Not surprisingly, these elevated rates of disturbance make COAs a high-service utilization population, with COAs over-represented in mental health and special education services. Notably, nearly 80% of children in families in the child welfare system are affected by substance abuse (Child Welfare League of America, 2004). Recent estimates indicate that 11 percent of all children live in families where one or more parents abuse alcohol or other drugs (Child Welfare League of America, 2004), making COAs both a substantial and multi-risk population deserving of effective preventive interventions. For these reasons, targeting COAs as a vulnerable group is among the top health priorities identified by the Surgeon General in a 2007 call to action to prevent and reduce underage drinking (US DHHS, 2007). Despite this clear need, few empirically evaluated prevention programs target COAs.
