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: 7458952
• 负责人: John T. Walkup
• 金额: $ 85.82万
• 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/7458952
• 关键词: Accident and Emergency department; Adolescence; Age; American Indians; Apache Indians; Attitude; Caring; Child; Child Abuse and Neglect; Child Rearing; Childhood; Communities; Competence; Drug abuse; Drug usage; Emotional; Ethnic group; Face; Family; Feeling hopeless; Funding; Gap Junctions; Goals; Health; Health Promotion; Health Resources; Health behavior; Health behavior outcomes; Home environment; Home visitation; Hospitalization; Hospitals; House Call; Indian reservation; Indigenous; Individual; Ingestion; Injury; Institution; Intervention; Interview; Laws; Learning; Life; Life Experience; Live Birth; Low income; Masks; Measures; Mediator of activation protein; Mental Health; Methods; Modeling; Mothers; Navajo; Nexus (resin cement); Nurses; Office Visits; Outcome; Parenting behavior; Participant; Patient Self-Report; Population; Poverty; Pregnancy; Prevention; Public Health Schools; Randomized; Randomized Controlled Trials; Rate; Recording of previous events; Reporting; Research Support; Reservations; Risk; Risk Factors; Safety; Schools; Score; Standards of Weights and Measures; Symptoms; Teenagers; Testing; Time; Transportation; Tribes; Unemployment; United States; United States Substance Abuse and Mental Health Services Administration; Visit; Week; Woman; Work; Writing; Youth; base; child neglect; day; depressive symptoms; early childhood; lifetime risk; prenatal; prevent; programs; reservation-based; response; social; teenage mother

DESCRIPTION (provided by applicant): Nearly twice as many American Indian (Al) women have their first child during their teenage years (46%) than any other racial or ethnic group in the United States (25%). Reservation life compounds challenges for Al teen mothers, and places them and their children at significant lifetime risk for drug abuse and other health and behavior problems. Two decades of research support the efficacy of prenatal and early childhood nurse delivered, home visiting programs to prevent health and behavior problems for low income, teen mothers and their children. Given the risks factors confronting young Al families and the shortage of indigenous nurses on reservations, a randomized controlled trial is proposed to assess the efficacy of a culturally-adapted, paraprofessional delivered, home visiting program for reservation-based Al teen mothers and their children. The nationally proven intervention model was selected, adapted, and piloted within the study communities since 1998. Eligible expectant Al teens (N=320), ages 12-19 and up to 28 weeks gestation from four reservation communities-will be randomized (1:1) to the Family Spirit Intervention (FS) + Optimized Standard Care vs. Optimized Standard Care (OSC) alone. The FS intervention is a 52-session home visiting program, delivered by Al paraprofessionals, beginning in pregnancy and continuing until the child is 24 months old (approximately 27 months). OSC participants receive free transportation to standard prenatal and well baby visits and written health promotion materials relevant to teen mothers. Masked independent evaluators will assess parental competence, and mother and child health and behavior outcomes at multiple intervals until the child is 36 months old. The study methods have been piloted in preliminary studies funded by SAMHSA. The Johns Hopkins Center for American Indian Health, the applicant institution and coordinating center, has a 22-year history of working with the participating Al communities. Consultants to this application are expert in parenting, home visiting interventions and early childhood assessment.

描述（由申请人提供）：在青少年时期（46％），几乎是美国印第安人（AL）妇女的第一个孩子的两倍，是美国的任何其他种族或族裔（25％）。保留生活将青少年母亲带来的挑战，并使他们和他们的孩子处于滥用药物以及其他健康和行为问题的一生中。二十年的研究支持了提供产前和幼儿护士的疗效，家庭访问计划，以防止低收入，青少年母亲及其子女的健康和行为问题。鉴于面临年轻家庭的风险因素以及土著护士在保留方面的短缺，提出了一项随机对照试验，以评估适应文化的，适应性的，副业的，家庭访问计划对基于预订的Al Al青少年母亲及其子女的疗效。自1998年以来，选择，改编并试用了全国证明的干预模型。符合条件的预期AL青少年（n = 320），年龄12-19岁以及最多28周的妊娠期，从四个保留社区将妊娠（1：1）随机分组（1：1），以便单独将家庭精神干预（FS） +优化的标准护理与最佳的标准护理vs.优化的标准护理（OPTIAM CAREMIZED SARTACAL CAREIZED SARTACION CARE（of）。 FS干预措施是一项由Al Profofessionals提供的52条课程的家庭访问计划，从怀孕开始，一直持续到孩子24个月大（约27个月）。 OSC参与者将免费运输到标准产前和婴儿访问良好的良好的婴儿访问以及与青少年母亲有关的书面促进材料。蒙面的独立评估者将评估父母的能力，母亲和儿童健康和行为成果多个间隔，直到儿童36个月大。该研究方法已在由SAMHSA资助的初步研究中进行了试验。约翰·霍普金斯（Johns Hopkins）美洲印第安人卫生中心，申请人机构和协调中心，与参与的AL社区合作有22年的历史。该申请的顾问是育儿，家庭访问干预措施和幼儿评估方面的专家。