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

说明(由申请者提供)：国家药物滥用研究所2009年战略计划强调，以新的干预措施为关键目标，在青年中预防毒品使用。早期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。在这些社区中普遍存在的早期和持续暴露在逆境中，与早期开始使用药物和随后的药物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周的以学校为基础的正念和瑜伽干预措施的影响，以防止弱势城市青年使用药物。这项干预是由认知神经科学的发现提供信息的，该发现表明正念练习增强了认知和情绪调节能力。有证据表明，加强这些能力可能会改善启动药物使用的关键社会-情感先兆，如内化和外化症状，从而降低药物使用问题的风险。参与者将是从巴尔的摩市六所K-8学校招募的266名五年级和六年级学生。学校将被随机分配到干预或控制条件下。将在基线、干预后以及6个月和12个月的随访中评估社会、情绪、行为和学习功能以及物质使用规范、态度和使用情况。数据将通过青少年自我报告、神经认知测试、教师报告和学术记录来收集。我们将评估干预结果，以及干预效果的假设调节因素(例如，压力暴露)和中介因素(例如，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之间的长期合作加强了这项研究的可行性，该基金会专门向城市青年教授正念和瑜伽。我们团队的一项试点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。这项拟议的研究将建立在这项工作的基础上，并将提供效应大小估计和其他数据，以指导设计一项更大规模的随机对照R01方案有效性试验。如果成功，干预不仅将减少物质使用的初始阶段，还将促进青少年在情感和行为领域的积极发展。这一干预措施有可能在当地和全国范围内传播。

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.