SET-Enhanced Aftercare for Mothers in Substance Abuse Recovery and Their Childre

SET 增强药物滥用康复中的母亲及其孩子的善后护理

• 批准号: 8469576
• 负责人: Victoria Behar-Zusman
• 金额: $ 45.54万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-01 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8469576
• 关键词: Address; Aftercare; Anxiety; Buffers; Child; Child health care; Chronic; Clinical; Communities; Data; Data Collection; Development; Disease; Ecosystem; Effectiveness; Environmental Risk Factor; Ethnic Origin; Family; HIV; Health; Health behavior; Health system; Hispanics; Home environment; Household; Intervention; Joints; Knowledge; Lead; Life; Mediating; Mental Health; Minority; Mothers; Motivation; Not Hispanic or Latino; Nurse Practitioners; Outcome; Parenting behavior; Patient Self-Report; Pharmaceutical Preparations; Play; Population; Primary Health Care; Problem behavior; Process; Provider; Randomized; Recording of previous events; Recovery; Relapse; Reporting; Research; Resources; Risk; Self Care; Services; Sleep; Social Environment; Socioeconomic Status; Substance Abuse Detection; Substance abuse problem; Supervision; Testing; Treatment Cost; Urine; Woman; Women' s Health; base; community setting; depressive symptoms; experience; health disparity; high risk; improved; maternal stress; physical conditioning; prevent; psychological distress; randomized trial; satisfaction; sobriety; social stigma; substance abuse treatment; translational study; treatment as usual; trial comparing

The proposed study will conduct a translational randomized trial comparing Structural Ecosystems Therapy (SET) as an enhancement of substance abuse aftercare treatment, to aftercare treatment as usual (TAU) among 172 Black, Hispanic and White non-Hispanic mothers discharged from residential substance abuse treatment. The study will be conducted with a community partner that delivers integrated substance abuse treatment and primary care. Agency staff will conduct data collection and agency nurse practitioners will deliver SET. Data will be collected at baseline and 4, 8, and 12 month post-randomization. The Specific Aims of the proposed study are to: 1) test the effectiveness of SET for improving physical and mental health and reducing relapse of mothers in substance abuse recovery; 2) test the effectiveness of SET for improving health and mental health outcomes of children of mothers in recovery; 3) test mechanisms of action of SET (self care, environmental risk, family functioning and stigma); 4) assess SET implementation and sustainability factors and the relationship between fidelity and outcomes; and 5) examine the interactions of ethnicity and ethnicity-related factors on outcomes. SET is a manualized, strength-based, directive and process-oriented family-ecosystemic intervention developed to address the needs of minority women. SET targets the woman's social environment by building on existing adaptive interactions and reducing maladaptive interactions within the family and between the woman, family and supportive resources. A recently completed randomized trial with minority women in drug recovery who were also HIV+ found that for women who were raising children, SET resulted in reduced relapse and psychological distress in the mothers, and reduced symptoms of depression, anxiety and behavioral problems in the children. The proposed study will aim to demonstrate SET'S effectiveness, acceptability and feasibility for implementation in a community setting. The partnership between El Centro and Banyan Health Systems, a substance abuse and primary care provider with considerable research experience, provides a unique opportunity to rigorously test substance abuse aftercare treatment enhanced by SET in a real-world setting.

拟议的研究将在 172 名从住院药物滥用治疗中出院的黑人、西班牙裔和白人非西班牙裔母亲中进行一项转化随机试验，将结构生态系统疗法 (SET) 作为药物滥用善后治疗的增强疗法与照常善后治疗 (TAU) 进行比较。该研究将与提供综合药物滥用治疗和初级保健的社区合作伙伴一起进行。机构工作人员将进行数据收集，机构执业护士将提供 SET。将在基线以及随机化后 4、8 和 12 个月收集数据。拟议研究的具体目标是：1）测试SET对于改善身心健康和减少母亲在药物滥用康复中复发的有效性； 2）测试SET对于改善康复中母亲的孩子的健康和心理健康结果的有效性； 3）测试SET的作用机制（自我护理、环境风险、家庭功能和耻辱）； 4）评估SET实施和可持续性因素以及保真度和结果之间的关系； 5) 检查种族和种族相关因素对结果的相互作用。 SET 是一种手动的、基于力量的、指导性的、面向过程的家庭生态系统干预措施，旨在满足少数群体妇女的需求。 SET 通过建立现有的适应性互动并减少家庭内部以及妇女、家庭和支持资源之间的适应不良互动来针对妇女的社会环境。最近完成的一项随机试验发现，对于正在抚养孩子的女性来说，SET 可以减少母亲的复发和心理困扰，并减少孩子的抑郁、焦虑和行为问题症状。拟议的研究旨在证明 SET 在社区环境中实施的有效性、可接受性和可行性。 El Centro 和 Banyan Health Systems（一家拥有丰富研究经验的药物滥用和初级保健提供商）之间的合作关系提供了一个独特的机会，可以在现实环境中严格测试 SET 增强的药物滥用后护理治疗。