RURAL YOUTH AND FAMILY COMPETENCIES BUILDING PROJECTS

说明(申请人提供)：这项拟议的五年功绩项目延期的目的是继续对最初在农村青年和家庭中实施的普遍、多因素干预进行纵向、对照研究。拟议的计划是在成年后期遵循我们的样本，这一阶段对于建立持久的物质使用模式和影响健康成人功能的物质相关问题至关重要。到目前为止，功绩项目研究已经解决了社区预防干预研究中常见的几个关键方法学问题--部分是通过使用多方法、多信息者测量程序。尽管研究需要干预和测量，但目标学校(N=36)是从随机选择的一组学校中成功招募的，并被随机分配到多组成部分的家庭和学校为基础的干预、仅以学校为基础的干预和控制条件；所有学校都保留到12年级的数据收集点。基于观察的评估证实了家庭和学校干预部分的高保真实施。86%的前测样本在高中毕业后的最后一波数据分析中保持不变；高中后样本中没有样本大小的损失。这项研究还解决了多因素家庭和学校干预对未充分研究人群的长期影响的知识基础方面的重大空白；在最初提案中的所有具体研究目标方面都取得了实质性进展。值得注意的是，通过早期成年期证明了积极的长期物质启动结果，在高风险参与者中产生了更强的影响，并通过减少药物使用机会的保护罩以及经济利益的证据对中介效应进行了经验验证。总体上取得初步进展的一个关键指标是，自1993年以来通过更大的研究方案完成了总共150多份手稿中的46份手稿，它是该方案的一部分。这项拟议的研究将评估普遍的、多元的中学干预对成年后期参与者的长期影响；具体地说，对物质使用和相关成人功能(犯罪和反社会行为、心理健康、身体健康、关系质量和性行为-目标1)的影响。此外，它还将研究长期多成分干预对新出现的成人物质使用和相关成人功能的影响的中介机制，复制和扩展早期研究(目标2)经验性支持的模型。最后，该项目还将审查与青春期早期风险相关的长期干预效果的缓和，以及与上大学和其他生活过程变化相关的问题行为轨迹的改变(目标3)。 公共卫生相关性： 这项拟议的研究审查了为普通人群设计的预防性干预措施如何能够对公共卫生产生重大影响。它扩展了早期的成果研究，这些研究已经证明了一些物质的实际显著相对减少率，包括处方药滥用(相对减少率高达50%)，高风险参与者的更强影响，以及经济利益的证据(例如，每投资一美元，估计回报超过9美元)。进一步的潜在公共健康和经济利益将通过研究干预措施的长期影响来评估--最初是在研究不足的农村中学实施的--参与者在30多岁时参与其中。

DESCRIPTION (provided by applicant): The purpose of this proposed five-year MERIT project extension is to continue a longitudinal, controlled study of a universal, multicomponent intervention initially implemented with rural youth and families. The proposed plan is to follow our sample during late emerging adulthood, a phase critically important to the establishment of enduring patterns of substance use and substance-related problems affecting healthy adult functioning. The MERIT project research to date has addressed several key methodological problems typical in community-based preventive intervention research-in part, through the use of multimethod, multi-informant measurement procedures. Intervention and measurement demands of the study notwithstanding, the targeted schools (N = 36) were successfully recruited from a randomly selected set of schools and randomly assigned to a multicomponent family- and school-based intervention, a school-based intervention alone, and control conditions; all schools were retained through the 12th grade data collection point. Observation-based assessment confirmed high fidelity implementation of both family and school intervention components. Eighty- six percent of the pretest sample remained through the last wave of data analyzed post high school; there has been no loss of sample size in the post high school sample. The study also has addressed major gaps in the knowledge base on long-term effects of multicomponent family and school-based interventions in understudied populations; substantial progress has been achieved on all of the specific research aims in the original proposal. Notably, positive long-term substance initiation outcomes have been demonstrated through early emerging adulthood, with stronger effects among higher-risk participants and empirical verification of mediated effects through a protective shield of reduced substance use opportunities, along with evidence of economic benefits. A key indicator of initial progress overall is the completion of 46 manuscripts, among a total of over 150 manuscripts produced since 1993 through the larger program of research of which it is a part. The proposed study will evaluate long-term effects of a universal, multicomponent middle school intervention on participants in the late emerging adulthood phase; specifically, effects on substance use and related adult functioning (criminal and antisocial behavior, mental health, physical health, relationship quality and sexual behavior-Aim 1). In addition, it will examine mediating mechanisms of long-term multicomponent intervention effects on emerging adult substance use and related adult functioning, replicating and extending models empirically supported by earlier research (Aim 2). Finally, the project also will examine moderation of long-term intervention effects associated with early adolescent risk and the alteration of problem behavior trajectories associated with attending college and other life course changes (Aim 3). PUBLIC HEALTH RELEVANCE: The proposed study examines how preventive interventions designed for general populations can have substantial public health impact. It extends earlier outcome research that already has demonstrated practically significant relative reduction rates for a number of substances, including prescription drug misuse (relative reduction up to 50%), stronger effects among higher-risk participants, and evidence of economic benefits (e.g., over $9 estimated return for every dollar invested). Further potential public health and economic benefits will be evaluated by studying long-term effects of interventions-originally implemented in understudied rural middle schools-among participants when they are in their late 20s.