Improving Delay Discounting to Decrease Harsh Parenting among Parents Receiving Substance Use Treatment in a Low Resource Community

改善延迟折扣以减少在资源匮乏社区接受药物滥用治疗的父母的严厉养育行为

• 批准号: 10630341
• 负责人: JULIA W FELTON
• 金额: $ 20.62万
• 依托单位: HENRY FORD HEALTH SYSTEM
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-15 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10630341
• 关键词: Age; Aggressive behavior; Alcohol consumption; Alcohols; Attention; Behavioral; Caring; Case Series; Child; Child Abuse and Neglect; Child Behavior; Child Rearing; Cities; Clinical; Complex; Data; Decision Making; Discipline; Distress; Drug usage; Emotional; Enrollment; Event; Family; Fathers; Future; Health; Illicit Drugs; Individual; Inpatients; Interruption; Intervention; Intervention Trial; Interview; Life Cycle Stages; Link; Longevity; Manuals; Measures; Memory; Methods; Michigan; Minority; Modeling; Mothers; Outcome; Parent-Child Relations; Parents; Participant; Patient Self-Report; Pattern; Population; Public Health; Punishment; Randomized; Recovery; Research; Residential Treatment; Resource-limited setting; Resources; Rewards; Risk; Risk Behaviors; Science; Severities; Shapes; Substance Use Disorder; Substance abuse problem; Surveys; Techniques; Thinking; Time; addiction; behavior change; behavioral outcome; brief intervention; comparison intervention; contingency management; cost; cost effectiveness; discounting; dosage; effectiveness evaluation; effectiveness testing; effectiveness/implementation design; efficacy evaluation; efficacy testing; evidence base; experience; feasibility testing; feasibility trial; flexibility; follow-up; high risk; illicit drug use; implementation outcomes; implementation trial; implementation/effectiveness; improved; intergenerational; intervention cost; maltreatment; neglect; peer recovery; physical abuse; pilot test; pilot trial; prevent; programs; recruit; reduced substance use; residence; skills; social stigma; substance use; substance use treatment; tailored messaging; transmission process; treatment program; underserved community; uptake; verbal; visual imagery; Age; Aggressive behavior; Alcohol consumption; Alcohols; Attention; Behavioral; Caring; Case Series; Child; Child Abuse and Neglect; Child Behavior; Child Rearing; Cities; Clinical; Complex; Data; Decision Making; Discipline; Distress; Drug usage; Emotional; Enrollment; Event; Family; Fathers; Future; Health; Illicit Drugs; Individual; Inpatients; Interruption; Intervention; Intervention Trial; Interview; Life Cycle Stages; Link; Longevity; Manuals; Measures; Memory; Methods; Michigan; Minority; Modeling; Mothers; Outcome; Parent-Child Relations; Parents; Participant; Patient Self-Report; Pattern; Population; Public Health; Punishment; Randomized; Recovery; Research; Residential Treatment; Resource-limited setting; Resources; Rewards; Risk; Risk Behaviors; Science; Severities; Shapes; Substance Use Disorder; Substance abuse problem; Surveys; Techniques; Thinking; Time; addiction; behavior change; behavioral outcome; brief intervention; comparison intervention; contingency management; cost; cost effectiveness; discounting; dosage; effectiveness evaluation; effectiveness testing; effectiveness/implementation design; efficacy evaluation; efficacy testing; evidence base; experience; feasibility testing; feasibility trial; flexibility; follow-up; high risk; illicit drug use; implementation outcomes; implementation trial; implementation/effectiveness; improved; intergenerational; intervention cost; maltreatment; neglect; peer recovery; physical abuse; pilot test; pilot trial; prevent; programs; recruit; reduced substance use; residence; skills; social stigma; substance use; substance use treatment; tailored messaging; transmission process; treatment program; underserved community; uptake; verbal; visual imagery

