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: 7127188
• 负责人: John T. Walkup
• 金额: $ 89.61万
• 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/7127188
• 关键词: Native Americans; adolescence (12-20); age at pregnancy; allied health personnel; behavioral /social science research tag; child behavior; child psychology; child rearing; clinical research; drug abuse prevention; emotional adjustment; female; health care service utilization; home health care; human pregnant subject; longitudinal human study; low socioeconomic status; maternal behavior; medically underserved population; mother child interaction; prenatal care; substance abuse related behavior; substance abuse related disorder; women' s health

DESCRIPTION (provided by applicant): Nearly twice as many American Indian (Al) women have their first child during their teenage years (46%) than any other racial or ethnic group in the United States (25%). Reservation life compounds challenges for Al teen mothers, and places them and their children at significant lifetime risk for drug abuse and other health and behavior problems. Two decades of research support the efficacy of prenatal and early childhood nurse delivered, home visiting programs to prevent health and behavior problems for low income, teen mothers and their children. Given the risks factors confronting young Al families and the shortage of indigenous nurses on reservations, a randomized controlled trial is proposed to assess the efficacy of a culturally-adapted, paraprofessional delivered, home visiting program for reservation-based Al teen mothers and their children. The nationally proven intervention model was selected, adapted, and piloted within the study communities since 1998. Eligible expectant Al teens (N=320), ages 12-19 and up to 28 weeks gestation from four reservation communities-will be randomized (1:1) to the Family Spirit Intervention (FS) + Optimized Standard Care vs. Optimized Standard Care (OSC) alone. The FS intervention is a 52-session home visiting program, delivered by Al paraprofessionals, beginning in pregnancy and continuing until the child is 24 months old (approximately 27 months). OSC participants receive free transportation to standard prenatal and well baby visits and written health promotion materials relevant to teen mothers. Masked independent evaluators will assess parental competence, and mother and child health and behavior outcomes at multiple intervals until the child is 36 months old. The study methods have been piloted in preliminary studies funded by SAMHSA. The Johns Hopkins Center for American Indian Health, the applicant institution and coordinating center, has a 22-year history of working with the participating Al communities. Consultants to this application are expert in parenting, home visiting interventions and early childhood assessment.

描述（由申请人提供）：美国印第安人 (Al) 妇女在青少年时期生育第一个孩子的人数 (46%) 几乎是美国任何其他种族或族裔群体 (25%) 的两倍。保留地生活给青少年母亲带来了更大的挑战，使她们及其孩子终生面临药物滥用和其他健康和行为问题的巨大风险。二十年的研究支持产前和幼儿护士提供的家访计划的有效性，以预防低收入、青少年母亲及其孩子的健康和行为问题。考虑到年轻的阿尔家庭面临的风险因素以及保留地土著护士的短缺，建议进行一项随机对照试验，以评估针对保留地的阿尔青少年母亲及其子女的文化适应、专业辅助人员提供的家访计划的效果。自 1998 年以来，经过全国验证的干预模型在研究社区内进行了选择、调整和试点。来自四个保留社区的符合条件的预期青少年 (N=320)，年龄 12-19 岁，妊娠期不超过 28 周，将被随机分配（1: 1) 家庭精神干预 (FS) + 优化标准护理与单独优化标准护理 (OSC) 的比较。 FS 干预是一个为期 52 次的家访计划，由 Al 专业人员提供，从怀孕开始一直持续到孩子 24 个月大（约 27 个月）。 OSC 参与者可以获得免费交通前往标准产前和婴儿健康检查以及与青少年母亲相关的书面健康宣传材料。蒙面独立评估员将多次评估父母的能力、母亲和孩子的健康和行为结果，直到孩子 36 个月大。该研究方法已在 SAMHSA 资助的初步研究中进行了试点。申请机构和协调中心约翰霍普金斯大学美洲印第安人健康中心与参与的印第安人社区有着 22 年的合作历史。该应用程序的顾问是育儿、家访干预和幼儿评估方面的专家。