Developing a Brief Intervention for Parental Alcohol Socialization to be Delivered by Pediatric Providers: A Feasibility Study

项目总结 儿童第一次接触酒精通常发生在他们的家里，在他们父母的监督下。 早期饮酒和父母对青少年饮酒的宽容态度预示着随后的 酒精问题。以家庭为导向的预防性干预通常是最有效的，但大多数干预措施 是在学校里进行的。以家庭为基础的家庭干预是资源密集型的，很难实施 规模很大；因此，它们的影响范围和可持续性是有限的。这项R34规划拨款的长期目标 是开发和评估防止酗酒社会化的简短干预的初始版本的可行性 (BI-PAS)，将由儿科保健医生在培训期间分发给六年级学生的父母 每年一次的健康儿童探望。与提供商的简短会面中包含的信息将得到以下支持 每周短信，包含基于父母自我报告的态度的量身定做的干预内容 青少年饮酒。作为一种以初级保健为基础的干预措施，BI-PAS将有广泛的覆盖范围，因为 非污名化干预背景。进入中学是以初级保健为基础的理想时间 干预，因为所需加强免疫的时间表确保了难以到达的机会 人口。此外，这种干预可能提供一种方式来满足美国儿科学会 关于父母对青少年饮酒的预期指导的标准。我们有两个具体的 目标。首先，我们将开发和优化BI-PAS干预消息的内容和通过半 对父母和儿科提供者进行结构化的定性访谈。我们的第二个目标是进行一次试点 研究以评估可行性、实施情况和随时间推移的父母参与度。在我们的设计中，我们将招聘 在两家大型儿科诊所(一家治疗诊所和一家对照诊所)提供医疗服务。我们会训练所有人 来自治疗诊所的提供者与50名六年级学生的父母一起实施BI-PAS。中国的50位家长 对照组将遵循与治疗父母相同的研究方案，但不会接受 提供商干预或定制的文本消息。研究中的所有100名父母将重复完成这项研究 在基线和基线后6个月的每月评估与酒精相关的态度和行为。 接受治疗的家庭将每周收到根据他们最近的治疗信息量身定做的干预信息 评估。供应商将使用实施核对表来跟踪实施质量。他们还将 在研究结束时参加后续访谈，以评估以下项目的可行性和障碍 实施。初步分析将评估干预部分的实施情况，家长 随时间推移与干预材料的接触、BI-PAS实施质量以及许可中的变化 治疗组与对照组的父母态度随着时间的推移而变化。预期的结果 建议的研究是一种干预措施的发展，可以在随机对照试验中进行测试 通过一个大的、可推广的样本，对父母和孩子的短期和长期结果进行研究。

PROJECT SUMMARY Children’s first exposure to alcohol often occurs within their homes, under the supervision of their parents. Early onset alcohol use and permissive parental attitudes about adolescent alcohol use predict subsequent alcohol problems. Family-oriented preventive interventions are generally most effective, but most interventions are delivered in schools. Home-based family interventions are resource intensive and difficult to implement on a wide scale; thus, their reach and sustainability are limited. The long-term objective of this R34 Planning Grant is to develop and assess feasibility of an initial version of the Brief Intervention to Prevent Alcohol Socialization (BI-PAS), which will be delivered to parents of rising 6th graders by pediatric healthcare practitioners during the annual well-child visit. Messages contained within the brief encounter with providers will be bolstered by weekly text messages that contain tailored intervention content based on parents’ self-reported attitudes about adolescent alcohol use. As a primary care-based intervention, BI-PAS will have a wide reach because of the non-stigmatizing intervention context. Entry into middle school is the ideal time for a primary care-based intervention because the schedule of required booster immunizations ensures access to difficult-to-reach populations. Furthermore, this intervention may provide a way to meet American Academy of Pediatrics standards regarding anticipatory guidance for parents about adolescent alcohol use. We have two specific aims. First, we will develop and optimize the BI-PAS intervention message content and delivery through semi- structured qualitative interviews with parents and pediatric providers. Our second aim is to conduct a pilot study to assess feasibility, implementation, and parental engagement over time. In our design, we will recruit providers in two large pediatric clinics (one treatment clinic and one comparison clinic). We will train all providers from the treatment clinic to implement BI-PAS with 50 parents of rising 6th graders. The 50 parents in the comparison group will follow the same study protocol as the treatment parents but will not receive the provider intervention or tailored text messages. All 100 parents in the study will complete repeated assessments of alcohol-related attitudes and behaviors at baseline and monthly for 6 months after baseline. Treatment families will receive weekly intervention messages that are tailored based on their most recent assessments. Providers will use implementation checklists to track implementation quality. They will also participate in a follow-up interview at the conclusion of the study to assess feasibility and barriers to implementation. Primary analyses will assess implementation of intervention components, parental engagement with intervention material over time, BI-PAS implementation quality, and change in permissive parental attitudes over time in the treatment group compared to the control group. The expected outcome of the proposed research is the development of an intervention that can be tested in a randomized control trial of short- and long-term parent and child outcomes with a large, generalizable sample.