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，以测试青少年文化信息和灵活的基于家庭的治疗(CIFFTA)，这是作为第一阶段治疗开发工作的一部分开发的，并显示出非常有希望的初步结果。吸毒率在拉美裔中学生中最高，到目前为止，几乎没有任何治疗方法被证明对滥用药物的拉美裔青少年有效。拉美裔青年和家庭的进一步治疗因以下事实而变得复杂：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药物治疗的参与度、保留率和效力/效果。我们开发和全面测试能够解决这些问题的更有效的治疗方法的努力始于第一阶段研究：1)导致开发了一种灵活的手册，允许根据独特的家庭特征进行治疗，2)显示了非常有希望的可行性和可接受性指标(Santisteban和Mena，正在印刷中)，3)在药物使用和家庭层面的假想调解人方面显示了非常有希望的初步结果(Santisteban等人，未发表的手稿)。这项申请提出了一项第二阶段的随机试验，对象是220名14-17岁的西班牙裔青少年，他们符合药物滥用及其家人的标准。这项研究将在一项更大规模和更严格的试验中，与对照条件相比，测试治疗在影响药物使用、危险的性行为和假设的改变机制(家庭功能和治疗联盟)方面的有效性。这项研究还包括对剂量-反应关系的测试和对治疗结果调节因素的探索。此应用程序响应计划公告(PA-07-111)，其中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更好地满足以下特定需求的治疗方法：1)青少年、2)少数族裔和一个特殊的文化群体--拉美裔美国人，通过一种适用于夫妇和家庭的治疗方法来提高治疗效果。 公共卫生相关性：如果这一系列研究继续取得成功，它将有助于该领域：1)针对拉美裔药物滥用青少年的高度创新和有效的治疗；2)更好地了解药物滥用青少年家庭治疗的变化机制；3)灵活和量身定制的治疗框架，可用于更好地满足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highly promising preliminary outcomes on both drug use and family-level hypothesized mediators (Santisteban et al., unpublished manuscript).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.