Culturally Informed Family Based Treatment of Adolescents: A Randomized Trial

描述（由申请人提供）：本申请提议进行一项II期随机试验，以测试文化知情和灵活的基于家庭的青少年治疗（CIFFTA），这是作为I期治疗开发工作的一部分开发的治疗方法，并显示出非常有希望的初步结果。毒品使用率在西班牙中学青少年中最高，迄今为止，几乎没有任何治疗方法被证明对药物滥用的西班牙青少年有效。西班牙裔青少年和家庭的进一步治疗是复杂的，因为这些家庭通常在价值观、信仰和行为上与主流吸毒者不同，这些价值观、信仰和行为会直接影响药物治疗的参与、保留和效果。我们开发和全面测试一种更有效的治疗方法来解决这些问题的努力始于第一阶段的研究：1)导致了一种灵活的手册的发展，允许针对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，出版中）；3)在药物使用和家庭水平假设介质方面显示了非常有希望的初步结果（Santisteban等人，未发表的手稿）。本申请提出一项II期随机试验，纳入220名14-17岁符合药物滥用标准的西班牙裔青少年及其家庭。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、危险性行为和假设机制（家庭功能和治疗联盟）变化方面的疗效。该研究还包括对剂量-反应关系的检验和治疗结果调节因子的探索。此应用程序响应计划公告（PA-07-111），该公告概述了感兴趣的领域“…妇女、少数民族、家庭、夫妻、特定文化群体、青少年……”第二阶段试验的重点是一种旨在提高治疗效果的治疗方法，通过建立一个灵活的定制过程，更好地满足以下人群的具体需求：1)青少年，2)少数民族和一个特殊的文化群体——西班牙裔，通过一种对夫妇和家庭有效的治疗。

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highly promising preliminary outcomes on both drug use and family-level hypothesized mediators (Santisteban et al., unpublished manuscript).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.