Optimizing a Drug Abuse Prevention Program for Dissemination

优化药物滥用预防计划的传播

• 批准号: 9275950
• 负责人: Nancy A. Gonzales
• 金额: $ 78.08万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-15 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9275950
• 关键词: AIDS/HIV problem; Address; Adolescence; Adopted; Adult; Alcohol abuse; Alcohol or Other Drugs use; Behavioral; Biological; Child; Child Rearing; Childhood; Communities; Competence; Control Groups; Cost Analysis; Criminal Justice; Dimensions; Disease; Economics; Emotional; Employee Strikes; Employment Status; Enrollment; Evidence based intervention; Family; Family Relationship; Foundations; Frequencies; Health Status; Hour; Hybrids; Immigrant; Individual Differences; Informal Social Control; Intervention; Language; Length; Long-Term Effects; Low income; Mediating; Mediation; Mediator of activation protein; Mental Health; Mental disorders; Mexican Americans; Middle School Student; Modeling; Monitor; Neurobiology; Not Hispanic or Latino; Outcome; Parents; Participant; Preparation; Prevention; Prevention program; Preventive Intervention; Process; Public Health; Randomized; Randomized Controlled Trials; Reporting; Request for Applications; Resources; Risk; Sampling; Schools; Science; Services; Sexually Transmitted Diseases; Socioeconomic Status; Structure; Student Dropouts; Students; Subgroup; Substance abuse problem; Symptoms; System; Testing; Training; Youth; arm; base; binge drinking; biological systems; bridge program; coping; cost effectiveness; design; deviant; disparity reduction; drug abuse prevention; early adolescence; effectiveness trial; eighth grade; epidemiologic data; evidence base; follow-up; high risk sexual behavior; high school; innovation; intervention effect; junior high school; marijuana use; mental disorder diagnosis; peer; physical conditioning; prevent; program dissemination; programs; prospective; public health relevance; randomized trial; seventh grade; sexual debut; substance abuse prevention; substance use prevention; transmission process; twelfth grade

DESCRIPTION (provided by applicant): This project is a hybrid efficacy/effectiveness trial of a streamlined version of the Bridges program, an evidence-based intervention (EBI) to prevent substance abuse and mental health disorders. Bridges is an integrated parent-youth intervention evaluated in a randomized controlled trial (RCT) with Mexican Americans (immigrant and U.S. born) that showed long-term effects on multiple outcomes: substance use initiation and escalation, externalizing and internalizing symptoms, deviant peer association, and grade point average (GPA) in early adolescence; alcohol abuse disorder, binge drinking, marijuana use, risky sexual behavior, diagnosed mental disorder, and school dropout in late adolescence. Building on evidence of core intervention components and strategies for redesigning EBIs for the real-world, we will partner with low-income, multiethnic schools to adapt the program to a brief, 4-session format (Bridges short program, BSP), and optimize engagement, delivery, training, and implementation monitoring systems to facilitate dissemination and sustainability. The proposed RCT will also examine whether a parent-youth EBI can impact multiple channels of youth self- regulation (e.g., biological, behavioral, emotional) during adolescence when neurobiological systems are changing rapidly, and whether preexisting individual differences in self-regulation moderate program effects. The specific aims of this RCT are to: 1) examine the effects of the BSP vs. a control group on targeted family and youth competencies at post-test, multiple systems of youth self-regulation at 6-month follow-up, and multiple youth outcomes at 1-year follow-up: substance use, externalizing and internalizing symptoms, deviant peer association, risky sexual behaviors, and GPA; 2) examine whether effects are mediated by program- induced improvements on targeted parent and youth competencies and by changes on multiple indicators of youth self-regulation; 3) examine program language (English vs. Spanish), baseline youth risk (including biological risk), and baseline family risk as moderators of BSP effects on youth outcomes and mediators; 4) examine whether variability in implementation accounts for variability in mediators and outcomes; and 5) conduct a cost analysis of the BSP vs. the original Bridges program, as well as estimate the cost-effectiveness of the BSP vs. the control group on delayed SU initiation and quantity and frequency of SU at 1-year follow-up. In the proposed trial, 500 7th grade students and their parents will be randomized to receive the BSP or the control group within each school. The trial will include 4 assessment points: pretest (W1) and immediate posttest in 7th grade (W2), 6-month (W3) and one-year follow-up in 8th grade (W4). Assessment of multiple dimensions of self-regulation will address innovative questions for prevention. The resulting intervention package and findings from the randomized trial will lay the foundation for dissemination of the BSP.

描述（由申请人提供）：该项目是Bridges计划的简化版本的混合疗效/有效性试验，该计划是一种以证据为基础的干预措施（EBI），旨在预防药物滥用和精神健康障碍。桥梁是一个综合性的父母-青少年干预评估在随机对照试验（RCT）与墨西哥裔美国人（移民和美国出生的），显示出对多种结果的长期影响：物质使用的启动和升级，外在和内在的症状，越轨的同伴交往，以及青春期早期的平均成绩（GPA）;酒精滥用障碍、酗酒、大麻使用、危险性行为、诊断为精神障碍和青春期后期辍学。基于核心干预组成部分的证据和为现实世界重新设计EBI的战略，我们将与低收入，多民族学校合作，使该计划适应简短的4节课程格式（桥梁短计划，BSP），并优化参与，交付，培训和实施监测系统，以促进传播和可持续性。拟议的RCT还将研究父母-青少年EBI是否会影响青少年自我调节的多个渠道（例如，生物学、行为学、情感学），以及是否存在自我调节的个体差异。 本随机对照试验的具体目的是：1）检查BSP与对照组相比，在后测时对目标家庭和青少年能力的影响，在6个月随访时对青少年自我调节的多个系统的影响，以及在1年随访时对青少年多个结果的影响：物质使用，外化和内化症状，偏差同伴交往，危险性行为和GPA; 2）检查效果是否是由计划引起的针对父母和青少年能力的改善以及青少年自我调节的多个指标的变化所介导的; 3）检查程序语言（英文与西班牙文），基线青年风险（包括生物风险）和基线家庭风险作为BSP对青年结果和中介影响的调节因子; 4）检查实施的可变性是否解释了中介和结果的可变性;以及5）对BSP与原始Bridges项目进行成本分析，并估计BSP与对照组在延迟SU启动以及1年随访时SU数量和频率方面的成本效益。 在拟议的试验中，500名七年级学生和他们的父母将被随机分配到每所学校接受BSP或对照组。试验将包括4个评估点：7年级的前测（W1）和后测（W2），8年级的6个月（W3）和一年随访（W 4）。对自我监管的多个方面进行评估将解决预防方面的创新问题。由此产生的干预方案和随机试验的结果将为BSP的传播奠定基础。