Early Prevention of Substance Use Initiation in Foster Care

7岁时的儿童攻击性与25岁时非法药物依赖风险增加四倍有关。尽管有父母忽视史的儿童具有很高的攻击性，但理论驱动和有效的药物预防计划，以减少青少年物质使用开始（SUI）的关键前体，并没有被适应，也没有实验评估被忽视的儿童安置在常规寄养家庭。拟议的项目通过对儿童、其亲生父母和养父母进行多成分（儿童、父母和共同父母）早期药物预防干预的初步测试，解决了这一关键差距。社会心理干预基于跨理论方法（忽视心理生物学、社会学习理论和家庭系统），主要显示早期易患SUI过程、儿童攻击性和积极父母教养方面的改善，其次是神经内分泌（皮质醇）功能、支持性共同抚养和寄养家庭稳定性方面的改善：(1)儿童培训；(2)育儿培训；(3)共同育儿培训。干预是通过为期12周的家长和儿童小组提供的，该小组利用了适合寄养人口的“不可思议的岁月”计划，并由训练有素的大学-寄养机构工作人员团队领导。养育和共同养育的组成部分被整合在一个联合（多个生物和寄养对）父母群体形式中。小组在儿童接受服务的寄养机构举行。五家寄养机构和纽约大学儿童研究中心加入了社区-学术伙伴关系，在100个家庭中实施了试点干预措施。该研究采用机构内部设计，将家庭分配到干预（N= 50）或“常规护理”比较（N= 50）的条件下。降低污染风险的计划已经到位。由于他们的虐待历史，所有参与的孩子都被认为是儿童攻击的高风险。将进行三项评估：干预前（wave1）、干预后（wave2）和干预后6个月随访（wave3）。数据收集自亲生父母，养父母，孩子，老师，培训人员

Childhood aggressivity at age 7 is associated with a fourfold increased risk for illicit drug dependence at age 25. Despite high rates of aggressivity in children with histories of parental neglect, theory-driven and efficacious drug prevention programs to curtail key precursors of youth substance use initiation (SUI) have not been adapted nor experimentally evaluated with neglected children placed in regular foster homes. The proposed project addresses this critical gap by initially testing a multi-component (child, parenting, and co parenting) early drug prevention intervention for children, their biological parent, and foster parent. The psychosocial intervention is based on a transtheoretical approach (psychobiology of neglect, social learning theory, and family systems) to show improvement primarily in early predisposing SUI processes, child aggressivity, and positive parenting, and secondarily in neuroendocrine (cortisol) functioning, supportive co parenting, and foster home stability by: (1) child training; (2) parenting training; and (3) co parenting training. The intervention is delivered via 12-week Parent and Child Groups which utilizes the Incredible Years programs adapted for a foster care population and led by trained hybrid university-foster agency worker teams. Parenting and Co parenting components are integrated in a joint (multiple biological and foster pairs) parent group format. Groups take place in the foster agency where the children are served. Five foster care agencies and NYU Child Study Center have joined in a community-academic partnership to implement the pilot intervention with N = 100 families. The study uses a within agency design to assign families to intervention (N= 50) or a 'usual care' comparison (N = 50) conditions. A plan to reduce contamination risk is in place. Due to their maltreatment histories, all participating children are considered high-risk for child aggressivity. Three assessments will be conducted: pre-intervention (wave1), postintervention (wave2), and 6 month follow-up after intervention (wave3). Data are gathered from the biological parent, foster parent, child, teacher, a trained observer, and CPS records regardless of whether the child remains in foster care, is discharged home, or enters a preadoptive home. We will complete power analyses regarding the magnitude of intervention effects in primary and secondary outcomes in preparation for a large-scale clinical trial; and feasibility studies (attendance and fidelity) involving this multi component intervention. This application has considerable