被当地的独特保护因素抵消 包括促进强大扩展家庭网络并重视家庭的传统在内的社区 个人力量的联系。二十年的研究支持产前和早期的功效 童年家庭访问计划，以防止低收入，青少年母亲和行为问题 他们的孩子。尚未评估家庭访问的干预措施的青少年。虽然的功效 护士家庭访问计划已被证明/AL护士和潜在的文化障碍短缺 与非印度家庭游客相关的限制了这种方法对基于预订的青少年的可行性 母亲。有资格的预期青少年（n = 320），来自四个保留社区的12-19岁 随机（1：1）与家庭精神干预（FS） +优化的标准护理与优化标准 一个人关心（OSC）。父母的能力以及母亲和儿童成果将在多个时间进行评估 要点直到孩子36个月大，并将包括自我报告；访谈；医疗，社会服务和 法律记录评论；和对家庭环境的观察。研究方法和评估具有 自1998年以前的SAMHSA资助以来，自1998年以来就一直进行了试验。 我们建议评估美洲印第安人（AL）的疗效 基于预订的Al青少年母亲及其子女计划。拟议的干预将：1）火车 纳瓦霍人和阿帕奇专访者实施和评估基于证据的家庭访问 干预，2）结合传统和西方对健康家庭形成力量的理解 保护青春期父母及其子女免受未来风险，3）为新的系统方法提供 减轻了AL社区的毒品滥用负担。