Pediatrician Office Drug Prevention

描述（由申请人提供）：拟议的第一阶段 SBIR 项目将证明开发可通过儿科医生办公室托管的药物预防模块的可行性。该干预措施将帮助青少年（11-15 岁）的父母预防入门药物的发作，包括酒精、烟草、大麻和吸入剂。该计划将通过 CHADIS 托管，CHADIS 是一个可供儿科医生办公室使用的订阅门户网站。该模块将包括：（1）针对父母及其青春期子女的访视前筛查调查； （2）数据驱动的风险诊断； (3) 以临床医生为中心的指导，为家长选择适合风险的教育材料； (4)家长教育部分。在第一阶段，将开发并试点测试诊断算法的原型版本和原型家长教育材料。该计划将重点关注先前评估的预防吸毒养育计划共有的 11 个要素。其中包括帮助父母对不当行为进行适当的管教，为可接受的行为建立界限，并为不可接受的行为定义限制，关注并强化积极行为，有效地传达亲社会规范、价值观和期望，提供监督，监视朋友、活动和行踪，表现出温暖，给予社会支持，建立情感依恋，共享美好时光，并成功解决冲突。一期工程将重点完成五项任务。 (1) 我们将制定访问前评估。一系列调查将评估青少年的风险状况，并了解父母在养育子女方面的优势和劣势。该调查将排除那些需要对物质使用障碍进行临床治疗的青少年。对于那些未被排除在外的人，调查将评估青少年使用入门药物风险的有效标记。 (2) 我们将利用现有数据集开发精算风险算法，以精算方法估计个体青少年使用每种入门药物的风险。这些分析的目的是准确估计未来 30 天入门药物使用的概率。 (3)我们将完成原型干预开发。我们将开展一系列新的关键活动，逐一解决家庭毒品预防的 11 个共同要素。这些将帮助父母改善与预防青少年吸毒相关的育儿态度和技能。 (4) 我们将制定一个原型医师办公室协议。这将使儿科医生和支持人员 成为提供育儿干预的中间人。 （五）完成可行性研究。这项研究的目的是证明所有元素都发挥作用 设计，能够履行其预期角色并被认为是可以接受的。参与者将是 20 个家庭，他们的青少年接受儿科诊所的照顾。青少年和家长将接受筛查。未来药物使用的精算估计将提供给儿科办公室。儿科医生将向家长制定预防计划，家长将集体测试所有教学内容。从父母、青少年、医生和其他工作人员那里收集的干预后评估将评估干预措施的功能、可用性和可接受性。

DESCRIPTION (provided by applicant): The proposed Phase I SBIR project will demonstrate the feasibility of developing a drug prevention module that can be hosted through pediatrician offices. The intervention will assist parents of adolescents (ages 11-15) prevent the onset of gateway drugs, including alcohol, tobacco, marijuana, and inhalants. The program will be hosted via CHADIS, a subscription web portal available to pediatrician offices. This module will include: (1) pre-visit screening surveys for both parents and their adolescent children; (2) data-driven risk diagnoses; (3) clinician-focused instructions for selecting risk-appropriate educationa materials for parents; and (4) parental education components. During Phase I, a prototype version of the diagnosis algorithm and prototypical parent education materials will be developed and pilot tested. The program will focus on 11 elements common to previously evaluated parenting programs for the prevention of drug use. These include helping parents provide appropriate discipline for misbehavior, establish boundaries for acceptable behavior and define restrictions for unacceptable behavior, attend to and reinforce positive behavior, effectively communicate prosocial norms, values and expectations, provide supervision, monitor friends, activities, and whereabouts, show warmth, give social support, build emotional attachments, share quality time together, and successfully resolve conflicts. The Phase I project will focus on completing five tasks. (1) We will develop a pre-visit assessment. A set of surveys will assess the risk-status of adolescents and understand the parenting strengths and weakness of parents. The survey will exclude from consideration those youth who have the need for clinical treatment for substance use disorders. Among those not excluded, the survey will then assess validated markers of a teen's risk for using gateway drugs. (2) We will use existing datasets to develop an actuarial risk algorithm to estimate an individual adolescent's risk for using each gateway drug using actuarial methods. The objective of these analyses is to accurately estimate the probability of future 30-day gateway drug use. (3) We will complete prototype intervention development. We will develop a new series of key activities that address each of the 11 common elements of family-based drug prevention. These will help parents improve their parenting attitudes and skills related to preventing drug use among their adolescents. (4) We will develop a prototype physician office protocol. This will allow pediatricians and support staff to be intermediaries in the delivery of the parenting intervention. (5) We will complete a feasibility study. The objective of this study will be to demonstrate that all elements function as designed, are capable of fulfilling their intended roles and are deemed acceptable. Participants will be 20 families whose adolescents are cared for by a pediatric practice. Adolescents and parents will be screened. Actuarial estimates of future drug use will be provided to the pediatric office. Pediatricians will prescribe the prevention program to parents who will collectively test al instructional components. Post intervention assessments gathered from parents, adolescents, physicians, and other staff will assess intervention functioning, usability, and acceptability.