Adolescent Family-Based Alcohol Prevention

描述（由申请人提供）：本研究考察了两个基于理论的、普遍的家庭预防项目的功效和效果，这些项目已经显示出减少青少年酗酒和其他药物使用的功效：家庭问题（FM）（鲍曼，1996）和（爱荷华州）加强家庭计划（Spoth, 1999），当家庭被随机分配到两种不同的条件之一时：一个家庭“选择”条件（两组-FM或SFP）和一个传统的随机控制试验条件（三组-FM， SFP和对照组）称为“分配”条件。将比较两种情况（选择与指定）在以下方面的差异：(a)与酒精使用和相关行为相关的青少年结果；(b)参与者的家庭特征；(c)家庭入学、留校和毕业率；(d)项目实施费用。样本来自北加州四个医疗中心之一的家庭（N=725），他们的孩子年龄在11岁或12岁，目前参加了凯撒永久医疗保健计划（KP）。在项目实施前，将分别与家长和青少年进行首次面对面访谈，并分别通过电话与家长和青少年进行两次后续访谈（12个月和24个月后）。卫生保健系统代表了向家庭提供青少年酒精使用预防项目的重要新模式。该项目的具体目标将提供对执行问题和可行性的真实世界测试。最后，选择条件代表了一种创新的、现实的条件，在这种条件下，家庭可以在传统的实验研究设计协议之外做出参与决策。基于个人偏好选择治疗可以增加患者对行为改变的自主性和自我效能感，从而改善结果（Williams,1998; Clarke, 1999）。社会认知理论和自我调节原则提供了这些心理结构与行为选择/健康结果之间的联系（Bandura, 1986; Clark & Zimmerman, 1990）。

DESCRIPTION (provided by applicant): This study examines the efficacy and effectiveness of two theory based, universal family prevention programs that have shown efficacy for reducing adolescent alcohol and other drug use: Family Matters (FM) (Bauman, 1996) and (Iowa) Strengthening Families Program (Spoth, 1999) when implemented with families randomly assigned to one of two different conditions: a family "choice" condition (two-groups--FM or SFP) and a traditional random control trial condition (three groups--FM, SFP, and control) called the "assigned" condition. The two conditions (choice vs. assigned) will be compared for differences in: (a) adolescent outcomes related to alcohol use and related behaviors; (b) family characteristics for those who participate; (c) family recruitment, retention and completion rates; (d) costs for program implementation. The sample is drawn from families (N=725) with a child aged 11 or 12 currently enrolled in Kaiser Permanente Health Care Plan (KP), in one of four medical centers in Northern California. An initial face-to-face interview will be conducted (separately) with the parent and adolescent prior to program delivery and two follow-up interviews (12 and 24 months later) will be conducted over the telephone with the parent and adolescent (separately). The health care system represents an important new mode for delivering adolescent alcohol use prevention programs to families. The specific aims of this project will provide a real world test of implementation issues and feasibility. Finally, the choice condition represents an innovative, realistic condition under which families make participation decisions outside of the traditional experimental study design protocols. Choosing a treatment based on personal preference may increase patient's sense of autonomy and self-efficacy for behavior change thereby improving outcomes (Williams,1998; Clarke, 1999). Social cognitive theory and principles of self-regulation provide a connection between these psychological constructs and behavioral choices/health outcomes (Bandura, 1986; Clark & Zimmerman, 1990).