Early Family-Centered Prevention of Drug Use Risk

描述(由申请人提供)： 这项申请提出了一项为期5年的多地点预防结果研究，以儿童早期的育儿实践为目标，以降低导致早发性药物使用和滥用的发展轨迹的风险。以家庭为中心的干预措施是为在妇女、婴儿和儿童服务提供系统(WIC)计划内实施而设计的。这项干预措施是为了让高危家庭参与进来，并最大限度地提高公共卫生对早发性药物使用风险和相关风险的影响。这三个WIC地点包括城市、郊区和农村，每个地点都有240户家庭(N=720)。像往常一样，家庭将被随机分配到WIC，以及由家庭增强的WIC服务，该服务为2至7岁的父母实践提供直接支持。2至7岁的儿童将接受跟踪，以评估家庭服务对入学适应的影响，以及家庭和学校行为问题的出现，这些都是吸毒和药物滥用的前兆。此外，我们建议支持跟踪从2000年秋季在匹兹堡启动的120个有幼儿的高危家庭到6岁的试点样本。对实施的影响的分析将依赖于混合建模策略，以更好地了解干预对谁最有效。此外，对WIC的系统动力学、干预剂量和干预的保真度的分析将与降低早期行为问题的风险和早期使用药物的风险相关。最后，将完善干预、评估和评估程序，以促进以家庭为中心的干预措施在全国各地的WIC地点的相关性和传播。

DESCRIPTION (provided by applicant): This application proposes a 5-year, multisite prevention outcome study that targets parenting practices in early childhood to reduce risk for a developmental trajectory leading to early-onset substance use and abuse. The family-centered intervention is designed for implementation within the service delivery system of Women, Infants, and Children (WIC) programs. The intervention is tailored to engage high-risk families and to maximize the public health impact on risk for early-onset drug use and related risk. The three WIC sites include an urban, suburban, and rural setting, each containing 240 families (N = 720). Families will be assigned randomly to WIC, as usual, and a family-enhanced WIC service that provides direct support for parenting practices from ages 2 through 7. Children will be followed from age 2 to 7 to evaluate the impact on the family service on school entry adjustment and the emergence of behavior problems at home and school, all precursors to onset use and substance abuse. In addition, we propose support to follow a pilot sample of 120 high-risk families with toddlers, initiated in the fall of 2000 in Pittsburgh, to age 6. Analyses of the impact of implementation will rely on mixture-modeling strategies, to better understand for whom the intervention was most effective. In addition, analyses of the systemic dynamics of WIC, intervention dosage, and the fidelity of the intervention will be associated with reduction of risk for early behavior problems and risk for early-onset substance use. Finally, the intervention, assessment and evaluation procedures will be refined to promote relevance and diffusion of the family-centered intervention to WIC sites across the nation.