Preventing Substance Use in the Context of Poverty: Risk and Protection from Early Childhood to Early Adulthood

项目摘要 在美国，孩子们遇到的最脆弱和最普遍的高风险生态之一 社会是贫穷和它的许多相关因素，如妥协的养育，剥夺 社区和学校，不正常的同龄人聚集，以及营养不良和医疗保健。 尽管与贫困相关的适应不良后果的风险更大，但很少有研究表明， 已经前瞻性地研究了年轻人对出生于贫困家庭的孩子的适应能力， 两岁的时候在幼儿期开始的纵向试验中， 一个简短的和重复的家庭干预，以防止酒精和药物使用障碍（ADUD）。 早期步骤多站点（ESM）预防试验是专门为满足需求而设计的 生活贫困的儿童和家庭，其特点往往是父母的养育和 well-being. ESM样本从2岁儿童开始，在9个年龄段进行随访，直到16岁， 我从WIC中心招募了三个地理，社会经济和种族 不同的社区：宾夕法尼亚州匹兹堡;弗吉尼亚州夏洛茨维尔;和俄勒冈州尤金。增加 样本家庭的数量在以后的ADUD风险，资格仅限于WIC家庭， 其他社会经济、家庭和儿童风险因素。家庭被随机分配到 提供了一个年度FCU干预，包括调整和定制的家庭管理， 干预措施。这些儿童和家庭最初在儿童2岁时进行评估，然后每年进行一次 到10.5岁，使用多代理和多方法策略，包括直接 在大多数年份观察家庭互动，随后在14岁和16岁时进行随访。在 在当前申请中，我们建议继续跟踪该多种族样本（N=731） 在19岁和21岁的年轻人中，基因分型在广泛的 当代阵列，关于邻里风险和种族/民族差异的前瞻性数据，我们 建议检查直接的，互动的，级联效应的儿童，遗传，家庭，同伴，和 邻里因素对成人UD和相关结果的影响;家庭检查对成人UD的持久影响 ADUD和相关问题和亲社会行为;以及家庭检查的调节作用- 的效率。

Project Summary One of the most debilitating and pervasive high-risk ecologies children encounter in American society is poverty and its many correlates, such as compromised parenting, deprived neighborhoods and schools, deviant peer clustering, and poor nutrition and medical care. Despite the greater risk of a host of maladaptive outcomes associated with poverty, few studies have prospectively examined young adult adjustment for children born into poverty beginning at age 2. Even fewer longitudinal trials initiated in early childhood have examined the impact of a brief and repeated family intervention in preventing alcohol and drug use disorder (ADUD). The Early Steps Multisite (ESM) prevention trial was specifically designed to address the needs of children and families living in poverty, often marked by compromised parenting and parent well-being. Initiated at child age 2 and follow-ups at nine ages through age 16, the ESM sample was recruited from WIC centers in three geographically, socioeconomically, and ethnically diverse communities: Pittsburgh, PA; Charlottesville, VA; and Eugene, OR. To increase the number of sample families at risk for later ADUD, eligibility was restricted to WIC families with additional socioeconomic, family, and child risk factors. Families were randomly assigned to be offered a yearly FCU intervention, including adapted and tailored family management interventions. The children and families were initially assessed at child age 2 and then yearly through age 10.5, using a multi-agent and multi-method strategy that included direct observations of family interaction in most years, and subsequently followed at ages 14 and 16. In the current application, we are proposing to continue following this multiethnic sample (N=731) of youth who are transitioning to adulthood, at ages 19 and 21. With genotyping on an extensive contemporary array, prospective data on neighborhood risk and racial/ethnic disparities, we propose to examine direct, interactive, and cascading effects of child, genetic, family, peer, and neighborhood factors on ADUD and related outcomes; lasting effects of the Family Check-Up on ADUD and related problem and prosocial behavior; and moderating effects of the Family Check- Up’s effectiveness.