Early Family Prevention of Adolescent Alcohol, Drug Use and Psychopathology - Research Supplements to Promote Diversity in Health Related Research Supplement

描述(由申请人提供)：这项提案将测试家庭体检(FCU)方法的长期影响，该方法通过加强父母教育，防止从蹒跚学步到青春期的药物使用和其他高风险问题行为。像这样的随机预防试验的一个关键问题是，早期家庭支持在多大程度上减少了青少年酒精和药物使用(ADU)、与艾滋病毒/艾滋病有关的高危性行为以及青春期的严重问题行为。这项研究还将研究这些青少年问题行为的减少是如何通过父母养育和同伴环境的改善来调节的，并受到家庭生态和遗传风险的调节。拟议的研究将包括对731名青春期儿童的后续评估，包括收集DNA；观察家庭互动；家长、青少年和教师关于适应情况的报告；以及对同伴环境的评估和报告。早期步骤(ES)多站点样本是从WIC中心招募的，这些中心位于三个地理、社会经济和种族多元化的社区：宾夕法尼亚州匹兹堡、弗吉尼亚州夏洛茨维尔和俄勒冈州尤金。为了增加以后ADU的风险样本家庭的数量，资格仅限于具有额外的社会经济(即父母教育程度低)、家庭(即母亲压力)和儿童(即幼儿品行问题)风险因素的WIC家庭。这些儿童和家庭最初的评估是在 2岁的孩子，然后每年到10.5岁，使用多代理和多方法策略，包括在大多数年份直接观察家庭互动。家庭被随机分配到每年一次的FCU干预，包括适应和定制的家庭管理干预。具体地说，家庭体检将被评估为涉及减少青少年药物使用、与艾滋病毒有关的高危性行为以及14岁和16岁时的其他严重问题行为，这些干预效果可能如何通过父母养育方式的改变来调节，以及如何通过邻里逆境和GxE互动来缓和。

DESCRIPTION (provided by applicant): This proposal will test the long-term impact of the Family Check-Up (FCU) approach to preventing substance use and other high-risk problem behaviors from toddlerhood through adolescence by enhancing parenting. A critical question for a randomized prevention trial such as this is the extent to which early family support reduces adolescent alcohol and drug use (ADU), high-risk sexual behavior linked to HIV-AIDS, and serious problem behaviors in adolescence. The study also will examine how reduction in these adolescent problem behaviors is mediated by improvement in parenting and peer environments and is moderated by the family ecology and genetic risk. The proposed study will include follow-up assessments of 731 children through adolescence that include the collection of DNA; observations of family interaction; parent, youth and teacher report of adjustment; and assessments of and reports about peer environments. The Early Steps (ES) multisite sample was recruited from WIC centers in three geographically, socioeconomically, and ethnically diverse communities: Pittsburgh, PA; Charlottesville, VA; and Eugene, OR. To increase the number of sample families at risk for later ADU, eligibility was restricted to WIC families with additional socioeconomic (i.e., low parental education), family (i.e., maternal stress), and child (i.e., toddler conduct problems) risk factors. The children and families were initially assessed at child age 2 and then yearly through age 10.5, using a multi-agent and multi-method strategy that included direct observations of family interaction in most years. Families were randomly assigned to be offered a yearly FCU intervention, including adapted and tailored family management interventions. Specifically, the Family Check-Up will be evaluated as it relates to reducing adolescent substance use, high-risk sexual behavior linked to HIV, and other serious problem behavior at ages 14 and 16, how such intervention effects might be mediated by changes in parenting, and moderated by neighborhood adversity and GxE interactions.