Social Network Influences on Adolescent AUD Treatment Outcomes

描述（由申请人提供）：社会影响，如家庭环境和同伴特征，是相对强大的，青少年药物使用的最接近的预测因素。最初项目期间的结果表明，在社区环境中提供基于群体的治疗后，青少年的药物使用平均减少了；改变的意愿预示着后续药物的使用；同龄人中吸毒人数的减少与吸毒人数的减少有关。为了跟进这些发现，将从社区药物使用强化门诊治疗（IOP）招募200名青少年（及其父母）参加一项纵向研究，研究与治疗结果相关的社会影响（即基于群体的治疗、同伴网络、家庭环境）。青少年在基线（治疗开始）、6个月和12个月时完成评估，内容包括药物使用、个人社交网络和精神状况。青少年还完成每月的随访，以跟踪他们的社会网络的变化，并在每次IOP治疗后完成评分，以检查基于群体的治疗（例如，关于戒断的“规范”治疗）与改变物质使用的准备程度之间的联系。家长在基线（治疗开始）、6个月和12个月完成评估。研究的目的是：(1)追踪青少年改变物质使用的准备程度（物质使用行为的敏感和最接近的预测因子）在IOP治疗期间和之后的变化，以确定与青少年改变准备程度和物质使用相关的常见群体治疗因素；(2)探讨同伴选择和同伴影响作为青少年物质使用变化的机制；(3)确定促进或阻碍青少年物质使用减少的家庭环境特征。这些研究旨在为青少年群体治疗的短期效果和社会网络对青少年治疗结果的影响的生态学有效研究提供重要的新的纵向数据。研究结果将用于发展以社会为基础的干预措施，在接受治疗的青少年中促进健康的同伴和家庭关系。

DESCRIPTION (provided by applicant): Social influences, such as family environment and peer characteristics, are relatively robust, proximal predictors of adolescent substance use. Results from the original project period indicate reductions, on average, in adolescents' substance use following group-based treatment delivered in a community setting; readiness to change predicts substance use over follow-up; and reduction in substance using peers is associated with lower substance use. To follow-up on these findings, 200 adolescents (and their parent) will be recruited from community-based Intensive Outpatient Treatment (IOP) for substance use to participate in a longitudinal study examining social influences (i.e., group-based treatment, peer network, family environment) associated with treatment outcome. Adolescents complete assessments at baseline (treatment entry), 6-, and 12-months covering substance use, personal social network, and psychiatric status. Adolescents also complete monthly follow-ups to track changes in their social network, and new to the continuation, complete ratings after each IOP session to examine associations between group-based treatment (e.g., session "norm" regarding abstinence) and readiness to change substance use. Parents complete assessments at baseline (treatment entry), 6-, and 12-months. Study aims are to: (1) track changes in adolescent's readiness to change substance use, a sensitive and proximal predictor of substance use behavior, during and after IOP treatment to identify common group-based treatment factors associated with adolescents' readiness to change and substance use; (2) examine peer selection and peer influence as mechanisms underlying changes in adolescents' substance use; and (3) identify family environment characteristics that facilitate or impede reductions in adolescents' substance use. These study aims will provide important new longitudinal data relevant to the ecologically valid study of short-term outcomes of group-based treatment for adolescents, and social network influences on adolescents' treatment outcomes. Study findings will be used to develop socially- based interventions that promote healthy peer and family relations in treated adolescents. PUBLIC HEALTH RELEVANCE: Social influences, such as participation in group-based treatment for substance abuse, peer social network, and family environment, are relatively robust predictors of adolescent substance abuse treatment outcome. However, little is known regarding the association between common therapeutic factors in group-based treatment (e.g., group norm regarding abstinence) and treatment outcome, as well as how an adolescent's social network composition and structure are related to treatment outcome. This continuation project addresses these gaps in knowledge using intensive data collection in a naturalistic follow-up design to examine social influences on treated adolescent's substance use. Study results have potentially important implications for guiding the development of social network interventions for youth to enhance and maintain treatment gains.