ED Based Prevention Intervention to Delay Alcohol Use by Young Adolescents

描述（由申请人提供）： 项目概要：我们的长期目标是制定、实施和评估一项计划，通过在儿科急诊科（PED）开始的以家庭为基础的简短预防干预，增加保护因素并降低风险，预防或延迟青少年开始饮酒。拟议的发展研究的主要目的包括：（1）在酒精初治青少年中进行预防干预的初步试验，进行必要的修订，并最终确定干预手册;（2）进行一项随机试验，比较预防干预与加强标准护理。在对10名12-14岁的青少年及其陪同父母进行预防干预的开放试验并完善干预措施后，我们将使用两组随机设计来检验预防干预措施将预防/延迟开始使用酒精的假设。100名接受PED治疗的12-14岁青少年及其陪同父母/护理人员将入组本研究。合格的青少年及其同意的父母/照顾者将完成一系列与酒精和其他药物（AOD）使用，沟通方式，父母教养方式以及酒精态度和行为有关的评估工具。然后，父母/青少年家庭单位将被随机分配到两种情况之一：1）加强标准护理（ESC）或2）短期有针对性的预防干预与助推器（BTP）。第一次会议将包括以父母为目标的技能建设，主要针对父母的监测和父母与青少年沟通的重要性，作为成功监测的先决条件。预防会议的主要目标将是调动父母自己的资源，利用动机访谈技术加强沟通和监测。在这种情况下，父母还将在1个月和3个月时定期收到小册子和电话助推器会议，以探讨父母对前一届会议计划的执行情况，并在必要时进行修改。青少年和家长将在PED访问后六个月进行重新评估。青少年还将通过每月一次的、简短的、基于网络的后续接触进行评估，以确定他们的酒精使用状况。 公共卫生相关性： 项目叙述：本研究的目的是通过加强父母的监督和改善父母/青少年的对话，预防或延迟在儿科急诊科就诊的青少年开始使用酒精。以往的研究表明，儿科急诊科是一个很好的位置进行预防干预。通过针对PED中的个人及其家庭，我们正在利用机会在父母和青少年可能特别容易接受干预的高风险人群中进行预防干预。

DESCRIPTION (provided by applicant): PROJECT SUMMARY: Our long term goal is to develop, implement, and evaluate a program to prevent or delay the initiation of alcohol use in young adolescents by increasing protective factors and reducing risk through a family-based brief prevention intervention started in the pediatric emergency department (PED). The primary aims of the proposed developmental study include: (1) To pilot test a prevention intervention in alcohol-naive adolescents, make necessary revisions, and finalize an intervention manual and (2) conduct a randomized pilot trial comparing the prevention intervention with enhanced standard care. After conducting an open trial of the prevention intervention with 10 adolescents, ages 12-14, and their accompanying parent(s), and refining the intervention, we will use a two-group randomized design to test the hypothesis that the prevention intervention will prevent/delay the initiation of alcohol use significantly more than enhanced standard care only. 100 adolescents, ages 12-14, who present to the PED and their accompanying parent(s)/caregiver will be enrolled into the study. Eligible, assenting adolescents and their consenting parent(s)/caregiver will complete a series of assessment instruments relating to alcohol and other drug (AOD) use, communication styles, parenting styles, and alcohol attitudes and behaviors. Parent/youth family units will then be randomly assigned to one of two conditions: 1) Enhanced Standard Care (ESC) or 2) Brief Targeted Prevention Intervention with Boosters (BTP). The initial session will be comprised of parent-targeted skill building directed primarily at parental monitoring and the importance of parent-adolescent communication as the precursor to successful monitoring. The primary goal of the prevention session will be the mobilization of the parents' own resources to increase communication and monitoring using motivational interviewing techniques. Parents within this condition will also receive periodic brochures and telephone booster sessions at 1 and 3 months to explore parental implementation of the plan from the previous session(s) and make revisions as necessary. Adolescents and parents will then be reassessed six months following their PED visit. Adolescents will also be assessed with monthly, brief, web-based follow-up contacts to determine the status of their alcohol use. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE: The aim of the present study is to prevent or delay the initiation of alcohol use among young adolescents being seen in a pediatric emergency department, by enhancing parental monitoring and improving parent/adolescent conversations. Previous studies have shown that the pediatric emergency department is an excellent location for performing prevention interventions. By targeting individuals and their families in the PED, we are capitalizing on the opportunity to perform a prevention intervention among a high risk population when parent and youth may be particularly receptive to the intervention.