In-home prevention of SA risks for Native teen families

这项研究将评估产前和幼儿家访干预措施的有效性， 美国印第安人（Al）准专业人员，Al青少年母亲和他们的孩子。干预的目的- 家庭精神-是为了减少风险和促进保护因素，将减少药物滥用和相关 健康和行为问题的母亲和儿童的一生服务。期待，保留- 基地青少年面临多代人的挑战，包括地理隔离，压迫的历史， 贫困、失业、受教育程度有限、难以获得保健和心理健康资源、 吸毒和支离破碎的家庭。这些力量被本土独特的保护因素所抵消 社区，包括促进强大的大家庭网络和强调家庭作为 个体力量的纽带二十年的研究支持产前和早期 儿童家访计划，以防止低收入，青少年母亲和儿童的健康和行为问题， 子女家访干预措施尚未对Al青少年进行评估。虽然疗效 护士家访计划已被证明/人工智能护士的短缺和潜在的文化障碍 与非印度家庭游客相关的限制了这种方法对以预订为基础的青少年的可行性 妈妈们来自四个保留地社区的12 - 19岁的合格准Al青少年（N = 320）将被 随机（1：1）分配至家庭精神干预（FS）+优化标准治疗组与优化标准治疗组 单独护理（OSC）。将在多个时间评估父母能力和母婴结局 分数，直到孩子36个月大，将包括自我报告;采访;医疗，社会服务和 法律的记录审查;以及对家庭环境的观察。研究方法和评估 自1998年以来，在SAMHSA资助的先前研究中进行了试点。 我们建议评估美国印第安人（铝）辅助专业人员提供的有效性，家访 为保留地的Al青少年母亲和她们的孩子提供的计划。拟议的干预措施将：1）培训 纳瓦霍和阿帕奇准专业人员实施和评估以证据为基础的家访 2）将联合收割机传统和西方对健康家庭形成的力量的理解结合起来， 保护青少年父母及其子女免受未来风险，以及3）提供新的系统方法， 减少Al社区的药物滥用负担。

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.