In-home prevention of SA risks for Native teen families

描述（由申请人提供）：本竞争性修订[通知编号（no - od -09-058）和通知标题（“NIH宣布为竞争性修订申请提供恢复法案资金”）]的总体目标是扩大我们当前资助的范围，“本地青少年家庭药物滥用风险的家庭预防”(NIDA 5R01DA019042；FOA: PA-07-070)，正在评估“家庭精神”（FS）产前和儿童早期家访干预的效果，该干预由美国印第安人（AI）辅助专业人员向美国印第安人的青少年母亲及其子女提供。目前的家庭服务干预措施旨在促进母亲有效的养育做法，减少孕产妇吸毒，改善与终生吸毒相关的孕产妇和儿童结局。该修订版将研究与参加当前试验的AI青少年母亲生下孩子和/或其男性伴侣的男性目前的药物使用模式和育儿实践，并与社区合作，为父亲设计一种数据驱动的、了解文化的FS补充干预措施。具体目的是：1)描述人工智能父亲/男性伴侣的药物使用模式；2)探讨父亲和社区利益相关者对吸毒和父亲身份的看法和动机；3)研究父亲药物使用模式与父亲行为之间的关系；和4)设计一个FS父亲课程目标：a)药物拒绝和避免；B)有效的养育；C)工作准备，d)改善的家庭环境。在提交本竞争性修订时，招募了当前资助的样本（N=322对母亲/儿童），并随机分为FS干预+优化标准护理组与单独优化标准护理组。在基线时，来自四个西南保留地社区的怀孕~32周的AI青少年母亲的年龄为12-19岁，并且报告终生药物使用率很高。本研究旨在招募120名父亲（每个地点30名），平均分布在治疗组和对照组，以及40名社区专家（每个地点10名），为干预措施的发展过程提供建议。研究方法将把深入的定性研究过程与最先进的ACASI技术相结合，以最大限度地提高数据质量，加速传输、分析和传播研究结果。长期预期结果是减少年轻人工智能父母及其后代一生中与药物使用相关的持续人工智能行为健康差异。

DESCRIPTION (provided by applicant): The overarching goal of this Competitive Revision [Notice Number (NOT-OD-09-058) and Notice Title ("NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications")] is to expand the scope of our current grant, "In-Home Prevention of Substance Abuse Risks for Native Teen Families," (NIDA 5R01DA019042; FOA: PA-07-070) that is assessing the efficacy of the "Family Spirit" (FS) prenatal and early childhood home- visiting intervention delivered by American Indian (AI) paraprofessionals to AI teen mothers and their children. The current FS intervention is designed to promote mothers' effective parenting practices, reduce maternal drug use, and improve maternal and child outcomes associated with lifetime drug use. The Revision will research current drug use patterns and parenting practices of men who fathered a child with and/or are male partners of AI teen mothers enrolled in the current trial and work with communities to design a data-driven, culturally informed FS supplemental intervention for fathers. Specific aims are to: 1) describe drug use patterns of AI fathers/male partners; 2) explore fathers' and community stakeholders' beliefs and motivations regarding drug use and fatherhood; 3) examine relationships between fathers' drug use patterns and fathering practices; and 4) design a FS fathers curriculum targeting: a) drug refusal and avoidance; b) effective parenting; c) job readiness, and d) improved home environments. At the time of submission of this Competitive Revision, the sample for the current grant (N=322 mother/child pairs) is recruited and randomized to the FS Intervention + Optimized Standard Care vs. Optimized Standard Care alone. At baseline, expectant AI teen mothers at ~32 weeks gestation from four southwestern reservation communities were 12-19 years old and reported high rates of lifetime drug use. This study aims to recruit 120 fathers (30 from each site) evenly distributed across treatment and control groups and 40 community experts (10 from each site) to advise the intervention development process. Research methods will combine in-depth qualitative research processes with state-of-the-art ACASI technologies to maximize data quality and accelerate transmittal, analysis, and dissemination of findings. Long-term expected outcomes are to reduce persistent AI behavioral health disparities related to drug use over the life course of young AI parents and their offspring. PUBLIC HEALTH RELEVANCE: Given American Indian males' known risks for drug use and their impact on partners and children's drug-related outcomes, there is an urgent need to identify effective intervention strategies for young American Indian fathers. First-time fatherhood may provide a pivotal developmental time point for behavioral redirection and decrease related behavioral risks for partners/spouses and children.