Early Prevention of Substance Use Initiation in Foster Care

儿童在7岁时的攻击性与25岁时非法药物依赖的风险增加四倍有关。尽管有父母忽视病史的儿童的攻击性很高，但理论驱动的、有效的药物预防计划，以减少青少年物质使用开始(SUI)的关键前体，尚未在被忽视的儿童中得到调整或实验评估，被安置在常规寄养家庭中。拟议的项目通过最初测试针对儿童、他们的亲生父母和养父母的多组成部分(儿童、父母和共同养育)早期药物预防干预来解决这一关键差距。心理社会干预基于跨理论方法(忽视的心理生物学、社会学习理论和家庭系统)，主要表现在早期易患SUI过程、儿童攻击性和积极育儿方面，其次是神经内分泌(皮质醇)功能、支持性共同育儿，并通过以下方式促进家庭稳定：(1)儿童培训；(2)育儿培训；(3)共同育儿培训。干预是通过为期12周的亲子小组提供的，该小组利用适合寄养人口的令人难以置信的年份计划，并由训练有素的大学-寄养机构混合工作人员团队领导。育儿和共同育儿部分以联合(多个生物和寄养配对)父母组的形式集成。小组活动在为儿童提供服务的寄养机构进行。五家寄养机构和纽约大学儿童研究中心加入了社区-学术合作伙伴关系，在N=100个家庭中实施试点干预。这项研究采用机构内设计，将家庭分配到干预(N=50)或‘常规护理’比较(N=50)条件下。降低污染风险的计划已经到位。由于他们的虐待历史，所有参与的儿童都被认为是儿童攻击性的高风险。将进行三次评估：干预前(波1)、干预后(波2)和干预后6个月随访(波3)。数据从亲生父母、养父母、孩子、老师、训练有素的 无论儿童是否仍在寄养家庭、出院或进入收养前家庭，CPS都会进行记录。我们将完成对主要和次要结果中干预效果大小的力量分析，为大规模临床试验做准备；以及涉及这种多成分干预的可行性研究(出席人数和保真度)。这个应用程序有相当大的

Childhood aggressivity at age 7 is associated with a fourfold increased risk for illicit drug dependence at age 25. Despite high rates of aggressivity in children with histories of parental neglect, theory-driven and efficacious drug prevention programs to curtail key precursors of youth substance use initiation (SUI) have not been adapted nor experimentally evaluated with neglected children placed in regular foster homes. The proposed project addresses this critical gap by initially testing a multi-component (child, parenting, and co parenting) early drug prevention intervention for children, their biological parent, and foster parent. The psychosocial intervention is based on a transtheoretical approach (psychobiology of neglect, social learning theory, and family systems) to show improvement primarily in early predisposing SUI processes, child aggressivity, and positive parenting, and secondarily in neuroendocrine (cortisol) functioning, supportive co parenting, and foster home stability by: (1) child training; (2) parenting training; and (3) co parenting training. The intervention is delivered via 12-week Parent and Child Groups which utilizes the Incredible Years programs adapted for a foster care population and led by trained hybrid university-foster agency worker teams. Parenting and Co parenting components are integrated in a joint (multiple biological and foster pairs) parent group format. Groups take place in the foster agency where the children are served. Five foster care agencies and NYU Child Study Center have joined in a community-academic partnership to implement the pilot intervention with N = 100 families. The study uses a within agency design to assign families to intervention (N= 50) or a 'usual care' comparison (N = 50) conditions. A plan to reduce contamination risk is in place. Due to their maltreatment histories, all participating children are considered high-risk for child aggressivity. Three assessments will be conducted: pre-intervention (wave1), postintervention (wave2), and 6 month follow-up after intervention (wave3). Data are gathered from the biological parent, foster parent, child, teacher, a trained observer, and CPS records regardless of whether the child remains in foster care, is discharged home, or enters a preadoptive home. We will complete power analyses regarding the magnitude of intervention effects in primary and secondary outcomes in preparation for a large-scale clinical trial; and feasibility studies (attendance and fidelity) involving this multi component intervention. This application has considerable