Substance use prevention for youth with parents in recovery: a pilot randomized controlled trial

项目总结 物质使用障碍(SUD)的风险始于生命过程的早期。虽然预防和减少非法行为 在年轻人中使用非医疗药物是一个紧迫的公共卫生优先事项，目前几乎没有证据表明- 在初级保健环境中提供可行的基于预防的战略。我们提出了一项三年计划，以 收集关键的试点数据以试点测试和优化旨在提高家庭复原力的二元干预措施， 强化应对技能，帮助家庭谋划未来，预防青少年自闭症。 目前，美国超过12%的儿童生活在父母中至少有一人患有自闭症的家庭，包括 估计有300万年龄在12到17岁之间的儿童。父母的SUD是已知的风险因素 青春期和青春期物质使用的开始和发展。同时，父母 已经证明，从SUD中恢复可以防止青少年使用药物，特别是当有 提供支持以促进支持性的亲子关系、解决问题的技能和有效的家庭 应对策略。我们工作的一个关键前提是，为高危青少年制定有效的SUD预防战略 因此需要有意识地将家庭单位纳入干预过程。长期目标 这项拟议的工作轨迹之一是防止在有选择的青年人群中使用药物，这些青年人口 家长们正在从SUD中恢复。 我们干预方法的“原型”是家庭谈话，这是一种基于证据的亲子-青年二元论 可以在以患者为中心的医疗之家的现有基础设施内提供的干预。我们 已对模型进行了初步改装，为测试做准备。为后续的 疗效研究，我们将对40名父母进行干预的双臂试点随机对照试验。 青年二人组优化干预模式；评估可行性；获得研究的经验估计 为一项完全有效的随机对照试验的规划提供信息的参数； 干预目标采用半结构化定性访谈。 本R34末尾的产品将是一个优化的干预模型，准备进行疗效测试，经过调整 有家长和年轻人的参与。我们的最终目标是开发一种有效的青少年物质使用方法 可以在以患者为中心的医疗之家的基础设施内提供的预防。如果成功， 这一工作轨迹有可能确定一种新的、以家庭为中心的方法来预防 父母正处于休克期的青年高危人群。

PROJECT SUMMARY Risk for substance use disorder (SUD) begins early in the life course. Although preventing and decreasing illicit and nonmedical drug use among youth is an urgent public health priority, there are currently few evidence- based prevention strategies feasible for delivery in the primary care setting. We propose a three-year plan to collect critical pilot data to pilot test and optimize a dyadic intervention that aims to increase family resilience, strengthen coping skills, help families plan for the future, and prevent youth SUD. Currently, over 12% of children in the US live in households with at least one parent who has SUD, including an estimated 3 million children between the ages of 12 and 17. Parental SUD is a known risk factor for the initiation and progression of substance use in adolescence and young adulthood. At the same time, parental recovery from SUD has been shown to be protective against youth substance use, particularly when there are supports in place to promote supportive parent-child relationships, problem solving skills, and effective family coping strategies. A key premise of our work is that an effective SUD prevention strategy for high-risk youth therefore needs to incorporate the family unit deliberately in the intervention process. The long-term objective of this proposed trajectory of work is to prevent substance use among a selective population of youth whose parents are in recovery from SUD. The ‘prototype’ for our intervention approach is Family Talk, an evidence-based parent-youth dyadic intervention that can be delivered within the existing infrastructure of the patient-centered medical home. We have made preliminary adaptations to the model in preparation for testing. To prepare for a subsequent efficacy study, we will conduct a two-arm pilot randomized controlled trial of the intervention with 40 parent- youth dyads to optimize the intervention model; evaluate feasibility; obtain empiric estimates of study parameters to inform the planning of a fully powered randomized controlled trial; and identify plausible intervention targets using semi-structured qualitative interviews. The product at the end of this R34 will be an optimized intervention model, ready for efficacy testing, adapted with parent and youth input. Our ultimate goal is to develop an effective approach to youth substance use prevention that can be delivered within the infrastructure of the patient-centered medical home. If successful, this trajectory of work has the potential to identify a novel, family-centered approach to SUD prevention for a high-risk population of youth whose parents are in recovery from SUD.