In-home prevention of SA risks for Native teen families

说明(由申请人提供)：本次竞争性修订的总体目标是[通知编号(NOT-OD-09-058)和通知标题(“NIH宣布为竞争性修订申请提供恢复法案资金”)]是为了扩大我们目前拨款的范围，“原生青少年家庭药物滥用风险的家庭预防”(NIDA 5R01DA019042；FOA：PA-07-070)正在评估由美国印第安人(AI)准专业人员向AI青少年母亲及其孩子提供的“家庭精神”(FS)产前和幼儿家访干预的有效性。目前的FS干预措施旨在促进母亲有效的育儿实践，减少母亲药物使用，并改善与终生药物使用相关的母婴结局。此次修订将研究与目前试验中登记的人工智能青少年母亲有一个孩子和/或是他们的男性合作伙伴的男性的当前药物使用模式和育儿做法，并与社区合作，为父亲设计一种数据驱动、文化知情的FS补充干预措施。具体目标是：1)描述人工智能父亲/男性伴侣的药物使用模式；2)探索父亲和社区利益相关者对药物使用和为人父的信念和动机；3)检查父亲的药物使用模式与父亲实践之间的关系；以及4)设计一份FS父亲课程，目标是：a)拒绝和避免药物；b)有效的育儿方式；c)工作准备情况，以及d)改善家庭环境。在提交这一竞争性修订时，当前赠款(N=322对母子)的样本被招募并随机分为FS干预+优化标准护理与单独优化标准护理。在基线水平上，来自西南部四个保留社区的怀孕约32周的准AI青少年母亲年龄在12-19岁之间，报告称终身吸毒率很高。这项研究的目标是招募120名父亲(每个地点30名)平均分布在治疗组和对照组，以及40名社区专家(每个地点10名)，为干预发展过程提供建议。研究方法将把深入的定性研究过程与最先进的ACASI技术相结合，以最大限度地提高数据质量，并加快研究结果的传输、分析和传播。长期的预期结果是减少年轻的人工智能父母及其后代在一生中与药物使用有关的持续的人工智能行为健康差距。 公共卫生相关性：鉴于美国印第安人男性已知的吸毒风险及其对伴侣和儿童与毒品相关结果的影响，迫切需要为年轻的印第安人父亲确定有效的干预战略。第一次做父亲可能会为行为转向提供一个关键的发展时间点，并降低伴侣/配偶和孩子的相关行为风险。

DESCRIPTION (provided by applicant): The overarching goal of this Competitive Revision [Notice Number (NOT-OD-09-058) and Notice Title ("NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications")] is to expand the scope of our current grant, "In-Home Prevention of Substance Abuse Risks for Native Teen Families," (NIDA 5R01DA019042; FOA: PA-07-070) that is assessing the efficacy of the "Family Spirit" (FS) prenatal and early childhood home- visiting intervention delivered by American Indian (AI) paraprofessionals to AI teen mothers and their children. The current FS intervention is designed to promote mothers' effective parenting practices, reduce maternal drug use, and improve maternal and child outcomes associated with lifetime drug use. The Revision will research current drug use patterns and parenting practices of men who fathered a child with and/or are male partners of AI teen mothers enrolled in the current trial and work with communities to design a data-driven, culturally informed FS supplemental intervention for fathers. Specific aims are to: 1) describe drug use patterns of AI fathers/male partners; 2) explore fathers' and community stakeholders' beliefs and motivations regarding drug use and fatherhood; 3) examine relationships between fathers' drug use patterns and fathering practices; and 4) design a FS fathers curriculum targeting: a) drug refusal and avoidance; b) effective parenting; c) job readiness, and d) improved home environments. At the time of submission of this Competitive Revision, the sample for the current grant (N=322 mother/child pairs) is recruited and randomized to the FS Intervention + Optimized Standard Care vs. Optimized Standard Care alone. At baseline, expectant AI teen mothers at ~32 weeks gestation from four southwestern reservation communities were 12-19 years old and reported high rates of lifetime drug use. This study aims to recruit 120 fathers (30 from each site) evenly distributed across treatment and control groups and 40 community experts (10 from each site) to advise the intervention development process. Research methods will combine in-depth qualitative research processes with state-of-the-art ACASI technologies to maximize data quality and accelerate transmittal, analysis, and dissemination of findings. Long-term expected outcomes are to reduce persistent AI behavioral health disparities related to drug use over the life course of young AI parents and their offspring. PUBLIC HEALTH RELEVANCE: Given American Indian males' known risks for drug use and their impact on partners and children's drug-related outcomes, there is an urgent need to identify effective intervention strategies for young American Indian fathers. First-time fatherhood may provide a pivotal developmental time point for behavioral redirection and decrease related behavioral risks for partners/spouses and children.