Understanding for Whom Family-Based Substance Use Prevention Programs Work Best: A Person-Centered Approach

项目总结/摘要 青少年药物使用率（ASU）仍然处于有问题的水平1，尽管在以下方面进行了大量投资： 循证预防方案的实施，2，3特别是普遍的以家庭为基础的ASU预防 程序.为了加强以家庭为基础的预防方案的效果，有必要进行更深入的 了解差异化方案的有效性。传统的评估方法掩盖了 计划影响，使那些受益较少的人难以提高计划的有效性， 4 -8而不是使用单个项目（例如，性别）或累积指数（例如，“家庭风险”）作为调节剂 8、9申请人建议采用创新的以人为本的方法10 -12来研究 通过基于家庭水平和个人水平风险识别亚组， 保护因子（RPF）。这种方法将产生一个整体的类型学，解释同时出现的 不同的RPF，比累积指数更真实地描述青少年的情况。类型学可以是 用于提高对ASU病因学以及不同干预效果的理解。拟定研究 将使用来自PROSPER研究（R 01 DA 013709）的数据，这是一项大型社区随机试验， 随访数据，以检查以下三个目标：（1）确定家庭层面的共同发生的概况， 个人水平的RPF，（2）了解RPF曲线如何预测ASU随时间的变化，以及（3）确定 加强家庭方案：针对父母和10-14岁的青少年， ASU随着时间的推移。 通过解决上述每一个研究目标，拟议的研究将有助于知识， 帮助项目开发人员和预防科学家更好地为广大人口服务， 差异干预效果评价。这项研究中获得的知识将使未来的研究 改善现有干预措施并制定新的干预措施的项目， 特定子组的机制。为了更好地为自己的职业生涯做好准备， 研究，申请人还寻求额外的培训：（1）获得ASU病因学和 在这一发展过程中，（2）加深了对家庭生态干预效应的认识 和相关的ASU成果，（3）学习和应用先进的方法来评估ASU的RPF，（4） 加强稿件和赠款的写作技巧，从事专业活动，以及（5）负责任 开展预防青少年使用药物的研究。申请人的职业目标是进行 独立研究，目的是创新预防战略，以更好地服务于所有方案 参与者达到青少年药物使用流行率的人口水平的影响，从而 防止产生额外的负面下游后果。本论文的研究将为今后的研究奠定基础。 职业生涯长期研究计划调查和实施ASU预防策略。

PROJECT SUMMARY/ABSTRACT Rates of adolescent substance use (ASU) remain at problematic levels1 despite considerable investments in evidence-based prevention program implementation,2,3 specifically universal family-based ASU prevention programs. To enhance the effects of family-based prevention programs, it is necessary to have a deeper understanding of differential program effectiveness. Traditional assessments conceal the heterogeneity in program effects making it difficult to improve program effectiveness for those who may benefit less than others.4–8 Rather than using single items (e.g., gender) or cumulative indices (e.g., “family risk”) as moderators of program effectiveness,8,9 the applicant proposes to apply innovative person-centered methods10–12 to study differential program effects by identifying subgroups based on family-level and individual-level risk and protective factors (RPFs). This approach will yield a holistic typology that accounts for the co-occurrence of different RPFs, a more true-to-life depiction of adolescent context than cumulative indices. Typologies can be used to advance understanding in ASU etiology as well as differential intervention effects. The proposed study will use data from the PROSPER Study (R01 DA013709), a large, community randomized trial with longitudinal follow-up data to examine the following three aims: (1) To identify profiles of co-occurring family-level and individual-level RPFs, (2) To understand how RPF profiles predict ASU over time, and (3) To determine for whom the Strengthening Families Program: For Parents and Youth Ages 10-14 works best in the prevention of ASU over time. By addressing each of the above research aims, the proposed study will contribute to knowledge that will help program developers and prevention scientists better serve the larger population as a whole through evaluation of differential intervention effects. The knowledge gained in this study will allow future research projects to improve existing interventions, and develop new interventions, that target the most promising mechanisms for specific subgroups. To better prepare herself for a career conducting ASU prevention research, the applicant also seeks additional training to: (1) gain expertise on ASU etiology and the role of RPFs in this developmental process, (2) deepen understanding of intervention effects on the family ecology and the associated ASU outcomes, (3) learn and apply advanced methods for evaluating RPFs for ASU, (4) strengthen manuscript and grant writing skills and engage in professional activities, and (5) responsibly conduct research in adolescent substance use prevention. The applicant’s career goal is to conduct independent research with the objective of innovating preventive strategies to better serve all program participants to reach population-level effects on substance use prevalence rates in adolescents, and thus prevent additional negative downstream consequences. This dissertation research will lay the foundation for a career-long research program investigating and implementing ASU prevention strategies.