Isolating Targets with Existing Data to Prevent Teen Drug Use in Child Welfare

摘要： 儿童福利制度可能是代际物质使用的恶性循环的中心。在美国 大约830万依赖酒精或其他需要治疗的青少年实际居住在 与孩提时代被虐待的滥用药物的父母在一起。虐待父母的子女受到虐待 物质更有可能在成年后滥用物质。参与CWS的青少年有大量的 针对药物滥用的危险因素和保护因素很少。考虑到CWS所涉及的大量风险 对于青少年来说，CWS可以作为获得药物滥用预防服务的重要门户。CWS拥有 有潜力作为强大的非专业服务部门平台，因为它可以促进目标定位高 使青少年处于危险之中，维持预防和药物滥用治疗方案，并允许捕获 青少年和他们的照顾者在强制治疗环境中。关于物质使用预测因素的文献 参与CWS的青少年的启动和强度仍在不断增加，关于预防和治疗的文献也是如此 治疗服务。因此，拟议研究的总体目标是对现有的 全国儿童福利涉及青少年的概率队列，以确定患病率和影响物质 青少年发展过程中药物滥用的预测因素，以及当前儿童的作用 福利服务在改善药物使用和滥用方面发挥了作用。为了实现这一目标，我们提出了三个 响应PAR-10-018的年度研究，加快利用现有药物滥用研究的步伐 流行病学、预防和治疗研究数据，其中突出显示：1)基础科学发展 与CWS青少年吸毒行为的风险和弹性轨迹相关的知识；以及2) 分析提高可获得性、利用率和有效性的组织和系统环境 在非专科部门提供药物滥用预防服务。总体目标将通过以下方式实现 以下具体目标：1)调查发起和强度的流行率和纵向轨迹 CWS青少年的物质使用情况；2)调查CWS青少年物质使用的预测因素；3)确定 进入药物滥用服务的共同点、服务利用模式和服务利用 CWS青少年的结果；以及4)制定一个预防干预框架，用于选择和匹配 针对青少年CWS中物质使用的循证干预措施。

Abstract: The child welfare system may be the locus of a vicious circle of intergenerational substance use. In the U.S. some 8.3 million teens dependent on alcohol or otherwise needing treatment for substance use actually reside with substance-abusing parents who were maltreated as children. Maltreated children of parents who abuse substances are more likely to abuse substances in adulthood. Teens involved in CWS have an abundance of risk factors and few protective factors against substance abuse. Given the abundance of risk for CWS involved teens, CWS can serve as an important gateway to substance abuse prevention services. CWS has the potential to serve as a robust non-specialty service sector platform because it can facilitate targeting of high risk youth, sustain both preventive and substance abuse treatment programs, and allows for the capture of teens and their caregivers in a mandated treatment setting. The literature on predictors of substance use initiation and intensity among CWS involved teens is still emerging, as is the literature on prevention and treatment services. Therefore, the overall goal of the proposed research is to conduct analyses of an extant national probability cohort of child welfare involved teens to determine the prevalence and impact of substance use, predictors of substance abuse over the course of adolescent development, and the role that current child welfare services play in ameliorating substance use and abuse. To accomplish this goal, we propose a three year study in response to PAR-10-018, Accelerating the Pace of Drug Abuse Research Using Existing Epidemiology, Prevention, and Treatment Research Data, which highlights: 1) basic science development related to knowledge of risk and resilient trajectories of drug using behaviors among CWS teens; and 2) analyses of the organizational and system contexts that improve the accessibility, utilization, and, effectiveness of substance abuse prevention services within a non-specialty sector. The overall goal will be addressed by the following specific aims: 1) Investigate prevalence and longitudinal trajectories of initiation and intensity of substance use among teens in CWS; 2)Investigate predictors of substance use for teens in CWS; 3) Identify common points for entry into substance abuse services, service utilization patterns, and service utilization outcomes for teens in CWS; and 4) Develop a prevention intervention framework for selecting and fitting evidence based interventions to address substance use among CWS involved teens.