Parent SMART (Substance Misuse in Adolescents in Residential Treatment): Protocol of a Randomized Effectiveness Trial of a Technology-Assisted Parenting Intervention.
Parent SMART (Substance Misuse in Adolescents in Residential Treatment): Protocol of a Randomized Effectiveness Trial of a Technology-Assisted Parenting Intervention.
复制标题
父母智能（住宅治疗中的青少年的药物滥用）：技术辅助育儿干预的随机有效性试验的协议。
DOI：
10.2196/35934
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发表时间：
2022-02-28
影响因子：
1.7
通讯作者：
Wright T
中科院分区：
文献类型：
--
作者：
Becker SJ;Helseth SA;Kelly LM;Janssen T;Wolff JC;Spirito A;Wright T
接受住院药物使用治疗的青少年在返回社区后复发的风险极高。父母的做法，包括父母的监督和父母与青少年的沟通，已被确定为青少年药物使用结果和复发的关键预测因素。然而，传统的办公室为基础的治疗可能是不可行的父母谁面临结构性和系统性障碍。有一个明确的需要有效的，可访问的，可扩展的干预措施，为青少年的父母接受住宅物质使用治疗。在先前的试点随机对照试验中，我们测试了父母SMART（青少年在住院治疗中的物质滥用）-一种技术辅助的育儿干预，通过广泛的形成性研究作为住院治疗的辅助手段（TAU）。父母SMART表现出高度的可行性和可接受性，以及在改善父母的监督和沟通的有效性的证据。本方案文件描述了一项完全把握度的随机对照实用有效性试验，将父母SMART作为住宅TAU的辅助治疗。我们假设，家庭谁收到父母智能将表现出更大的改善，在养育子女的技能，减少青少年物质使用，并减少青少年问题行为相对于家庭，收到住宅TAU。我们将测试探索性的假设，即减少青少年物质使用将部分介导的改善养育技巧。青少年-父母二人组（n = 220对二人组;共440对）将被随机分配至仅住宅TAU或父母SMART + TAU。被随机分配到Parent SMART的父母将获得一个网络论坛，一个名为Parenting Wisely的现成计算机程序，以及多达四个远程医疗指导电话。将在出院后6、12和24周进行多方法随访评估，包括自我报告的父母和青少年测量、父母-青少年体内相互作用任务和8组尿液筛查。措施将评估养育技能、青少年药物使用和青少年问题行为。将使用潜在变化评分结构方程模型进行分析。该试验于2021年8月获得资助;在资助之前，于2020年8月获得伦理批准。由于担心试点试验中的管理界面，目前正在由不同的供应商重建Parent SMART网络论坛。计划于2021年12月前完成编程，并于2022年2月开始招募。拟议的研究有可能通过在重要的治疗关头为高需求，服务不足的人群提供服务来推进该领域;针对已被证明可以预测青少年药物使用结果的育儿实践（假定的调解人）;解决获得持续护理的障碍;并测试高度可扩展的干预模型。ClinicalTrials.gov
Adolescents in residential substance use treatment are at extremely high risk for relapse following discharge to the community. Parenting practices, including parental monitoring and parent-adolescent communication, have been established as key predictors of adolescent substance use outcomes and relapse. However, traditional office-based therapy may not be feasible for parents who face structural and systemic barriers. There is a clear need for effective, accessible, and scalable interventions for parents of adolescents receiving residential substance use treatment. In a prior pilot randomized controlled trial, we tested Parent SMART (Substance Misuse among Adolescents in Residential Treatment)—a technology-assisted parenting intervention informed by extensive formative research—as an adjunct to residential treatment as usual (TAU). Parent SMART demonstrated high feasibility and acceptability, as well as evidence of effectiveness in improving parental monitoring and communication. This protocol paper describes a fully-powered randomized controlled pragmatic effectiveness trial of Parent SMART as an adjunct to residential TAU. We hypothesize that families who receive Parent SMART will demonstrate greater improvements in parenting skills, reductions in adolescent substance use, and reductions in adolescent problem behaviors relative to families that receive residential TAU. We will test the exploratory hypothesis that reductions in adolescent substance use will be partially mediated by improvements in parenting skills. Adolescent-parent dyads (n = 220 dyads; 440 total) will be randomized to either residential TAU only or Parent SMART+TAU. Parents randomized to Parent SMART will receive access to a networking forum, an off-the-shelf computer program called Parenting Wisely, and up to four telehealth coaching calls. Multimethod follow-up assessments consisting of self-reported parent and adolescent measures, a parent-adolescent in vivo interaction task, and 8-panel urine screens will be conducted 6, 12, and 24 weeks postdischarge from residential care. Measures will assess parenting skills, adolescent substance use, and adolescent problem behaviors. Analyses will be conducted using latent change score structural equation modeling. The trial was funded in August 2021; ethics approval was obtained in August 2020, prior to funding. Due to concerns with the administrative interface in the pilot trial, the Parent SMART networking forum is currently being rebuilt by a different vendor. The programming is scheduled to be completed by December 2021, with recruitment beginning in February 2022. The proposed research has the potential to advance the field by serving a high-need, underserved population during a vital treatment juncture; targeting parenting practices (putative mediators) that have been shown to predict adolescent substance use outcomes; addressing barriers to accessing continuing care; and testing a highly scalable intervention model. ClinicalTrials.gov NCT05169385; https://clinicaltrials.gov/ct2/show/NCT05169385 PRR1-10.2196/35934