How Do Parents' Experiences with Services Influence Their Children's Service Use? A Longitudinal, Intergenerational Study of High-Risk Families

摘要 父母有药物使用障碍(SOD)或监禁史的儿童尤其 容易发展成有问题的物质使用和障碍。这些年轻人也更有可能挣扎 患有精神健康障碍，并从事反社会行为。虽然心理健康和 物质使用服务可以改善结果，但青年在接受这些服务方面面临许多障碍。这是第一次 高危家庭服务使用代际模式的前瞻性纵向研究。这就做 调查父母的经历--他们的SUD历史、服务使用情况和服务障碍--如何影响他们的 决定为他们的孩子寻求服务。数据来自两项研究：西北青少年项目 对司法系统中1829名青年的心理健康需求和结果进行前瞻性、纵向研究； 下一代，采访西北青少年项目的原始参与者，以及他们的 儿童，年龄10-18岁(预期样本，n=640名家长和儿童访谈)。所有数据收集都将 2023年4月前完工。目标1：是什么决定了需要服务的儿童是否能得到 他们?我将研究人口统计变量(例如，年龄、性别、种族、民族)和临床变量(类型 药物使用和精神健康障碍)影响儿童服务的使用。我预计黑人或拉丁裔 与非西班牙裔白人青年相比，青年接受所需服务的可能性更小；这种物质的类型 使用将确定青年是否接受服务；以及患有共病障碍的青年(例如，创伤后 压力障碍)将更有可能接受服务。目标2：父母如何体验肥皂水 和服务使用--在青春期和成年期--影响他们寻求服务的决定 他们的孩子？我将重点介绍父母使用肥皂水的历史、服务使用情况、态度和服务使用障碍。 在他们自己的青春期和成年期。我预计父母的肥皂水的时间(只在 他们自己的青春期与他们孩子一生中的)以及父母服务的地点(社区与 更正)将影响儿童的服务使用。我假设那些经历了障碍的父母 在青春期接受服务的人比那些没有接受服务的人更不可能为他们的孩子寻求服务。 我的发现将为未来的研究提供经验基础，以确定减少障碍的新策略 提供服务，并让高危青年参与服务。我的训练将得到博士的指导而加强。 Linda Teplin，西北青少年项目和下一代项目的首席研究员，她 合作者凯伦·艾布拉姆博士和莉亚·韦尔蒂博士，主要人员玛格丽塔·阿雷格里亚博士和费耶·塔尔曼博士， 卫生服务利用方面的不平等问题专家。拟议的奖学金培训计划将使我做好准备 成为成瘾科学的独立研究人员，专注于服务使用中的健康不平等。

ABSTRACT Children whose parents have substance use disorders (SUDs) or histories of incarceration are especially vulnerable to developing problematic substance use and disorders. These youth are also more likely to struggle with comorbid mental health disorders and engage in antisocial behaviors. Although mental health and substance use services can improve outcomes, youth face many barriers to receiving them. This is the first prospective, longitudinal study of intergenerational patterns of service use in high-risk families. I will investigate how parents’ experiences–their history of SUDs, service use, and barriers to services–affect their decision to seek services for their children. Data are from two studies: the Northwestern Juvenile Project, a prospective, longitudinal study of mental health needs and outcomes of 1829 youth in the justice system; and Next Generation, which interviews the original participants of the Northwestern Juvenile Project, and their children, ages 10-18 years (anticipated sample, n=640 parent and child interviews). All data collection will be completed by April 2023. Aim 1: What determines whether children who need services receive them? I will examine how demographic variables (e.g., age, sex, race, ethnicity) and clinical variables (type of drug used and comorbid mental health disorders) affect children’s service use. I anticipate that Black or Latinx youth will be less likely to receive needed services than non-Hispanic White youth; that the type of substance used will determine if youth receive services; and that youth with comorbid disorders (e.g., posttraumatic stress disorder) will be more likely to receive services. Aim 2: How do parents’ experiences with SUDs and service use—during adolescence and adulthood—affect their decision to seek services for their children? I will focus on parents’ history of SUDs, service use, attitudes, and barriers to service use during their own adolescence and adulthood. I anticipate that the timing of the parents’ SUDs (only during their own adolescence vs during their child’s lifetime) and the location of the parent’s services (community vs corrections) will affect the children’s service use. I hypothesize that parents who experienced barriers to receiving services during adolescence are less likely to seek services for their children than those who did not. My findings will provide the empirical basis for future studies to identify novel strategies to reduce barriers to services and to engage high-risk youth in services. My training will be strengthened by the mentorship of Dr. Linda Teplin, the Principal Investigator of the Northwestern Juvenile Project and Next Generation, her collaborators, Drs. Karen Abram and Leah Welty, and key personnel, Drs. Margareta Alegria and Faye Taxman, experts in health inequities in service utilization. The proposed fellowship training plan will prepare me to become an independent researcher of addiction science, focusing on health inequities in service use.