This revised competing continuation application of a K05 Senior Scientist Award requests salary support for the PI to contribute to the societal prevention of serious problem outcomes, including substance abuse, behaviors that place one at risk for HIV/AIDS, and child abuse, in two related populations: multi-problem adolescents and young high-risk mothers. The PI's strategy for each population is an integrated three-part program of research in translation science that corresponds to the first three specific aims.
The first aim i s to understand how chronic problem behaviors develop in these two populations. Two ongoing longitudinal studies will be completed during this award: 1) the Child Development Project of 585 boys and girls who have been followed since age 4 and will turn 29 during the award;and 2) Project MOM, a study of 500 women being followed from mid-pregnancy through the infant's first three years of life. Findings from both studies indicate high comorbidity of substance use, sexual behaviors that place one at risk of HIV/AIDS, and conduct disorder/antisocial behavior.
The second aim i s to translate findings from basic science into tests of ongoing prevention programs for these two populations: 1) The Fast Track randomized trial of 891 kindergarteners at risk for adolescent problem behaviors tests a 10-year comprehensive intervention that includes parent training, social-cognitive skills training, and peer coaching. Findings indicate that assignment to intervention prevents 75% of diagnosed adolescent conduct disorder in the highest-risk subgroup;and 2) The Durham Family Initiative (DFI) is an attempt to lower the county-wide incidence of child abuse through screening, triage, and intervention with pregnant women. Findings thus far indicate a 41% reduction in official child abuse, contrasted with 12% for 5 control counties.
The third aim i s to learn how to translate efficacious prevention models into community-wide change. Adolescent deviance will be addressed through economic evaluation of Fast Track;and maternal substance abuse, HIV/AIDS risk, and child abuse will be addressed through evaluation of a state-wide Multiple Response System.
The fourth aim i s to integrate studies of these populations in order to understand comorbidity of substance use, behaviors that place one at risk for HIV/AIDS, and conduct disorder. Developmental studies will examine the temporal relations among these problems over time, and intervention trials will test the hypothesis that change in one problem leads to changes in other problems. The fifth aim is to enhance the Pi's ability to provide research mentorship, through directorship of research centers and training of new scholars in a translation science approach to substance use and HIV/AIDS prevention. The sixth aim is to enhance the Pi's research skills and knowledge in HIV/AIDS and substance abuse, especially in economic analysis and public policy. This award will contribute to the prevention of multi-problem outcomes.
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