Hogue Aaron, Brykman Kelsey, Guilamo-Ramos Vincent, Ilakkuvan Vinu, Kuklinski Margaret R, Matson Pamela, McKnight Erin R, Powell Terrinieka W, Richter Linda, Walker-Harding Leslie R
Partnership to End Addiction, 711 Third Avenue, 5th floor, NY, NY, 10017, USA.
Center for Health Care Strategies, Hamilton, NJ, USA.
Prev Sci. 2024 Feb;25(2):307-317. doi: 10.1007/s11121-023-01584-4. Epub 2023 Nov 23.
This article advances ideas presented at a National Academies of Sciences, Engineering, and Medicine workshop in 2022 that highlighted clinical practice and policy recommendations for delivering universal, family-focused substance use preventive interventions in pediatric primary care. Pediatric primary care is a natural setting in which to offer families universal anticipatory guidance and links to systematic prevention programming; also, several studies have shown that offering effective parenting programs in primary care is feasible. The article describes a blueprint for designing a pragmatic national agenda for universal substance use prevention in primary care that builds on prior work. Blueprint practice schematics leverage efficacious family-focused prevention programs, identify key program implementation challenges and resources, and emphasize adopting a core element approach and utilizing digital interventions. Blueprint policy schematics specify avenues for improving cross-sector policy and resource alignment and collaboration; expanding, diversifying, and strengthening the prevention workforce; and enhancing financing for family-focused prevention approaches. The article then draws from these schematics to assemble a candidate universal prevention toolkit tailored for adolescent patients that contains four interlocking components: education in positive parenting practices, parent and youth education in substance use risks, a parent-youth structured interaction task, and parent and youth linkage to in-person and web-based prevention resources.
本文提出了2022年美国国家科学院、工程院和医学院研讨会上提出的观点，该研讨会重点讨论了在儿科初级保健中提供普及的、以家庭为中心的物质使用预防干预措施的临床实践和政策建议。儿科初级保健是为家庭提供普及的预期指导以及与系统预防计划建立联系的自然场所；此外，多项研究表明，在初级保健中提供有效的育儿计划是可行的。本文描述了一个基于先前工作设计实用的国家初级保健物质使用预防议程的蓝图。蓝图实践示意图利用有效的以家庭为中心的预防计划，确定关键的计划实施挑战和资源，并强调采用核心要素方法和利用数字干预措施。蓝图政策示意图明确了改善跨部门政策和资源协调与合作的途径；扩大、多样化和加强预防工作队伍；以及增加对以家庭为中心的预防方法的资金投入。然后，本文借鉴这些示意图，为青少年患者组装了一个候选的普及预防工具包，其中包含四个相互关联的组成部分：积极育儿实践教育、物质使用风险的家长和青少年教育、家长-青少年结构化互动任务，以及家长和青少年与面对面和基于网络的预防资源的联系。
