In-home prevention of SA risks for Native teen families

本土青少年家庭的 SA 风险家庭预防

• 批准号: 7486101
• 负责人: John T. Walkup
• 金额: $ 5万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-30 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7486101
• 关键词: Accident and Emergency department; Adolescent; Age; American Indians; Apache Indians; Attitude; Birth Intervals; Caring; Child; Child Abuse and Neglect; Child Rearing; Childhood; Classification; Communities; Competence; Drug abuse; Drug usage; Education; Emotional; Extended Family; Face; Family; Funding; Future; Gap Junctions; Goals; Health; Health Promotion; Health Resources; Health behavior; Home environment; Home visitation; Hospitalization; Hospitals; House Call; Indian reservation; Individual; Ingestion; Injury; Intervention; Interview; Learning; Legal; Life Experience; Low income; Measurement; Measures; Mediator of activation protein; Medical; Mental Health; Methods; Mothers; Navajo; Nexus (resin cement); Nurses; Office Visits; Outcome; Parenting behavior; Parents; Patient Self-Report; Poverty; Pregnancy; Prevention; Public Health Schools; Randomized; Rate; Recording of previous events; Reporting; Research Support; Risk; Schools; Score; Social Work; Standards of Weights and Measures; Symptoms; Teenagers; Time; Training; Transportation; Tribes; Unemployment; United States Substance Abuse and Mental Health Services Administration; Visit; Writing; base; child neglect; day; depressive symptoms; early childhood; prenatal; prevent; programs; reservation-based; response; social; teenage mother

is study will assess the efficacy of a prenatal and early childhood home visiting intervention, delivered by American Indian (Al) paraprofessionals, to Al teen mothers and their children. The goal of the intervention- Family Spirit-is to reduce risks and promote protective factors that will decrease drug abuse and related health and behavior problems over the lifetime of the mothers and children served. Expectant, reservation- based Al teens face multigenerational challenges, including geographic isolation, history of oppression, poverty, unemployment, limited education, poor access to health and mental health resources, high rates of drug use and fragmented families. These forces are countered by unique protective factors in Native communities including traditions that promote strong extended family networks and emphasis on family as the nexus of strength for individuals. Two decades of research support the efficacy of prenatal and early childhood home visiting programs to prevent health and behavior problems for low income, teen mothers and their children. Home-visiting interventions have not yet been evaluated for Al teens. Although the efficacy of nurse home visiting programs has been proven/the shortage of Al nurses and potential cultural barriers associated with non-Indian home visitors limits the feasibility of this approach for reservation-based teen mothers. Eligible expectant Al teens (N=320), ages 12-19 from four reservation communities will be randomized (1:1) to the Family Spirit Intervention (FS) + Optimized Standard Care vs. Optimized Standard Care (OSC) alone. Parental competence and maternal and child outcomes will be assessed at multiple time points until the child is 36 months old and will include self-reports; interviews; medical, social service and legal record reviews; and observations of the home environment. Study methods and assessments have been piloted since 1998 in previous studies funded by SAMHSA. We propose to assess the efficacy of an American Indian (Al) paraprofessional delivered, home visiting program for reservation-based Al teen mothers and their children. The proposed intervention will: 1) train Navajo and Apache paraprofessionals to implement and assess an evidence-based home-visiting intervention, 2) combine traditional and western understanding of the power of healthy family formation to protect adolescent parents and their children from future risks, and 3) offer new systematic approaches for reducing the burden of drug abuse in Al communities.

这项研究将评估产前和幼儿期家访干预的效果，该干预由以下机构提供： 美国印第安人 (Al) 辅助专业人员，为青少年母亲及其孩子服务。干预的目标—— 家庭精神——降低风险并促进保护性因素，从而减少药物滥用和相关问题 所服务的母亲和儿童一生中的健康和行为问题。期待、保留—— 阿尔青少年面临着多代人的挑战，包括地理隔离、压迫历史、 贫困、失业、教育有限、获得健康和精神卫生资源的机会少、患病率高 吸毒和支离破碎的家庭。这些力量被本土独特的保护因素所抵消 社区，包括促进强大的大家庭网络和强调家庭的传统 个人力量的纽带。二十年的研究支持产前和早期治疗的功效 儿童家访计划，旨在预防低收入、青少年母亲和儿童的健康和行为问题 他们的孩子。尚未对阿尔青少年的家访干预进行评估。虽然功效 护士家访计划已被证明/Al护士的短缺和潜在的文化障碍 与非印度家庭访客相关的限制了这种方法对于基于预订的青少年的可行性 妈妈们。来自四个保留社区的符合资格的预期 Al 青少年 (N=320)，年龄 12-19 岁 随机 (1:1) 接受家庭精神干预 (FS) + 优化标准护理与优化标准护理 单独护理（OSC）。父母能力和母婴结局将多次评估 直到孩子 36 个月大为止的分数，其中包括自我报告；采访；医疗、社会服务和 法律记录审查；以及对家居环境的观察。研究方法和评估 自 1998 年起，在 SAMHSA 资助的先前研究中进行了试点。 我们建议评估美国印第安人 (Al) 专业人员进行家访的效果 针对保留型青少年母亲及其孩子的计划。拟议的干预措施将：1）训练 纳瓦霍和阿帕奇专业人员辅助人员实施和评估基于证据的家访 干预，2）结合传统和西方对健康家庭形成力量的理解 保护青少年父母及其孩子免受未来风险的影响，3) 提供新的系统方法 减轻阿尔社区的药物滥用负担。