Early Intervention to Engage Parents in Socializing Children Against Alcohol Use

描述(由申请人提供)：近40%的美国年轻人在12岁前首次饮酒。童年时期开始饮酒显著增加了青少年习惯性饮酒、高风险饮酒和与酒精相关的健康危险行为的可能性。目标一：开发一种亲子干预措施，旨在增加无酒童年的可能性。这项干预将使父母和孩子参与到活动中来，向他们灌输和加强反对未成年人饮酒的态度和行为规范。例如，在正常育儿做法(例如，交流、建模、制定规则、监测)的背景下，干预措施将使父母能够传达禁止饮酒和自己饮酒的规范；消除儿童在家中接触酒精产品的机会；消除儿童参与成人饮酒(例如，拿饮料)；向亲戚和其他父母宣传有关儿童饮酒、接触、服务等的家庭规范；教孩子如何应对可能提供酒精的同龄人或成年人；反对饮酒的形象和电视和其他媒体的信息；并加强儿童戒酒的意识。这一全面的保护性酒精使用社会化计划将效仿成功的反吸烟社会化干预措施。目的II：进行两组随机对照试验，以检验干预措施对儿童开始饮酒的影响。招募1406名母亲、继母或其他女性监护人，这些母亲、继母或其他女性监护人的长子8岁，从未为非宗教目的饮酒。将完成基线电话采访的符合条件的参与者随机分配到一种治疗(干预加两次年度助推剂)或替代对照(情况说明书)。在每个干预单元交付后评估实施情况。通过在基线后1、2、3和4年采访儿童和母亲来衡量干预效果。测试主要假设：接受干预的儿童在12岁之前开始饮酒的可能性明显低于对照组。测试次要假设：在12岁之前继续戒酒的儿童中，接受干预的儿童开始饮酒的敏感性明显低于对照组。进行分析，以确定干预效果的调解人和调解人。与公共健康相关：在青春期早期开始饮酒会显著增加饮酒、高风险饮酒(例如酗酒)、与酒精有关的问题(例如学习成绩下降)以及其他健康风险后果(例如机动车受伤或死亡；怀孕)的可能性。需要一个初级预防计划，从儿童时期开始，让父母参与，并成功地促进无酒的童年。这项研究项目将为父母及其小学年龄的孩子设计和评估一个以家庭为基础的酒精使用预防计划。

DESCRIPTION (provided by applicant): Nearly 40% of young people in the United States first consume alcohol by age 12. Initiation of alcohol use during childhood increases significantly the likelihood of habitual alcohol use, high risk alcohol use, and alcohol-related health risk behaviors during adolescence. Aim I: Develop a parent-child intervention designed to increase the likelihood of an alcohol-free childhood. The intervention will engage parents and children in activities that instill and reinforce attitudinal and behavioral norms against any underage consumption of alcohol. Within the context of normal parenting practices (e.g., communication, modeling, rule setting, monitoring), the intervention will, for example, enable parents to communicate norms that prohibit ever sipping another's drink with alcohol and ever having a drink of one's own; eliminate child access to alcohol products at home; eliminate any child involvement in adult alcohol use (e.g., fetching drinks); communicate family norms regarding child sipping, access, serving, etc. to relatives and other parents; teach children how to respond to peers or adults who might offer alcohol; counter pro-drinking images and messages from television and other media; and reinforce children for staying alcohol-free. This comprehensive program of protective alcohol use socialization will be modeled after a successful anti-smoking socialization intervention. Aim II: Conduct a two-group, randomized controlled trial to test the effect of the intervention on initiation of alcohol use by children. Recruit 1,406 mothers, stepmothers, or other female guardians who have an eldest 8-year old child who has never consumed alcohol for a nonreligious purpose. Randomize eligible participants who complete baseline telephone interviews to a treatment (intervention plus two annual boosters) or alternative control (fact sheet) condition. Evaluate implementation following delivery of each intervention unit. Measure intervention effects by interviewing children and mothers 1, 2, 3, and 4 years post-baseline. Test primary hypothesis: Children exposed to the intervention will be significantly less likely than controls to initiate alcohol use by age 12. Test secondary hypothesis: Among children who remain abstinent to age 12, those exposed to the intervention will have significantly lower susceptibility to initiating alcohol use than controls. Conduct analyses to identify mediators and moderators of intervention effects. PUBLIC HEALTH RELEVANCE: Early initiation of alcohol use increases significantly the likelihood of alcohol use, high risk alcohol use (e.g., binge drinking), alcohol-related problems (e.g., diminished school performance), and other health risk outcomes (e.g., motor vehicle injury or death; pregnancy) during adolescence. A primary prevention program is needed that begins during childhood, engages parents, and successfully promotes an alcohol- free childhood. This research project will design and evaluate a home-based alcohol use prevention program for parents and their elementary-school-aged children.