Social Network Influences on Adolescent AUD Treatment Outcomes

描述(由申请人提供)：社会影响，如家庭环境和同伴特征，是青少年药物使用的相对可靠的、近距离的预测因素。最初项目期的结果表明，在社区环境中提供基于群体的治疗后，青少年的物质使用平均减少；变化的意愿预示着后续行动中的物质使用；使用同伴的物质减少与较少的物质使用有关。为了跟进这些发现，200名青少年(及其家长)将从基于社区的强化门诊治疗(IOP)中招募来使用药物，参与一项纵向研究，探讨与治疗结果相关的社会影响(即基于群体的治疗、同伴网络、家庭环境)。青少年在基线(进入治疗阶段)、6个月和12个月完成评估，包括药物使用、个人社交网络和精神状态。青少年还完成每月的跟踪，以跟踪其社交网络的变化，并在每次IOP疗程后完成持续的新的完整评分，以检查基于群体的治疗(例如，关于禁欲的疗程“规范”)与改变药物使用准备之间的关系。父母在基线(开始治疗)、6个月和12个月时完成评估。这项研究的目的是：(1)跟踪青少年在眼压治疗期间和治疗后改变药物使用意愿的变化，这是药物使用行为的敏感和近距离预测因素，以确定与青少年准备改变和药物使用有关的常见基于群体的治疗因素；(2)考察同伴选择和同伴影响作为青少年药物使用变化的潜在机制；以及(3)确定促进或阻碍青少年减少药物使用的家庭环境特征。这些研究目的将提供重要的新的纵向数据，与基于群体的青少年治疗的短期结果的生态有效性研究相关，以及社会网络对青少年治疗结果的影响。研究结果将用于开发基于社会的干预措施，促进接受治疗的青少年的健康同伴和家庭关系。 公共卫生相关性：社会影响，如参与基于群体的药物滥用治疗、同伴社交网络和家庭环境，是青少年药物滥用治疗结果的相对可靠的预测因素。然而，关于以团体为基础的治疗中的常见治疗因素(例如，关于禁欲的团体规范)与治疗结果之间的联系，以及青少年的社会网络组成和结构与治疗结果之间的关系，人们知之甚少。这一延续项目通过在自然主义后续设计中密集收集数据来解决这些知识差距，以检查社会对接受治疗的青少年药物使用的影响。研究结果可能对指导制定针对青年的社会网络干预措施以加强和维持治疗成果具有重要意义。

DESCRIPTION (provided by applicant): Social influences, such as family environment and peer characteristics, are relatively robust, proximal predictors of adolescent substance use. Results from the original project period indicate reductions, on average, in adolescents' substance use following group-based treatment delivered in a community setting; readiness to change predicts substance use over follow-up; and reduction in substance using peers is associated with lower substance use. To follow-up on these findings, 200 adolescents (and their parent) will be recruited from community-based Intensive Outpatient Treatment (IOP) for substance use to participate in a longitudinal study examining social influences (i.e., group-based treatment, peer network, family environment) associated with treatment outcome. Adolescents complete assessments at baseline (treatment entry), 6-, and 12-months covering substance use, personal social network, and psychiatric status. Adolescents also complete monthly follow-ups to track changes in their social network, and new to the continuation, complete ratings after each IOP session to examine associations between group-based treatment (e.g., session "norm" regarding abstinence) and readiness to change substance use. Parents complete assessments at baseline (treatment entry), 6-, and 12-months. Study aims are to: (1) track changes in adolescent's readiness to change substance use, a sensitive and proximal predictor of substance use behavior, during and after IOP treatment to identify common group-based treatment factors associated with adolescents' readiness to change and substance use; (2) examine peer selection and peer influence as mechanisms underlying changes in adolescents' substance use; and (3) identify family environment characteristics that facilitate or impede reductions in adolescents' substance use. These study aims will provide important new longitudinal data relevant to the ecologically valid study of short-term outcomes of group-based treatment for adolescents, and social network influences on adolescents' treatment outcomes. Study findings will be used to develop socially- based interventions that promote healthy peer and family relations in treated adolescents. PUBLIC HEALTH RELEVANCE: Social influences, such as participation in group-based treatment for substance abuse, peer social network, and family environment, are relatively robust predictors of adolescent substance abuse treatment outcome. However, little is known regarding the association between common therapeutic factors in group-based treatment (e.g., group norm regarding abstinence) and treatment outcome, as well as how an adolescent's social network composition and structure are related to treatment outcome. This continuation project addresses these gaps in knowledge using intensive data collection in a naturalistic follow-up design to examine social influences on treated adolescent's substance use. Study results have potentially important implications for guiding the development of social network interventions for youth to enhance and maintain treatment gains.