Effects of the Family Check-Up on Adolescent and Teen Sibling Alcohol Use

描述(申请人提供)：青少年开始使用药物的时间越早，长期问题的风险就越大。尽管国家药物使用率随着时间的推移发生了变化，但这种联系仍然存在，表明其作为预防目标的稳定性和可行性。与此同时，在青春期，父母对青少年行为的监测往往会减少，这为过早开始使用药物创造了一个风险来源。因此，促进养育行为和家庭关系的方案在帮助青少年避免药物滥用方面具有保护性，是继续研究的一个重要领域。到目前为止，大多数研究都是基于学校的普遍预防计划进行的。还在学校开展了一些针对高危人群的选择性预防计划。这些普及性或选择性的项目很少涉及家长。家庭体检(FCU)是这一趋势的一个例外，因为它是一项以父母为重点的选择性干预计划。FCU的一个独特优势是，反馈是个性化的，并根据特定的育儿技能量身定做，因为它们通常与家庭中已确定的青少年有关。我们的小组发现，家庭体检在减少青少年饮酒方面有更好的效果，在6个月的随访中，向急诊科报告酒精阳性的青少年比个人动机干预更有效。在本申请中，针对PA-07-406“未成年人和青少年酒精人群的筛查和简短干预”，我们建议评估FCU在应用于青少年确诊患者(IP)和年龄接近的兄弟姐妹时的效果。我们在年龄上纳入兄弟姐妹的理由来自强大的经验基础，它表明：1)兄弟姐妹饮酒相似性很高，兄弟姐妹共有的环境因素可以解释青少年饮酒的很大一部分差异；2)兄弟姐妹关系的特定互动动态(串通)与青少年饮酒有关。为了确定其他类型的基于家庭的干预是否像FCU一样有帮助，将兄弟姐妹增强的FCU的有效性与育儿心理教育计划家庭事务(FM)进行比较。此应用程序的主要目标是评估兄弟姐妹增强的FCU在青少年IP中减少酒精和其他药物使用的有效性，该青少年IP表现为与酒精相关的事件和年龄接近的兄弟姐妹。父母监测和其他青少年健康危险行为的变化也将在一年内进行衡量。

DESCRIPTION (provided by applicant): The earlier an adolescent initiates substance use, the greater the risk of long-range problems. This association persists despite changes in national substance use rates over time, indicating its stability and viability as a target for prevention. At the same time, parent monitoring of youth behavior tends to decrease during the adolescent years, creating a source of risk for the early onset of substance use. Thus, programs that foster parenting behaviors and family relationships that are protective in helping youth to avoid substance abuse are an important area of continuing research. To date, most of the research has been conducted on universal prevention programs based in schools. Some selective prevention programs with high risk groups have also been conducted in schools. Only rarely do these universal or selective programs involve parents. The Family Check-Up (FCU) is an exception to this trend as it is a selective intervention program that focuses on parents. A unique strength of the FCU is that feedback is individualized and tailored to specific parenting skills as they typically pertain to an identified adolescent in the family. Our group has found that the Family Check-Up had better effects on reducing alcohol use in teens presenting to an Emergency Department as alcohol-positive at 6 month follow-up than an individual motivational intervention. In this application, which is submitted in response to PA-07-406, "Screening and Brief Interventions in Underage and Young Adult Alcohol Populations," we propose to evaluate the efficacy of the FCU when applied to both an adolescent Identified Patient (IP) and a sibling close in age. Our rationale for including a sibling close in age derives from a strong empirical base which has shown that: 1) sibling resemblance for alcohol use is high and environmental factors shared by siblings account for substantial portions of variance in adolescent alcohol use; and 2) specific interactional dynamics of the sibling relationship (collusion) are related to teen alcohol use. In order to determine whether other types of family-based interventions might be just as helpful as the FCU, efficacy of the sibling-enhanced FCU will be compared to a parenting psychoeducational program, Family Matters (FM). The major goal of this application is to evaluate the efficacy of a sibling-enhanced FCU in reducing alcohol and other drug use in an adolescent IP presenting with an alcohol-related event and a sibling close in age. Changes in parental monitoring and other adolescent health risk behaviors will also be measured over a 1-year period.