Developing a Brief Intervention for Parental Alcohol Socialization to be Delivered by Pediatric Providers: A Feasibility Study

项目摘要 儿童第一次接触酒精通常发生在家中，在父母的监督下。 早发性饮酒和父母对青少年饮酒的宽容态度预测了青少年饮酒后的生活质量。 酒精问题。以家庭为导向的预防性干预措施通常最有效，但大多数干预措施 都是在学校里进行的。以家庭为基础的家庭干预措施是资源密集型的，很难实施。 因此，其影响范围和可持续性有限。R34规划补助金的长期目标 是开发和评估预防酒精社会化的简短干预的初始版本的可行性 （BI-PAS），将由儿科保健医生在2016年期间向正在上升的6年级学生的父母提供 一年一度的亲子游与提供者的简短会面中包含的信息将得到以下方面的支持： 每周一次的短信，其中包含根据父母自我报告的态度定制的干预内容， 青少年饮酒作为一种基于初级保健的干预措施，BI-PAS将具有广泛的覆盖面，因为 非污名化干预背景。进入中学是一个理想的时间为基础的初级保健 干预，因为所需的加强免疫接种时间表确保了难以到达的 人口数量。此外，这种干预可能会提供一种方法，以满足美国儿科学会 关于青少年饮酒的家长预期指导标准。我们有两个具体的 目标。首先，我们将开发和优化BI-PAS干预信息内容，并通过半 与父母和儿科提供者进行结构化定性访谈。我们的第二个目标是进行试点 研究评估可行性，实施和家长参与随着时间的推移。在我们的设计中，我们将招募 两个大型儿科诊所（一个治疗诊所和一个比较诊所）的供应商。我们将训练所有 来自治疗诊所的供应商与50名六年级学生的家长一起实施BI-PAS。50位家长在 对照组将遵循与治疗父母相同的研究方案，但不接受 提供商干预或定制的文本消息。所有参与研究的100名父母都将完成重复的 在基线和基线后6个月每月评估酒精相关态度和行为。 治疗家庭将收到每周干预信息，这些信息是根据他们最近的 评估。供应商将使用实施检查表来跟踪实施质量。他们还将 在研究结束时参加后续访谈，以评估 实施.主要分析将评估干预成分的实施情况，父母 随着时间的推移参与干预材料，BI-PAS实施质量，以及许可的变化 与对照组相比，治疗组的父母态度随时间的变化。的预期成果 拟议的研究是开发一种干预措施，可以在一项随机对照试验中进行测试， 短期和长期的父母和孩子的结果与一个大的，可推广的样本。

PROJECT SUMMARY Children’s first exposure to alcohol often occurs within their homes, under the supervision of their parents. Early onset alcohol use and permissive parental attitudes about adolescent alcohol use predict subsequent alcohol problems. Family-oriented preventive interventions are generally most effective, but most interventions are delivered in schools. Home-based family interventions are resource intensive and difficult to implement on a wide scale; thus, their reach and sustainability are limited. The long-term objective of this R34 Planning Grant is to develop and assess feasibility of an initial version of the Brief Intervention to Prevent Alcohol Socialization (BI-PAS), which will be delivered to parents of rising 6th graders by pediatric healthcare practitioners during the annual well-child visit. Messages contained within the brief encounter with providers will be bolstered by weekly text messages that contain tailored intervention content based on parents’ self-reported attitudes about adolescent alcohol use. As a primary care-based intervention, BI-PAS will have a wide reach because of the non-stigmatizing intervention context. Entry into middle school is the ideal time for a primary care-based intervention because the schedule of required booster immunizations ensures access to difficult-to-reach populations. Furthermore, this intervention may provide a way to meet American Academy of Pediatrics standards regarding anticipatory guidance for parents about adolescent alcohol use. We have two specific aims. First, we will develop and optimize the BI-PAS intervention message content and delivery through semi- structured qualitative interviews with parents and pediatric providers. Our second aim is to conduct a pilot study to assess feasibility, implementation, and parental engagement over time. In our design, we will recruit providers in two large pediatric clinics (one treatment clinic and one comparison clinic). We will train all providers from the treatment clinic to implement BI-PAS with 50 parents of rising 6th graders. The 50 parents in the comparison group will follow the same study protocol as the treatment parents but will not receive the provider intervention or tailored text messages. All 100 parents in the study will complete repeated assessments of alcohol-related attitudes and behaviors at baseline and monthly for 6 months after baseline. Treatment families will receive weekly intervention messages that are tailored based on their most recent assessments. Providers will use implementation checklists to track implementation quality. They will also participate in a follow-up interview at the conclusion of the study to assess feasibility and barriers to implementation. Primary analyses will assess implementation of intervention components, parental engagement with intervention material over time, BI-PAS implementation quality, and change in permissive parental attitudes over time in the treatment group compared to the control group. The expected outcome of the proposed research is the development of an intervention that can be tested in a randomized control trial of short- and long-term parent and child outcomes with a large, generalizable sample.