Isolating Targets with Existing Data to Prevent Teen Drug Use in Child Welfare

摘要： 儿童福利制度可能是代际药物使用恶性循环的根源。在美国 大约有830万依赖酒精或因使用药物而需要治疗的青少年实际上居住在 从小就被虐待的吸毒父母父母虐待儿童， 在成年期滥用药物的可能性更大。参与CWS的青少年有丰富的 风险因素和对药物滥用的保护因素很少。考虑到大量的风险， 青少年，CWS可以作为一个重要的门户，药物滥用预防服务。CWS拥有 作为一个强大的非专业服务部门平台的潜力，因为它可以促进高 风险青年，维持预防和药物滥用治疗方案，并允许捕获 青少年和他们的照顾者在一个强制性的治疗设置。关于物质使用预测因素的文献 涉及CWS的青少年中的启动和强度仍在出现，关于预防和 治疗服务。因此，拟议研究的总体目标是对现存的 国家儿童福利概率队列涉及青少年，以确定物质的流行和影响 使用，青少年发展过程中药物滥用的预测因素，以及当前儿童 福利服务在改善药物使用和滥用方面发挥作用。为了实现这一目标，我们提出了三个 响应PAR-10-018的一年研究，使用现有的药物滥用研究加速药物滥用研究的步伐 流行病学，预防和治疗研究数据，其中重点是：1）基础科学发展 与CWS青少年的风险知识和吸毒行为的弹性轨迹有关; 2） 分析组织和系统环境，提高可访问性，利用率和有效性 在非专业部门提供药物滥用预防服务。总体目标将通过以下方式实现： 以下具体目标：1）调查发病率和纵向轨迹的启动和强度 CWS中青少年的物质使用; 2）调查CWS中青少年物质使用的预测因素; 3）确定 进入药物滥用服务的共同点、服务利用模式和服务利用 CWS青少年的结果;以及4）制定预防干预框架， 解决CWS中药物使用问题的循证干预措施涉及青少年。

Abstract: The child welfare system may be the locus of a vicious circle of intergenerational substance use. In the U.S. some 8.3 million teens dependent on alcohol or otherwise needing treatment for substance use actually reside with substance-abusing parents who were maltreated as children. Maltreated children of parents who abuse substances are more likely to abuse substances in adulthood. Teens involved in CWS have an abundance of risk factors and few protective factors against substance abuse. Given the abundance of risk for CWS involved teens, CWS can serve as an important gateway to substance abuse prevention services. CWS has the potential to serve as a robust non-specialty service sector platform because it can facilitate targeting of high risk youth, sustain both preventive and substance abuse treatment programs, and allows for the capture of teens and their caregivers in a mandated treatment setting. The literature on predictors of substance use initiation and intensity among CWS involved teens is still emerging, as is the literature on prevention and treatment services. Therefore, the overall goal of the proposed research is to conduct analyses of an extant national probability cohort of child welfare involved teens to determine the prevalence and impact of substance use, predictors of substance abuse over the course of adolescent development, and the role that current child welfare services play in ameliorating substance use and abuse. To accomplish this goal, we propose a three year study in response to PAR-10-018, Accelerating the Pace of Drug Abuse Research Using Existing Epidemiology, Prevention, and Treatment Research Data, which highlights: 1) basic science development related to knowledge of risk and resilient trajectories of drug using behaviors among CWS teens; and 2) analyses of the organizational and system contexts that improve the accessibility, utilization, and, effectiveness of substance abuse prevention services within a non-specialty sector. The overall goal will be addressed by the following specific aims: 1) Investigate prevalence and longitudinal trajectories of initiation and intensity of substance use among teens in CWS; 2)Investigate predictors of substance use for teens in CWS; 3) Identify common points for entry into substance abuse services, service utilization patterns, and service utilization outcomes for teens in CWS; and 4) Develop a prevention intervention framework for selecting and fitting evidence based interventions to address substance use among CWS involved teens.