The prevention of substance use and misuse among adolescents is a national public health priority. Universal prevention programs that include parents in this effort have been proven efficacious in preventing and reducing substance use problems among adolescents. However, the programs that have been most effective are resource and participant intensive. In addition, the majority of the current programs are not gender-specific and in some cases, long-term effects have been shown for one gender but not the other. The proposed Stage 1 grant addresses this gap by evaluating the feasibility, acceptability, and preliminary efficacy of a novel, brief, gender-specific substance use and misuse preventive intervention for parents/guardians of pre-adolescents (aged 9-12) in an uncontrolled pilot and in a subsequent randomized controlled pilot. The brief intervention framework will comprise two components: an in-person session and a home-based element. For the in-person session, parents will meet for one-hour with an intervention specialist. One-to-two weeks prior to this session, parents will be provided with a handbook, specific to the gender of their child that emphasizes communication, monitoring, and talking with their child about the harms of substance use. During the in-person session, the main points in the handbook will be reviewed and parents will be given the opportunity to ask questions to increase their competencies around the suggestions in the handbook. A particularly innovative component is a focus on eating meals together as a primary intervention strategy to facilitate communication. For the home- based component, tips and reminders with content from the handbooks are to be sent via text messaging throughout the study period, and parents will fill out a weekly meal log. Framed within the context of the Ecodevelopmental Theory, we hypothesize that over the study period, compared to parents who are randomized to the control condition, parents who receive the intervention will self-report an increase in the number of meals eaten together with their children per week, number of minutes spent per meal eaten with their children per week, frequency of conversations about substance use with their children, and frequency of parent-to-child communication and monitoring. Furthermore, we hypothesize that compared to children of parents randomized to the control condition, children of parents who are randomized to receive the intervention will self-report fewer intentions to use substances and increased negative attitudes and expectancies regarding substance use. Estimates of effect size and other information obtained from this pilot proposal will be used to design a larger, refined randomized controlled trial to test the efficacy of the intervention. Development of this intervention will follow the guidelines outlined by NIH for stage-wide development of interventions for substance use and will address the major goal of reducing rates of adolescent substance use and misuse put forth by NIDA and Healthy people 2020.
The short-term goal of this study is to increase the time that parents spend with their children through eating meals together, and in so doing, talking about the harms associated with substance use (intermediate endpoint), which will in turn, lead to the long-term goal of preventing the use and misuse of substances among their children as they enter adolescence. Ultimately, this intervention could present a new approach to universal substance use and misuse prevention programming that is effective, cost- and resource-efficient, able to be disseminated easily, and sustainable.
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