School-Based Mindfulness Intervention to Prevent Substance Use Among Urban Youth

描述（由申请人提供）：国家药物滥用研究所的2009年战略计划强调使用新的干预措施作为关键目标来预防青少年开始吸毒。过早开始使用药物是一个严重的公共卫生问题，全国调查显示，近三分之一的八年级学生使用过某种形式的非法药物。对来自弱势社区的青年进行预防尤为紧迫。早期和持续暴露于不良环境（在这些社区普遍存在）与早期开始吸毒和随后出现物质使用障碍的风险增加有关。拟议的R34项目是一项随机对照研究，旨在评估为期24周、以学校为基础的正念和瑜伽干预对预防弱势城市青少年吸毒的影响。认知神经科学的研究结果表明，正念练习可以增强认知和情绪调节能力。有证据表明，加强这些能力可以改善开始使用药物的主要社会情感前兆，例如内化和外化症状，从而减少药物使用问题的风险。参与者将从巴尔的摩市六所K-8学校招募266名五年级和六年级学生。学校将被随机分为干预组和对照组。社会、情感、行为和学术功能以及药物使用规范、态度和使用情况将在基线、干预后以及6个月和12个月的随访时进行评估。数据将通过青少年自我报告、神经认知测试、教师报告和学业记录收集。我们将评估干预结果，以及干预效果的假设调节因子（如压力暴露）和调节因子（如自我调节能力）。约翰霍普金斯大学布隆伯格公共卫生学院、宾夕法尼亚州立大学预防研究中心和总部位于巴尔的摩的整体生活基金会（专门向城市青年教授正念和瑜伽）之间的长期合作，增强了这项研究的可行性。我们团队的一项随机试验为干预的可行性和初步结果提供了令人鼓舞的证据。拟议的研究将建立在这项工作的基础上，并将提供效应量估计和其他数据，以告知设计更大规模的随机对照R01试验。如果成功，干预不仅会减少物质使用的开始，还会促进青少年在情感和行为领域的积极发展。该干预措施有可能在地方和全国推广。

DESCRIPTION (provided by applicant): The National Institute on Drug Abuse's 2009 Strategic Plan highlights prevention of drug use initiation among youth using novel interventions as a key objective. Early initiation of substance use is a serious public health problem, with national surveys suggesting close to one third of eighth graders have used some form of illicit drug. Prevention with youth from disadvantaged communities is particularly urgent. Early and continued exposure to adversity-widespread in such communities--is associated with increased risks for early drug use initiation and subsequent substance use disorders. The proposed R34 project is a randomized controlled study to assess the impact of a 24-week, school-based mindfulness and yoga intervention to prevent substance use among disadvantaged, urban youth. The intervention is informed by findings in cognitive neuroscience, which suggest that mindfulness practices enhance cognitive and emotion regulation capacities. Evidence suggests that strengthening those capacities may improve key social-emotional precursors of substance use initiation, such as internalizing and externalizing symptoms, thereby reducing risks for substance use problems. Participants will be 266 fifth and sixth graders recruited from six K-8 Baltimore City schools. Schools will be randomized either to an intervention or control condition. Social, emotional, behavioral, and academic functioning and substance use norms, attitudes, and use will be assessed at baseline, post-intervention, and 6- and 12-month follow ups. Data will be collected via youth self-reports, neurocognitive tests, teacher reports, and academic records. We will assess intervention outcomes, as well as hypothesized moderators (e.g., stress exposure) and mediators (e.g., self- regulatory capacities) of intervention effects. Feasibility of this research is enhanced by longstanding collaboration among the Johns Hopkins Bloomberg School of Public Health, Pennsylvania State University's Prevention Research Center, and the Baltimore-based Holistic Life Foundation, which specializes in teaching mindfulness and yoga to urban youth. A pilot randomized trial by our team provided encouraging evidence for intervention feasibility and preliminary outcomes. The proposed study will build on that work and will provide effect size estimates and other data to inform the design of a larger-scale randomized controlled R01 trial of program efficacy. If successful, the intervention will not only reduce substance use initiation but will also promote positive youth development across emotional and behavioral domains. The intervention has potential for dissemination locally and nationally. PUBLIC HEALTH RELEVANCE: This study will evaluate feasibility and preliminary outcomes of a 24-week, school-based substance use prevention program that trains urban youth in mindfulness and yoga. Chronically stressed and disadvantaged youth are vulnerable to early initiation of drug use and subsequent substance use disorders. Feasible and effective prevention programs for such populations can improve substantially the health and well-being of our nation's young people.