Concurrent Treatment of Substance Abuse and Child Maltreatment

药物滥用和虐待儿童的同时治疗

• 批准号: 8293750
• 负责人: RONALD J PRINZ
• 金额: $ 65.23万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-15 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8293750
• 关键词: 8 year old; Abstinence; Address; Age; Behavioral; Caregivers; Child; Child Abuse; Child Abuse and Neglect; Child Welfare; Combined Modality Therapy; Communities; Data; Data Sources; Disadvantaged; Drug usage; Educational Background; Evidence based treatment; Family; Family health status; Goals; Growth; HIV; Household; Income; Individual; Intercept; Intervention; Lead; Legal; Medical; Modeling; Outcome; Outcome Measure; Outcome Study; Outpatients; Parent-Child Relations; Parenting Education; Parenting behavior; Parents; Participant; Pathway interactions; Patient Self-Report; Perceived quality of life; Pharmaceutical Preparations; Procedures; Process; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Records; Regimen; Reporting; Research Design; Risk; Risk Behaviors; Risk Reduction; Sampling; Severities; Social Functioning; Substance abuse problem; System; Testing; Toxicology; Treatment Protocols; Treatment outcome; addiction; alcohol abuse therapy; base; child protective service; contingency management; cost; design; follow-up; high risk; improved; indexing; maltreatment; psychological distress; recidivism; socioeconomics; substance abuse treatment; teacher; treatment as usual; treatment duration; treatment effect; treatment response

DESCRIPTION (provided by applicant): The co-occurrence of child maltreatment and parental substance abuse is a major public health problem with serious consequences for children, parents, families, and the community at large. The need for effective dual treatment of caregiver substance abuse and child maltreatment is unquestionable, but there is a dearth of controlled treatment outcome studies with substance-abusing parents who have engaged in child maltreatment. This project examines two evidence-based treatments-Contingency Management for substance abuse and Pathways Triple P parenting intervention to improve parenting and address child maltreatment. The main study is a longitudinal, factorial, randomized controlled trial to gauge impact on outcome variables that include parental substance abuse, parenting-related functioning (parenting practices, child-maltreatment recidivism, observed parent-child interaction), child adjustment, parent's HIV behavioral risk, and parental quality of life. The sample includes parents in the child welfare system that is struggling with substance-abuse difficulties and has at least one child 2-8 years of age. The study design and implementation features are rigorous and build on adequate statistical power, careful randomization procedures preserving an intent-to-treat model, multiple sources of data (i.e., toxicology samples, self-report, observation, CPS data, treatment records, and teacher report), procedures for promoting and verifying treatment fidelity, an analytic framework centering on random-intercept linear growth models and inclusion of 12 and 18 month follow-up assessments. A second study draws on part of the first study and focuses on potential correlates or predictors of individual variabilty in outcome with the dual treatment, such as parent age and education, level of socioeconomic disadvantage, psychological distress, family difficulties, and legal difficulties. The results of tis project will inform the field about how well the combination of state-of-the-art treatments for substance abuse and child maltreatment impacts families in the child welfare system and move closer to reducing the misery and societal costs associated with these serious public health problems. PUBLIC HEALTH RELEVANCE: This project addresses a serious and all-too-frequent public health problem of families involved with the child protective services system, where there is the co-occurrence of child maltreatment and caregiver substance abuse. At the conclusion of this project, we will know how well the combination of state-of-the-art treatments for substance abuse and child maltreatment impacts families in the child welfare system regarding parental substance abuse, parenting, and recurring child abuse, and what the effects are on promoting positive child adjustment, reducing risky behaviors for HIV, and improving quality of life for children and parents.

描述（由申请人提供）：儿童虐待和父母药物滥用的共同发生是一个重大的公共卫生问题，对儿童，父母，家庭和整个社区造成严重后果。毫无疑问，需要有效的双重治疗的照顾者药物滥用和虐待儿童，但有一个缺乏控制的治疗结果的研究与药物滥用的父母谁从事虐待儿童。本研究探讨两种循证治疗-物质滥用的应急管理和路径三P亲职干预，以改善亲职和解决儿童虐待。主要研究是一项纵向，析因，随机对照试验，以衡量对结果变量的影响，包括父母药物滥用，父母相关功能（父母的做法，儿童虐待累犯，观察到的亲子互动），儿童适应，父母的艾滋病毒行为风险和父母的生活质量。样本包括儿童福利系统中的父母，他们正在与药物滥用问题作斗争，至少有一个2-8岁的孩子。研究设计和实施特征是严格的，并建立在足够的统计功效、保留意向治疗模型的仔细随机化程序、多个数据来源（即，毒理学样本、自我报告、观察、CPS数据、治疗记录和教师报告）、促进和验证治疗保真度的程序、以随机截取线性生长模型为中心的分析框架以及包含12个月和18个月的随访评估。第二项研究借鉴了第一项研究的部分内容，重点关注双重治疗结果中个体变量的潜在相关因素或预测因素，如父母年龄和教育程度、社会经济劣势水平、心理困扰、家庭困难和法律的困难。该项目的结果将告知该领域，最先进的药物滥用和虐待儿童治疗方法的结合如何影响儿童福利系统中的家庭，并更接近于减少与这些严重的公共卫生问题相关的痛苦和社会成本。 公共卫生相关性：该项目处理的是儿童保护服务系统所涉家庭的一个严重和过于频繁的公共卫生问题，即虐待儿童和照料者滥用药物的问题。在本项目结束时，我们将了解药物滥用和儿童虐待的最先进治疗方法的结合对儿童福利系统中有关父母药物滥用，养育和经常性虐待儿童的家庭的影响，以及对促进积极的儿童适应，减少艾滋病毒的危险行为，提高儿童和父母的生活质量的影响。