This study will develop, test, and disseminate cancer prevention strategies for high-risk youth, defined as adolescents aged 10 to 11 years from families with incomes that fall below the Federal poverty line. The study has three aims: 1) Develop intervention strategies suitable for community sites to reduce cancer risks associated with tobacco and alcohol use; 2) Test the effects of these strategies in a randomized clinical trial; and 3) Disseminate the tested prevention strategies. The proposed study will occur in three phases. In a 12-month preparation phase, the investigators will develop intervention and measurement protocols, draw a representative sample of community organizations for study participation, and recruit and train intervention delivery agents. An 18-month implementation phase will initiate field operations of a clinical trial, including pretesting, intervention delivery, process data collection, and posttesting. A follow-up and dissemination phase in the last 30 months of the study will involve booster session delivery, data analyses, and, if outcome results are positive, intervention dissemination. The study's cancer risk reduction strategy includes skills intervention that will engage groups of high-risk youth in community settings and parent-enhanced skills intervention that will help family members nurture and sustain youths' cancer risk reduction efforts. The randomized field trial will involve the administration of psychometrically tested and refined pretest measurement batteries to all consenting youths at all collaborating community sites. Following analyses of pretest data to ensure comparability among sites, sites will be divided among three arms: a skills intervention alone arm, a parent-enhanced skills intervention arm, and a no-intervention control arm. Initial delivery of skills and parent-enhanced skills interventions will occur at intervention condition sites. After initial intervention and semiannually, all youths will retake outcome measurement batteries and intervention arm youths will receive booster sessions specific to the initial intervention that they received. The planned research enjoys the support of community organizations in greater New York City that serve high-risk youth.
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