Teens' Risk During Transition: Preventing Drug Use, HIV & School Problems

对许多青少年来说，过渡到中学可能是一个危险的时期，因为年轻人面临着许多新的学术挑战和与年长同龄人的社会关系。被寄养放大了这种风险。本研究的目的是进行一项随机有效性试验，以确定在这个关键的过渡期增加预防性干预是否有效，在改善结果方面是否具有成本效益，如药物和烟草使用，参与HIV风险性行为，犯罪，心理健康问题和寄养青少年的学业失败。拟议的LINKS干预措施结合了儿童福利和教育系统的目标，将在加州第二大学区圣地亚哥联合学区实施。LINKS是一项为期20周的双管齐下的干预措施，重点是增加父母和青年的技能和支持，将由社区辅助专业人员提供，他们将接受培训和监督，以实施干预措施。一个持续的忠诚度监测系统将使干预工作人员的业绩符合遵守标准，为当地工作人员培训提供业绩标准，并建立对当地支持和监督的监测（即，在学区和儿童福利系统的系统领导层）。该研究旨在最大限度地提高吸收，可持续性和未来扩大到其他学校和儿童福利系统的潜力，因为这种有效性试验取得了积极的结果。其目标是：a）确定LINKS干预对关键行为健康和学校适应结果的有效性，B）检查作用机制，特别是安置失败对结果的中介作用，c）检查忠诚对结果的调节作用，以及d）检查LINKS的成本效益和成本避免。所有符合条件的五年级学生就读于圣地亚哥联合学区放置在寄养或亲属照顾（及其照顾者）将在4年内招募，并将在基线进行评估，并在6，12和18个月的后续行动。据推测，那些参加LINKS将经历较少的负面行为健康结果和更好的学校适应，这些影响将介导的安置稳定性和干预保真度分数较高的水平。

DESCRIPTION (provided by applicant): The transition to middle school can be a risky time for many adolescents, as youth are exposed to a host of new academic challenges and social relationships with older peers. Being placed foster care amplifies this risk. The purpose of this study is to conduct a randomized effectiveness trial to determine whether adding a preventive intervention at this critical transition period is effective and cost effective in terms of ameliorating outcomes such as drug and tobacco use, participation in HIV- risking sexual behavior, delinquency, mental health problems, and school failure for young adolescents in foster care. The proposed LINKS intervention marries the goals of child welfare and educational systems and will be implemented in the San Diego Unified School District which is the 2nd largest school district in California. LINKS, a 20-week, two pronged intervention that focuses on increasing parent and youth skills and support will be delivered by community-based paraprofessionals who will be trained and supervised to implement the intervention. An ongoing fidelity monitoring system will allow for the calibration of intervention staff performance to adherence standards, provide performance standards for local staff training, and build in monitoring for local support and oversight (i.e., at the system leadership level) in the school district and child welfare systems. The study is designed to maximize the potential for uptake, sustainability, and future scale-up to other school and child welfare systems given positive results from this effectiveness trial. The aims are: a) to determine the effectiveness of the LINKS intervention on key behavioral health and school adjustment outcomes, b) to examine mechanisms of action; specifically the mediating effects of placement failure on outcomes, c) to examine the moderating role of fidelity on outcomes, and d) to examine cost effectiveness and cost avoidance of LINKS. All eligible 5th graders enrolled in the San Diego Unified School District placed in foster or kinship care (and their caretakers) will be recruited over a 4-year period and will be assessed at baseline, and at 6, 12, and 18 month follow-ups. It is hypothesized that those participating in LINKS will experience fewer negative behavioral health outcomes and better school adjustment and that these effects will be mediated by higher levels of placement stability and moderated by intervention fidelity scores.