Adolescents with Substance Use Disorders Transitioning from Residential Treatment to the Community: Improving Outcomes via a Computer Assisted Parenting Program

患有药物滥用障碍的青少年从住院治疗过渡到社区：通过计算机辅助育儿计划改善治疗结果

• 批准号: 9034960
• 负责人: Sara J. Becker
• 金额: $ 22.19万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-05-01 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9034960
• 关键词: Address; Adolescent; Aftercare; Alcohol or Other Drugs use; Appointment; Behavioral; Categories; Child Rearing; Communication; Communities; Computer Assisted; Computers; Consumer Satisfaction; Data; Drug Addiction; Drug abuse; Effectiveness; Enrollment; Family; Feedback; Focus Groups; Frequencies; Goals; Group Interviews; Health Services Accessibility; Hour; Improve Access; Intervention; Interview; Legal; Link; Maintenance; Mediation; Mediator of activation protein; Methods; Modeling; National Institute of Drug Abuse; Outcome; Parents; Pattern; Persons; Pilot Projects; Population; Problem behavior; Public Health; Relapse; Reporting; Residential Facilities; Residential Treatment; Schools; Severities; Substance Use Disorder; Symptoms; Technology; Teenagers; Testing; Text; Time; Treatment outcome; Truancy; Withdrawal; Work; Youth; adolescent substance use; base; computerized; cost; criminal behavior; design; externalizing behavior; follow-up; high risk; high risk behavior; improved; improved outcome; in vivo; innovation; meetings; member; novel; parental monitoring; pilot trial; programs; psychologic; public health relevance; randomized trial; relapse risk; sex risk; skills; time use; treatment as usual; treatment center

 DESCRIPTION (provided by applicant): Adolescents with substance use disorders (ASUD) in residential treatment have the most serious substance use disorders and the highest rates of psychological, motivational, behavioral, legal, environmental, and vocational problems. ASUD in residential treatment are also at extremely high risk of relapse, with follow-up studies suggesting that 60% of ASUD will relapse within the first 90 days of discharge. Parenting practices have been established as a key influence on adolescents' initiation and maintenance of substance use, as well as their substance use outcomes and likelihood of relapse. However, therapists who treat ASUD have reported a myriad of systemic barriers to engaging parents in treatment. Findings such as these deem ASUD in residential treatment a high priority population and argue for the value of easily accessible parenting interventions during this critical time. The proposed study evaluates one potential low cost, low intensity model for delivering parenting skills to parents preparing for their adolescent's discharge from residential substance use treatment. Specifically, this project involves adapting the delivery of a computerized parenting intervention (Parenting Wisely; PW) that has preliminary evidence of efficacy in improving parenting skills and reducing youth behavior problems. This study adapts the delivery of PW for a new population (parents of ASUD preparing for discharge) and new setting (residential treatment), and obtains initial data on its feasibility, acceptability, and effectiveness. First, an open trialwith 10 parents will adapt the delivery of PW to include moderate engagement strategies relevant to this population. Initial engagement strategies have been developed based on focus groups and interviews with 13 parents, 11 ASUD, and three staff members and include up to six sessions of individualized coaching that begin prior to discharge (incorporated into standing family appointment times) and the use of technology (e.g., text messaging and an online parent message board) to maintain contact between staff and parents post-discharge. Second, a randomized trial with 60 parents will compare an adapted PW plus treatment as usual (TAU) condition (PW+TAU) versus TAU only in a residential treatment center. Both treatment conditions will be delivered by Master's-level community clinicians. Use of a low-cost, low-intensity intervention paired with moderate engagement strategies represents a marked change from traditional treatment delivery methods, with potential for extending treatment gains after discharge. Innovative aspects of the current approach include its timing, use of novel engagement strategies, combination of in-person and computer-delivered content, and focus on putative mediators. The approach has the potential to advance public health by: addressing a high-needs population; targeting parenting practices (putative mediators of change) that have been shown to influence ASUD outcomes; working with parents during a critical treatment juncture; improving parental engagement and access to care, and increasing ease of dissemination and implementation.

 描述（由申请人提供）：住院治疗中患有物质使用障碍（ASUD）的青少年的物质使用障碍最为严重，并且在住院治疗中出现心理、动机、行为、法律、环境和职业问题的比例也最高。复发风险极高，后续研究表明 60% 的 ASUD 会在出院后的前 90 天内复发，这已被确定为影响青少年开始和维持药物使用以及药物使用结果和复发可能性的关键因素。治疗 ASUD 报告了让父母参与治疗的无数系统性障碍，这些发现认为住院治疗中的 ASUD 是一个高度优先的人群，并论证了在这一关键时期易于获得的育儿干预措施的价值。拟议的研究评估了一个潜在的低点。成本，具体来说，该项目涉及调整计算机化育儿干预（明智育儿；PW）的提供，该模式已初步证明在提高育儿技能和能力方面有效。本研究针对新人群（准备出院的 ASUD 父母）和新环境（住院治疗）调整了 PW 的实施，并获得了有关其可行性、可接受性和有效性的初步数据。 10 名家长将调整 PW 的实施方式，以纳入与该人群相关的适度参与策略。初步参与策略是根据焦点小组和对 13 名家长、11 名 ASUD 和 3 名工作人员的访谈制定的，其中包括最多六次个性化辅导。出院前开始（纳入常规家庭预约时间），并使用技术（例如短信和在线家长留言板）在出院后保持工作人员和家长之间的联系。 其次，一项随机试验，涉及 60 名患者。家长将比较适应的 PW 加常规治疗 (TAU) 条件 (PW+TAU) 与仅在住院治疗中心的 TAU 两种治疗条件均由硕士级社区信徒使用低成本、低成本的设施提供。强度干预与适度参与策略相结合代表了传统治疗方法的显着变化，当前方法的创新方面包括时间安排、新颖参与策略的使用、面对面和计算机的结合。交付的内容和重点该方法有可能通过以下方式促进公共卫生：针对高需求人群；针对已被证明会影响 ASUD 结果的养育做法；在关键治疗时刻与父母合作；父母的参与和获得护理的机会，以及增加传播和实施的便利性。