Kumpfer K L
Department of Health Promotion and Education, University of Utah, Salt Lake City, UT 84112, USA.
ISRN Addict. 2014 Mar 3;2014:308789. doi: 10.1155/2014/308789. eCollection 2014.
Standardized family-based interventions are the most effective way of preventing or treating adolescent substance abuse and delinquency. This paper first reviews the incidence of adolescent substance abuse worldwide emphasizing gender and causes by etiological risk and protective factors. New epigenetic research is included suggesting that nurturing parenting significantly prevents the phenotypic expression of inherited genetic diseases including substance abuse. Evidence-based family interventions are reviewed including family change theories behind their success, principles and types of family-based interventions, research results, cultural adaptation steps for ethnic and international translation, and dissemination issues. The author's Strengthening Family Program is used as an example of how these principles of effective prevention and cultural adaptation can result in highly effective prevention programs not only for substance abuse, but for other impulse control disorders as well. The conclusions include recommendations for more use of computer technologies to cut the high cost of family interventions relative to youth-only prevention programs and increase the public health impact of evidence-based prevention programs. The paper recommends that to reduce health care costs these family-based approaches should be applied to the prevention and treatment of other impulse control disorders such as obesity and type 2 diabetes, sexually transmitted diseases, and delinquency.
标准化的家庭干预措施是预防或治疗青少年药物滥用和犯罪行为的最有效方式。本文首先回顾了全球青少年药物滥用的发生率，重点关注性别以及由病因风险和保护因素导致的原因。文中纳入了新的表观遗传学研究，表明养育方式得当能显著预防包括药物滥用在内的遗传性疾病的表型表达。本文回顾了循证家庭干预措施，包括其成功背后的家庭变革理论、家庭干预措施的原则和类型、研究结果、针对不同种族和国际翻译的文化适应步骤以及传播问题。作者的“强化家庭计划”被用作一个例子，来说明这些有效预防和文化适应原则如何能产生不仅对药物滥用，而且对其他冲动控制障碍也非常有效的预防计划。结论包括建议更多地使用计算机技术，以降低相对于仅针对青少年的预防计划而言家庭干预措施的高昂成本，并提高循证预防计划对公共卫生的影响。本文建议，为降低医疗保健成本，这些基于家庭的方法应应用于预防和治疗其他冲动控制障碍，如肥胖症和2型糖尿病、性传播疾病以及犯罪行为。
