Optimizing Prevention of Costly Adult Outcomes

 描述(由申请人提供)：尽管预防科学家已经记录了有效的干预措施，以防止成人药物滥用、反社会行为和危险的性行为，但这些干预措施尚未应用于优化投资回报，因此尚未被社区完全接受。这一应用程序建议绘制早期风险概况(和预防性干预)与成人健康和财务结果之间的关系。过去的研究估计了这些与回归系数的关系，这些回归系数令学者满意，但提供的信息不足以使从业者和政策制定者能够根据年龄和风险状况针对儿童进行干预。拟议的研究将按年龄确定与各种风险概况相关的政府服务结果和财务成本，以及快速通道干预的可能投资回报，该干预已被记录在案，以防止反社会行为和药物使用问题。我们建议在30-34岁对两项正在进行的纵向研究的参与者进行访谈和管理数据收集，这两项研究跟踪儿童从幼儿园到成年的详细风险因素测量，儿童发展项目(n=585，保留率=90%)和快速跟踪随机对照试验(n=1199，保留率=81%)。我们将追求三个目标：1)在不同风险水平、质量和年龄下建立早期风险与成人健康结果之间的关系模型，以确定最佳干预时机和目标；2)绘制成人风险状况与成人服务利用率和最终公共成本之间的关系，以货币化预防投资的可能回报；以及3)按分组评估快速通道干预对成人健康和财务结果的影响。这一发现将为一门新兴的投资儿童科学提供模板，以改善公共健康和保护公共资源。

 DESCRIPTION (provided by applicant): Although prevention scientists have documented effective interventions to prevent adult substance abuse, antisocial behavior, and risky sexual behavior, these interventions have not been applied to optimize return on investment and thus have not yet been fully embraced by communities. This application proposes to map the relations between early risk profiles (and preventive intervention) and adult health and financial outcomes. Past studies have estimated these relations with regression coefficients that satisfy scholars but provide insufficient information to enable practitioners and policy makers to target children for intervention by age and risk profile. The proposed studies will identify the government service outcomes and financial costs associated with various risk profiles by age and the likely return on investment for the Fast Track intervention, which has been documented to prevent antisocial behavior and substance use problems. We propose interviews and administrative data collection at ages 30-34 with participants in each of two ongoing longitudinal studies that have followed children with detailed measurement of risk factors from kindergarten into adulthood, the Child Development Project (n=585, retention=90%) and the Fast Track randomized controlled trial (n=1199, retention=81%). We will pursue three aims: 1) Model the relation between early risk and adult health outcomes at different levels, qualities, and ages of risk, to identify optimal intervention timing and targets; 2) Map the relation between risk profile and adult service utilization and ultimate public costs in adulthood, to monetize the possible returns on prevention investment; and 3) Evaluate the impact of the Fast Track intervention on adult health and financial outcomes, by subgroups. The findings will provide a template for an emerging Science of Investing in Children to improve public health and protect public resources.