Understanding and Preventing Childhood Drug Use Risk

描述（由申请人提供）：修订后的申请建议将早期步骤多站点项目（ES-M）延长五年，重点是了解和预防儿童药物使用风险。ES-M项目是俄勒冈大学（Dishion）、匹兹堡大学（Shaw）和弗吉尼亚大学（Wilson）儿童与家庭中心的合作项目。在最初的五年里，该项目超过了预期的招募率（731人），保持了很高的保留率（85%），成功地让家庭参与到我们的家庭干预模式中，并减少了2至4岁儿童的问题行为和情绪困扰。我们发现，儿童适应的改善是通过改善家庭管理实践来调解的。在未来五年内，我们建议调整家庭干预模式，为每个孩子进入公立学校系统提供支持，并进行发展分析，以更好地了解学校能力的早期出现，早期异常同伴参与问题行为和情绪困扰。我们还将讨论兄弟姐妹在儿童发展中的作用以及作为干预结果变量的作用。建议一年两次的密集评估，包括家访和直接观察，以及每年对儿童的问题行为和家庭环境中的自我调节进行评估。这项评估建立在现有的跨所有三个地点的多主体-多方法评估战略的基础上，该战略包括每年的直接观察以及对儿童和家庭特征的测量。我们建议，这项研究将测试一种可行的、具有成本效益的、以家庭为中心的干预措施的有效性，这种干预措施可以在WIC或类似的服务环境中启动，并在公立学校环境中继续和维持。此外，该数据集提供了丰富的机会，将护理人员参与干预与儿童和家庭结果联系起来。这种以家庭为中心的早期干预策略的净效果是显著降低了早发性问题行为的风险，提高了学校能力，减少了儿童心理健康障碍，并降低了2至10岁儿童吸毒的风险。多变量数据分析方面的进展，如一般生长混合模型，将用于研究与健康和高风险发展轨迹形成有关的环境因素，以及确定家庭干预在改变这些轨迹方面的有效性。

DESCRIPTION (provided by applicant): The revised application proposes a five-year extension of the Early Steps Multisite Project (ES-M) focused on Understanding and Preventing Childhood Drug Use Risk. The ES-M project is a collaboration of the Child and Family Center at the University of Oregon (Dishion), the University of Pittsburgh (Shaw), and the University of Virginia (Wilson). During its first five years the project exceeded expected recruitment rates (731), maintained high retention rates (85%), successfully engaged families in our family-intervention model, and produced reductions in problem behavior and emotion distress in children from ages 2 to 4 years. We have found that improvements in children's adjustment were mediated by improved family management practices. In the next five years we propose to adapt the family intervention model to provide support for each child's transition into the public school system, and conduct developmental analyses to better understand early emergence of school competence, early deviant peer involvement problem behavior, and emotion distress. We will also address the role of siblings in children's development and as an intervention outcome variable. Biannual intensive assessments are proposed that include home visits and direct observations, as well as yearly assessments of the child's problem behavior and self-regulation in the family context. This assessment builds on an existing multiagent-multimethod assessment strategy across all three sites that has included yearly direct observations as well as measurement of child and family characteristics. We propose that the study will test the effectiveness of a feasible, cost-effective, family-centered intervention that can be initiated within WIC or similar service settings and be continued and maintained in the public school environment. In addition, the data set affords a rich opportunity to link caregiver engagement in the intervention with child and family outcomes. The net effect of this family-centered, early intervention strategy is significant reduction of risk for early-onset problem behavior, improved school competence, reduction in children's mental health disorders, and reductions in risk for drug use from age 2 to 10. Advancements in multivariate data analysis such as general growth mixture modeling will be used to study the environmental factors associated with the formation of health and of high-risk developmental trajectories, as well as to determine the effectiveness of the family intervention in altering those trajectories.