Optimizing Prevention of Costly Adult Outcomes

 描述（由申请人提供）：虽然预防科学家已经记录了有效的干预措施，以防止成人药物滥用，反社会行为和危险的性行为，这些干预措施尚未被应用于优化投资回报，因此尚未被社区完全接受。该应用程序建议绘制早期风险概况（和预防性干预）与成人健康和财务结果之间的关系。过去的研究估计这些关系与回归系数，满足学者，但提供的信息不足，使从业人员和政策制定者有针对性的干预儿童的年龄和风险状况。拟议的研究将确定政府服务的成果和财务成本与各种风险状况的年龄和可能的投资回报的快速通道干预，这已被记录，以防止反社会行为和物质使用问题。我们建议在30-34岁时与两项正在进行的纵向研究中的每一项的参与者进行访谈和行政数据收集，这些研究对儿童从幼儿园到成年的风险因素进行了详细测量，儿童发展项目（n=585，保留率=90%）和快速通道随机对照试验（n=1199，保留率=81%）。我们将追求三个目标：1）建立不同风险水平、质量和年龄的早期风险与成人健康结果之间的关系模型，以确定最佳干预时机和目标; 2）绘制风险状况与成人服务利用率和成年期最终公共成本之间的关系，以货币化预防投资的可能回报; 3）按亚组评估快速通道干预对成人健康和财务结果的影响。研究结果将为一门新兴的投资于儿童的科学提供一个模板，以改善公共卫生和保护公共资源。

 DESCRIPTION (provided by applicant): Although prevention scientists have documented effective interventions to prevent adult substance abuse, antisocial behavior, and risky sexual behavior, these interventions have not been applied to optimize return on investment and thus have not yet been fully embraced by communities. This application proposes to map the relations between early risk profiles (and preventive intervention) and adult health and financial outcomes. Past studies have estimated these relations with regression coefficients that satisfy scholars but provide insufficient information to enable practitioners and policy makers to target children for intervention by age and risk profile. The proposed studies will identify the government service outcomes and financial costs associated with various risk profiles by age and the likely return on investment for the Fast Track intervention, which has been documented to prevent antisocial behavior and substance use problems. We propose interviews and administrative data collection at ages 30-34 with participants in each of two ongoing longitudinal studies that have followed children with detailed measurement of risk factors from kindergarten into adulthood, the Child Development Project (n=585, retention=90%) and the Fast Track randomized controlled trial (n=1199, retention=81%). We will pursue three aims: 1) Model the relation between early risk and adult health outcomes at different levels, qualities, and ages of risk, to identify optimal intervention timing and targets; 2) Map the relation between risk profile and adult service utilization and ultimate public costs in adulthood, to monetize the possible returns on prevention investment; and 3) Evaluate the impact of the Fast Track intervention on adult health and financial outcomes, by subgroups. The findings will provide a template for an emerging Science of Investing in Children to improve public health and protect public resources.