Maternal Influences of Substance Use Among Urban Black Male Adolescents

描述（由申请人提供）：在拟议的项目中，我们试图研究城市非洲裔美国母亲对其青春期儿子的健康风险行为-烟草，酒精和其他物质使用(TAOS) -发生的影响。本项目的目的是：1)检验家庭因素对城市青少年男性TAOS使用行为的影响；2)检验基于理论、文化特异性的亲子健康风险降低干预对城市非洲裔美国母亲改变其青春期儿子TAOS使用行为的有效性；3)检验哪些关键的产妇结局变量介导了这些干预效果。该研究是在理性行动理论以家庭为基础的扩展框架内进行的，并基于对RCT母子艾滋病毒风险降低干预数据的二次分析（R01 MH55742； L. Jemmott）。最初的研究包括575对非裔美国母亲和她们青春期的儿子（11-15岁），他们来自宾夕法尼亚州费城的公共住房。参与者被随机分配到两个结构相似的条件之一：a)艾滋病毒风险降低条件；b)健康促进/风险降低条件，重点是改变健康和物质使用行为（在原始研究中作为对照组）。在本研究中，我们将HIV风险降低条件作为对照组，我们将研究健康促进干预对儿子自我报告TAOS使用的影响。感兴趣的次要结果和潜在的中介包括母亲通过监控、父母-青少年沟通和TAOS使用的角色建模来影响儿子行为的意图和实际尝试。数据将使用广义估计方程（GEE）进行分析，并说明与结果变量水平相适应的联系。干预效果的中介也将使用理论框架和现有文献中的关键变量进行检验。通过利用现有数据，拟议的研究将能够回答有关在高风险城市青少年男性中使用TAOS的家庭影响的关键问题，而进行另一项随机对照试验研究和收集新数据所需费用的一小部分。研究结果将有助于制定有效的以家庭为基础的项目，以减少高风险城市非洲裔美国青少年男性及其家庭对TAOS的使用。

DESCRIPTION (provided by applicant): In the proposed project, we seek to examine the influence of urban African American mothers on the occurrence of health risk behaviors -tobacco, alcohol and other substance use (TAOS) - among their adolescent sons. The purposes of the project are to: 1) test family influences of urban adolescent males' TAOS use behaviors; 2) test whether a theory-based, culture-specific, parent-child health risk reduction intervention with urban African American mothers is effective in changing the TAOS use behaviors of their adolescent sons; and 3) test which key maternal outcome variables mediate these intervention effects. The study is framed within a family-based expansion of the Theory of Reasoned Action and based on a secondary analysis of data from a RCT mother-son HIV risk reduction intervention (R01 MH55742; L. Jemmott). The original study included 575 dyads of African American mothers and their adolescent sons (11-15 years), recruited from public housing in Philadelphia, PA. Participants were randomized to one of two structurally similar conditions: a) a HIV risk-reduction condition; or b) a health promotion/risk reduction condition focusing on changing health and substance use behaviors (served as control group in the original study). In the proposed study, the HIV risk reduction condition will serve as the control group and we will examine the effects of the health promotion intervention on sons' self-reported use of TAOS. Secondary outcomes of interest and potential mediators include mothers' intentions and actual attempts to influence their sons' behaviors through monitoring, parent- teen communication and role modeling of TAOS use. Data will be analyzed using generalized estimating equations (GEE), with specification of links that are appropriate to the level of the outcome variable. Mediation of intervention effects will also be examined using key variables from the theoretical framework and the existing literature. By utilizing existing data, the proposed study will be able to answer key questions regarding family influences of TAOS use among high risk urban adolescent males for a fraction of the cost involved in conducting another RCT study and collecting new data. The findings will contribute to the development of effective family-based programs to reduce TAOS use among high-risk urban, African American adolescent males and their families. PUBLIC HEALTH RELEVANCE: The reduction of substance use and tobacco behaviors among youth and adults is a primary objective of the Healthy People 2010. In this application we seek to understand how mother-son communication around tobacco, alcohol, and other substances (TAOS) may delay or decrease use of TAOS by African American adolescent males. Reduction of TAOS initiation, use, and abuse, are all important to public health. Few interventions have targeted TAOS risk reduction through a family lens. This unique perspective will help to inform public health prevention of TAOS use.