Early Prevention of Substance Use Initiation in Foster Care

7 岁时的童年攻击性与 25 岁时非法药物依赖风险增加四倍相关。尽管有父母忽视历史的儿童的攻击性发生率很高，但旨在减少青少年物质使用开始 (SUI) 关键前兆的理论驱动和有效的药物预防计划尚未得到调整，也没有对安置在常规寄养家庭的被忽视儿童进行实验评估。拟议的项目通过初步测试针对儿童、其亲生父母和养父母的多组成部分（儿童、养育和共同养育）早期毒品预防干预措施来解决这一关键差距。心理社会干预基于跨理论方法（忽视心理生物学、社会学习理论和家庭系统），主要通过以下方式改善早期易患 SUI 的过程、儿童攻击性和积极养育，其次改善神经内分泌（皮质醇）功能、支持性共同养育和促进家庭稳定：(1) 儿童训练； （二）育儿培训； (3) 共同育儿培训。该干预措施是通过为期 12 周的家长和儿童小组进行的，该小组利用适合寄养人群的不可思议的岁月计划，并由训练有素的大学-寄养机构混合工作团队领导。养育和共同养育组件以联合（多个亲生和寄养对）父母群体的形式集成。团体在为儿童提供服务的寄养机构中举行。五家寄养机构和纽约大学儿童研究中心已加入社区学术伙伴关系，对 N = 100 个家庭实施试点干预。该研究采用机构内部设计将家庭分配到干预（N = 50）或“常规护理”比较（N = 50）条件。降低污染风险的计划已经到位。由于他们有虐待历史，所有参与的儿童都被认为具有儿童攻击性的高风险。将进行三项评估：干预前（第 1 波）、干预后（第 2 波）和干预后 6 个月的随访（第 3 波）。数据收集自亲生父母、养父母、孩子、老师、受过训练的人 观察员和 CPS 记录，无论孩子是否留在寄养家庭、出院回家或进入预收养家庭。我们将完成主要和次要结局干预效果大小的功效分析，为大规模临床试验做准备；涉及这种多成分干预的可行性研究（出勤率和保真度）。该应用程序具有相当大的

Childhood aggressivity at age 7 is associated with a fourfold increased risk for illicit drug dependence at age 25. Despite high rates of aggressivity in children with histories of parental neglect, theory-driven and efficacious drug prevention programs to curtail key precursors of youth substance use initiation (SUI) have not been adapted nor experimentally evaluated with neglected children placed in regular foster homes. The proposed project addresses this critical gap by initially testing a multi-component (child, parenting, and co parenting) early drug prevention intervention for children, their biological parent, and foster parent. The psychosocial intervention is based on a transtheoretical approach (psychobiology of neglect, social learning theory, and family systems) to show improvement primarily in early predisposing SUI processes, child aggressivity, and positive parenting, and secondarily in neuroendocrine (cortisol) functioning, supportive co parenting, and foster home stability by: (1) child training; (2) parenting training; and (3) co parenting training. The intervention is delivered via 12-week Parent and Child Groups which utilizes the Incredible Years programs adapted for a foster care population and led by trained hybrid university-foster agency worker teams. Parenting and Co parenting components are integrated in a joint (multiple biological and foster pairs) parent group format. Groups take place in the foster agency where the children are served. Five foster care agencies and NYU Child Study Center have joined in a community-academic partnership to implement the pilot intervention with N = 100 families. The study uses a within agency design to assign families to intervention (N= 50) or a 'usual care' comparison (N = 50) conditions. A plan to reduce contamination risk is in place. Due to their maltreatment histories, all participating children are considered high-risk for child aggressivity. Three assessments will be conducted: pre-intervention (wave1), postintervention (wave2), and 6 month follow-up after intervention (wave3). Data are gathered from the biological parent, foster parent, child, teacher, a trained observer, and CPS records regardless of whether the child remains in foster care, is discharged home, or enters a preadoptive home. We will complete power analyses regarding the magnitude of intervention effects in primary and secondary outcomes in preparation for a large-scale clinical trial; and feasibility studies (attendance and fidelity) involving this multi component intervention. This application has considerable