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

项目摘要 我们建议为JiY设计和中试一种基于技术的、多成分的行为健康干预。 移动健康干预的设计和功能基于两个关键的发展 框架。首先，干预将解决实体与实体之间业已确立的双向关系 使用(SU)和共生问题(CP)，这是JJS参与青年(Jiy)的一个定义特征。第二，在 与当代以患者和年轻人为中心的医疗保健提供模式保持一致，移动医疗 干预措施将采用互动设计，允许青少年接受反馈并就以下问题做出积极选择 他们所受到的照顾。这种以年轻人为中心的方法明显背离了传统的JJS服务模式。 这些概念性的设计特点和功能将优化青年的参与度、赋权、 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 避免需要训练有素的专业人员进行交付，并可通过JJS轻松访问，包括 乡村环境。拟议的1a/1b阶段处理开发研究的目标是改进和中试 “ePACE”(EHealth Personalized Approach For Change Efference)，设计为JJS和JiY友好型 个性化、以青年为中心、移动的健康资源。EPACE由一个多问题筛选器组成，用于指导 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)提供了对SU和CPS的凝聚力。具体目标是：目标1：最后确定 EPACE的开发：1)与JJS员工和Jiy进行单独的焦点小组，以寻求对 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 更改模块，以及2)根据焦点小组的结果和新的研究文献修改计划特点。目标 2：评估ePACE和固定的非个性化版本(EFACE)对Jiy的影响 正在发生的问题，相对于SU和CP结果的等待名单组(WLG)。我们期待更好的苏和 EPACE和eFACE与WLG在6个月的随访中的CP结果，并预计ePACE与WLG 影响将比eFACE和WLG的影响更大。目的3：评价ePACE和eFACE的直接疗效 有针对性的功能和技能发展领域被假设为在SU和CP方面产生变化。我们预计 被分配到ePACE和eFACE的年轻人比被分配到WLG的年轻人表现出更大的进步， EPACE的作用大于eFACE。目标4：审查与以下方面有关的因素 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、以青年为中心的早期干预方法，对网络和智能手机友好， 为JJS提供了一个有前途的解决方案，以满足未得到充分服务的青年的需求，潜在地缓解了这一需求 以后进行更密集、成本更高的干预，并可能适应青年服务系统 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.