Early Prevention of Substance Use Initiation in Foster Care

早期预防寄养中开始使用药物

• 批准号: 7462709
• 负责人: LOURDES ORIANA LINARES
• 金额: $ 84.08万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7462709
• 关键词: 8 year old; Address; Adolescence; Age; Alcohol or Other Drugs use; Animals; Behavioral; Biological; Caring; Child; Child Rearing; Child Welfare; Childhood; Clinical Trials; Communities; Data; Development; Discipline; Drug Addiction; Drug Prevention Program; Effectiveness; Effectiveness of Interventions; Evidence based intervention; Face; Family; Feasibility Studies; Fostering; Future; Growth; Home environment; Hybrids; Hydrocortisone; Illicit Drugs; Individual; Informal Social Control; Intervention; Joints; Life; Modeling; Neurosecretory Systems; New York City; Outcome; Parenting behavior; Parents; Pattern; Pharmaceutical Preparations; Population; Preparation; Prevention; Preventive Intervention; Problem Solving; Process; Public Sector; Randomized; Randomized Clinical Trials; Recording of previous events; Records; Research Design; Resistance; Risk; Risk Factors; Salivary; Sampling; Social support; System; Testing; Time; Training; Universities; adolescent substance use; base; biopsychosocial; care systems; child neglect; design; dosage; ethnic minority population; expectation; experience; flexibility; follow-up; foster care; foster child; foster home; foster parent; high risk; intervention effect; maltreatment; mental health welfare; neglect; peer; post intervention; prevent; primary outcome; programs; psychobiology; psychosocial; public education; public health relevance; secondary outcome; social cognitive theory; substance use prevention; teacher; theories; treatment as usual; treatment effect; willingness

Childhood aggressivity at age 7 is associated with a fourfold increased risk for illicit drug dependence at age 25. Despite high rates of aggressivity in children with histories of parental neglect, theory-driven and efficacious drug prevention programs to curtail key precursors of youth substance use initiation (SUI) have not been adapted nor experimentally evaluated with neglected children placed in regular foster homes. The proposed project addresses this critical gap by initially testing a multi-component (child, parenting, and co parenting) early drug prevention intervention for children, their biological parent, and foster parent. The psychosocial intervention is based on a transtheoretical approach (psychobiology of neglect, social learning theory, and family systems) to show improvement primarily in early predisposing SUI processes, child aggressivity, and positive parenting, and secondarily in neuroendocrine (cortisol) functioning, supportive co parenting, and foster home stability by: (1) child training; (2) parenting training; and (3) co parenting training. The intervention is delivered via 12-week Parent and Child Groups which utilizes the Incredible Years programs adapted for a foster care population and led by trained hybrid university-foster agency worker teams. Parenting and Co parenting components are integrated in a joint (multiple biological and foster pairs) parent group format. Groups take place in the foster agency where the children are served. Five foster care agencies and NYU Child Study Center have joined in a community-academic partnership to implement the pilot intervention with N = 100 families. The study uses a within agency design to assign families to intervention (N= 50) or a 'usual care' comparison (N = 50) conditions. A plan to reduce contamination risk is in place. Due to their maltreatment histories, all participating children are considered high-risk for child aggressivity. Three assessments will be conducted: pre-intervention (wave1), postintervention (wave2), and 6 month follow-up after intervention (wave3). Data are gathered from the biological parent, foster parent, child, teacher, a trained observer, and CPS records regardless of whether the child remains in foster care, is discharged home, or enters a preadoptive home. We will complete power analyses regarding the magnitude of intervention effects in primary and secondary outcomes in preparation for a large-scale clinical trial; and feasibility studies (attendance and fidelity) involving this multi component intervention. This application has considerable

7岁时的儿童攻击性与25岁时非法药物依赖的风险增加四倍有关。尽管有父母忽视历史的儿童的攻击性高，理论驱动的和有效的药物预防计划，以减少青年物质使用开始（SUI）的关键前体尚未适应，也没有实验评估与被忽视的儿童放置在定期寄养家庭。拟议的项目解决了这一关键的差距，初步测试的多组件（儿童，父母，共同养育）早期药物预防干预儿童，他们的亲生父母，养父母。心理社会干预是基于一种跨理论的方法（忽视的心理生物学，社会学习理论和家庭系统），以显示改善主要是在早期易感SUI过程，儿童攻击性和积极的养育，其次是在神经内分泌（皮质醇）的功能，支持共同养育，并促进家庭的稳定性：（1）儿童培训;（2）父母培训;（3）共育训练。干预措施是通过12周的父母和儿童小组提供的，该小组利用了适合寄养人口的不可思议的几年计划，并由训练有素的混合大学寄养机构工作人员团队领导。养育和共同养育组件集成在一个联合（多个生物和寄养对）父母组格式。小组在为儿童提供服务的寄养机构举行。五个寄养机构和纽约大学儿童研究中心已经加入了社区-学术伙伴关系，在N = 100个家庭中实施试点干预。该研究采用机构内设计，将家庭分配到干预（N= 50）或“常规护理”比较（N = 50）条件。已制定减少污染风险的计划。由于他们的虐待历史，所有参与的儿童都被认为是儿童攻击性的高风险。将进行三次评估：干预前（第1波）、干预后（第2波）和干预后6个月随访（第3波）。数据是从亲生父母、养父母、孩子、老师、受过训练的 观察员和CPS记录，无论孩子是否仍在寄养，出院回家，或进入收养前的家庭。我们将完成关于主要和次要结局中干预效应大小的功效分析，为大规模临床试验做准备;以及涉及这种多组分干预的可行性研究（出勤率和保真度）。该应用程序具有相当大的