Abstract Parents with substance use disorders (SUD) are significantly more likely to engage in harsh parenting practices, including spanking, hitting, and belittling their children, than parents without SUD. Punitive physical and emotional discipline is, in turn, associated with increased rates of child maltreatment and the subsequent intergenerational transmission of substance use disorders. Parents in residential substance use treatment facilities are among those at highest risk for perpetrating harsh and abusive parenting; yet most behaviorally- based parenting interventions available within inpatient settings do not take into account the unique mechanisms linking parental substance use to harsh parenting. Specifically, parents with SUD may be at heightened risk for engaging in maladaptive parenting approaches given a tendency to prioritize immediate rewards (such as stopping a child’s misbehavior using physical punishment) relative to larger, but delayed rewards (including shaping positive child behavior over a longer term). This behavioral tendency is known as delay discounting and recent findings suggest that rates of delay discounting predict parents’ use of harsh physical discipline. Existing research also indicates a strong link between steeper (more problematic) rates of delay discounting and the severity of alcohol and illicit drug use across the lifespan. Thus, delay discounting may represent a specific vulnerability underlying both harsh parenting and disordered substance use. The current project proposes to pilot and feasibility test an adapted episodic future thinking (EFT) intervention to target the reduction of parenting-related delay discounting and examine its effects on parenting practices among families in a residential substance use treatment setting. EFT may be particularly well-suited for dissemination in a residential SUD setting because it is brief, flexible, and can be delivered by peer recovery coaches (PRCs), individuals with lived substance use and recovery experiences. Utilizing PRCs, who are already widely employed in SUD treatment settings, increases the scalability, acceptability and cost- effectiveness of this approach and may reduce stigma, a critical barrier to participation in parenting programs among individuals with SUD. Following a deployment-focused model, we will conduct a small case-series trial and collect data regarding critical implementation outcomes (including acceptability, tolerability, and dosage). Results from this aim will inform manual adaptation. We will then recruit 72 parents of children between the ages of 6 and 10 receiving inpatient substance use treatment in the low resource, majority-minority, city of Flint, Michigan. Participants will be randomized to receive EFT or a comparison intervention. Findings from this study will be used to plan a large-scale (R01) intervention trial and will inform public health approaches for reducing child maltreatment and preventing intergenerational cycles of addiction.

抽象的 患有药物使用障碍（SUD）的父母更有可能从事Harmh育儿 与没有SUD的父母相比，练习，包括打屁股，击打和贬低他们的孩子。惩罚性身体 而情感纪律反过来又与儿童虐待发生率增加有关 物质使用障碍的代际传播。父母在住宅药物治疗中 设施是造成伤害和虐待育儿的风险最高的设施之一；但是大多数行为 - 住院设置中可用的基于基于的育儿干预措施未考虑唯一 将父母物质用途与伤害育儿联系起来的机制。具体来说，有SUD的父母可能是 考虑到立即优先考虑的趋势，从事适应不良的育儿方法的风险增加 相对于较大但延迟 奖励（包括长期塑造积极的儿童行为）。这种行为趋势被称为 延迟折现和最近的发现表明，延迟打折的速度可以预测父母对苛刻的使用 身体学科。现有的研究还表明，钢人（更多问题）的速度有很强的联系 延迟折现以及整个生命周期中酒精和非法药物使用的严重性。那，延迟打折 可以代表既有危害育儿和使用无序物质使用的特定漏洞。 当前的项目建议和可行性测试适应的情节未来思维（EFT）干预 以育儿相关的延迟折现为目标，并检查其对育儿做法的影响 在住宅物质使用治疗环境中的家庭中。 EFT可能特别适合 在住宅SUD设置中的传播，因为它是简短的，灵活的，并且可以通过同行恢复来交付 教练（PRC），具有实用药物使用和恢复经验的个人。利用PRC， 已经在SUD治疗环境中广泛使用，提高了可伸缩性，可接受性和成本 - 这种方法的有效性并可能减少污名，这是参与育儿计划的关键障碍 在有SUD的个体中。按照以部署为中心的模型，我们将进行小型案例审判 并收集有关关键实施结果的数据（包括可接受性，耐受性和剂量）。 此目标的结果将为手动改编提供信息。然后，我们将招募72名儿童父母 年龄在低资源，多数少数人，城市的6岁和10岁年龄 密歇根州弗林特。参与者将被随机接受EFT或比较干预。从中的发现 研究将用于计划大规模（R01）干预试验，并将为公共卫生方法提供信息 减少儿童虐待并防止成瘾的代际周期。