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，以测试基于文化的灵活的青少年家庭治疗 (CIFFTA)，这是作为第一阶段治疗开发工作的一部分而开发的治疗方法，并显示出非常有希望的初步结果。西班牙裔中学生的吸毒率最高，迄今为止，很少有治疗方法被证明对滥用药物的西班牙裔青少年有效。西班牙裔青少年和家庭的进一步治疗变得复杂，因为这些家庭在价值观、信仰和行为方面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戒毒治疗的参与度、保留率和功效/效果。我们为开发和全面测试一种可以解决这些问题的更有效的治疗方法而付出的努力始于第一阶段的研究，该研究：1）开发了一份灵活的手册，允许根据独特的家庭特征定制治疗，2）显示出非常有希望的可行性和可接受性指标（Santisteban和Mena，正在出版），3）显示出在药物使用和家庭层面假设的中介因素方面非常有希望的初步结果（Santisteban等人，未发表的手稿）。该申请提议对 220 名 14-17 岁、符合药物滥用标准的西班牙裔青少年及其家人进行 II 期随机试验。该研究将通过一项更大规模、更严格的试验，测试该治疗与对照条件相比的疗效、对药物使用、危险性行为的影响以及假设的变化机制（家庭功能和治疗联盟）。该研究还包括剂量反应关系的测试和治疗结果调节因素的探索。该应用程序响应了一项计划公告 (PA-07-111)，该公告概述了感兴趣的领域“......妇女、少数族裔、家庭、夫妇、特定文化群体、青少年......”第二阶段试验的重点是通过建立灵活的定制流程来提高治疗效果的治疗，以更好地满足以下人员的特定需求：1) 青少年，2) 少数族裔和特殊文化群体 - 西班牙裔，通过与 3) 夫妇和家庭合作的治疗。 公共健康相关性：如果这一研究方向继续取得成功，它将对该领域做出贡献：1）为西班牙裔吸毒青少年提供高度创新和有效的治疗，2）更好地了解吸毒青少年家庭治疗的变化机制，以及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highly promising preliminary outcomes on both drug use and family-level hypothesized mediators (Santisteban et al., unpublished manuscript).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.