Adolescent Screening and Personalized Intervention Resource for Mild/Moderate Substance Abuse and Co-Occurring Problems

项目摘要 我们建议设计和试点测试的技术为基础的，多元的行为健康干预JIY。 移动的健康干预的设计和功能基于两个关键的发展 框架。第一，干预措施将解决实质性问题与 使用（SU）和共同出现的问题（CP），这是参与JJS的青年（JIY）的定义特征。二是 与当代以患者和青年为中心的卫生保健提供模式保持一致，移动的卫生保健 干预措施将采用互动设计，使青年能够得到反馈， 他们得到的照顾。这种以年轻人为中心的方法与传统的JJS服务模式截然不同。 这些概念性的设计特点和功能将优化青年的参与，赋予权力， 和机构，以最大限度地提高临床效果。可扩展到任何智能手机的数字健康资源将 避免了由训练有素的专业人员提供服务的需要，并且可以通过JJS轻松访问，包括 农村环境。拟议的第1a/1b阶段治疗开发研究的目标是完善和试点测试 “ePACE”（电子健康个性化方法的变化效果），设计为JJS和JIY友好 个性化的、以青年为中心的、移动的卫生资源。ePACE由多问题筛选器组成， 实施一套关键的综合行为改变模块（药物滥用，人际关系， 负面情绪，压力）提供了一个凝聚力的重点SU和CP。目标1：最后确定 ePACE开发：1）与JJS工作人员和JIY进行单独的焦点小组讨论， 资源筛选工具和行为初始版本的功能性、可行性和初始可接受性 改变模块，2）根据焦点小组的结果和新的研究文献修改程序功能。目的 2：评价ePACE和JIY的“固定”非个性化版本（eFACE）的影响， 发生的问题，相对于SU和CP结果的等待列表组（WLG）。我们期待更好的SU， 6个月随访期间ePACE和eFACE与WLG的CP结局，预计ePACE与WLG 效果将大于eFACE与WLG的效果。目标3：评估ePACE和eFACE对 功能和技能发展的目标领域假设产生SU和CP的变化。我们预计 与分配到WLG的青年相比，分配到ePACE和eFACE的青年表现出更大的改善， ePACE的影响大于eFACE。目标4：检查与 成功实施ePACE，包括参与者对可用性、可接受性和满意度的评级。 拟议的简短、个性化、以青年为中心、早期干预方法，网络和智能手机友好， 为JJS提供了一个很有前途的解决方案，以解决青年人服务不足的需求， 为更密集，昂贵的干预措施后，并可能容纳青年服务系统，往往 缺乏可获得和负担得起的行为健康服务。

Project Summary We propose to design and pilot-test a technology-based, multicomponent behavioral health intervention for JIY. The design and functionality of the mobile health intervention is grounded in two pivotal developmental frameworks. First, the intervention will address the well-established bidirectional relationship between substance use (SU) and co-occurring problems (CP), a defining characteristic of JJS-involved youth (JIY). Second, in keeping with contemporary patient- and youth-centered health care delivery models, the mobile health intervention will have an interactive design permitting youth to receive feedback and make active choices about the care they receive. This youth-centered approach is a clear departure from traditional JJS service models. These conceptually informed design features and functionalities will optimize youth engagement, empowerment, and agency in order to maximize clinical outcomes. A digital health resource scalable to any smart phone would avert the need for delivery by highly trained professionals, and could be easily accessed across the JJS, including rural settings. The goal of the proposed Stage 1a/1b Treatment Development research is to refine and pilot test “ePACE” (eHealth Personalized Approach for Change Efficacy), designed as a JJS- and JIY-friendly personalized, youth-centered, mobile health resource. ePACE is composed of a multi-problem screener to guide the implementation of a set of key integrated behavior change modules (Drug Abuse, Interpersonal Relations, Negative Emotions, Stress) providing a cohesive focus on SU and CPs. The specific aims of are: Aim 1: Finalize ePACE development by: 1) Conducting separate focus groups with JJS staff and JIY to seek input on the functionality, feasibility, and initial acceptability of the resource’s screening tool and initial version of the behavior change modules, and 2) Revise program features based on focus group results and new research literature. Aim 2: Evaluate the impact of ePACE and a “fixed” non-personalized version (eFACE) counterpart for JIY with co- occurring problems, relative to a waiting list group (WLG) on SU and CP outcomes. We expect better SU and CP outcomes for both ePACE and eFACE vs WLG over the 6-month follow-up and expect that ePACE vs WLG effects will be larger than eFACE vs WLG effects. Aim 3: Evaluate the direct effects of ePACE and eFACE on targeted areas of functioning and skill development hypothesized to produce change in SU and CP. We expect youth assigned to ePACE and eFACE to exhibit greater improvements compared to those assigned to WLG, with the effects of ePACE larger than those of eFACE. Aim 4: Examine factors associated with successful implementation of ePACE, including participant ratings of usability, acceptability, and satisfaction. The proposed brief, personalized, youth-centered, early intervention approach, web and smart-phone friendly, offers a promising solution for the JJS to address the underserved needs of youth, potentially mitigating the need for more intensive, costly interventions later and potentially accommodating a youth-serving system that often lacks accessible and affordable behavior health services.