Early Family-Centered Prevention of Drug Use Risk

描述（由申请人提供）： 该申请提出了一项为期5年的多地点预防结果研究，该研究针对幼儿期的养育做法，以降低导致早发性物质使用和滥用的发展轨迹的风险。以家庭为中心的干预措施旨在在妇女、婴儿和儿童方案的服务提供系统内实施。干预措施是专门针对高风险家庭的，并最大限度地提高对早发性吸毒风险和相关风险的公共卫生影响。三个WIC站点包括城市、郊区和农村环境，每个站点包含240个家庭（N = 720）。像往常一样，家庭将被随机分配到WIC，以及一个家庭增强的WIC服务，为2岁至7岁的育儿实践提供直接支持。将对2至7岁的儿童进行随访，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，所有这些都是开始使用和滥用药物的前兆。此外，我们建议支持跟踪一个试点样本的120个高风险家庭的幼儿，在2000年秋季开始在匹兹堡，到6岁。对实施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，WIC的系统动力学分析、干预剂量和干预的保真度将与早期行为问题风险和早发性物质使用风险的降低相关。最后，将完善干预、评估和评价程序，以促进以家庭为中心的干预在全国WIC场所的相关性和传播。

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.