Culturally Informed Family Based Treatment of Adolescents: A Randomized Trial

描述（由申请人提供）：本申请建议进行第二阶段随机试验，以测试青少年文化知情和灵活的家庭治疗（CIFFTA），这是作为第一阶段治疗开发工作的一部分开发的治疗，并显示出非常有希望的初步结果。药物使用率最高的是西班牙裔中学生，迄今为止，很少有任何治疗已被证明是有效的药物滥用西班牙裔青少年。对西班牙裔青年和家庭的进一步治疗是复杂的，因为这些家庭在价值观、信仰和行为上往往与主流吸毒者不同，这些价值观、信仰和行为可能直接影响吸毒者的参与、保留和药物治疗的疗效/有效性。我们努力开发和全面测试一种更强大的治疗方法，可以解决这些问题，从第一阶段研究开始：1）导致制定了一个灵活的手册，允许治疗量身定制的独特的家庭特征，2）显示了非常有前途的可行性和可接受性指标（Misteban和Mena，在出版中）和3）显示了药物使用和家庭水平假设介质的非常有希望的初步结果（Misteban等人，未出版的手稿）。该申请提出了一项第二阶段随机试验，其中220名14-17岁的西班牙裔青少年符合药物滥用及其家庭的标准。该研究将在一个更大、更严格的试验中，测试与对照条件相比，治疗在影响药物使用、危险性行为和假设的改变机制（家庭功能和治疗联盟）方面的疗效。该研究还包括剂量-反应关系的测试和治疗结果调节剂的探索。此应用程序响应程序公告（PA-07-111），概述了感兴趣的领域“...妇女、少数民族、家庭、夫妇、特定文化群体、青少年.“第二阶段试验的重点是一种旨在通过建立灵活的定制过程来提高治疗效果的治疗方法，以更好地满足以下人群的具体需求：1）青少年，2）少数民族和特殊文化群体-西班牙裔，通过3）夫妇和家庭的治疗。 公共卫生相关性：如果这一系列的研究继续取得成功，它将有助于该领域：1）一个高度创新和有效的治疗西班牙裔药物滥用青少年，2）更好地了解家庭治疗与药物滥用青少年的变化机制，和3）一个灵活和定制的治疗框架，可用于更好地解决其他特殊人群的独特需求。

DESCRIPTION (provided by applicant): This application proposes to conduct a Stage II randomized trial to test Culturally Informed & Flexible Family-Based Treatment for Adolescents (CIFFTA) a treatment developed as part of a Stage I treatment development effort and showing very promising preliminary findings. Drug use rate are highest among Hispanic middle school youth and to date there are few if any treatments that have been proven effective with substance abusing Hispanic adolescents. Further treatment for Hispanic youth and families is complicated by the fact that these families often differ from mainstream drug users in values, beliefs and behaviors that can directly impact engagement, retention, and efficacy/effectiveness of drug treatment. Our efforts to develop and fully test a more powerful treatment that can address these issues began with a Stage 1 study that: 1) led to the development of a flexible manual that allows treatment tailoring to the unique family characteristics, 2) showed highly promising feasibility and acceptability indicators (Santisteban and Mena, in press) and 3) showed highly promising preliminary outcomes on both drug use and family-level hypothesized mediators (Santisteban et al., unpublished manuscript). This application proposes a Stage II randomized trial with 220 Hispanic youngsters' ages 14-17 meeting criteria for drug abuse and their families. The study will test the treatment's efficacy compared to a control condition, in impacting drug use, risky sexual behavior, and hypothesized mechanisms (family functioning and therapeutic alliance) of change, in a larger and more rigorous trial. The study also includes a test of the dose-response relationship and exploration of moderators of treatment outcome. This application responds to a Program Announcement (PA-07-111) that outlines as areas of interest "...women, minorities, families, couples, specific cultural groups, adolescents..." The Stage II trial focuses on a treatment designed to boost the treatment effects by building in a flexible tailoring process to better address the specific needs of: 1) adolescents, 2) minorities and a special cultural group - Hispanics, via a treatment that works with 3) couples and families. PUBLIC HEALTH RELEVANCE: Should this line of research continue to be successful, it will contribute to the field: 1) a highly innovative and effective treatment for Hispanic drug abusing adolescents, 2) a better understanding of the mechanisms of change in family therapy with drug abusing adolescents, and 3) a framework for flexible and tailored treatment that can be used to better address the unique needs of other special populations.