iHeLP: Interactive Technology to Prevent Substance Use in Foster Youth

每年，大约有30,000名青少年在18岁时因“老化”而离开寄养系统，失去了获得支持服务的机会，同时也要对自己的经济、健康、就业和住房需求完全负责。从不成比例的忽视、虐待和父母物质使用的家庭中成长起来，这些新兴的成年人面临着独立，发展物质使用障碍的可能性也在增加。与非寄养的同龄人相比，这些青少年一旦离开寄养，获得医疗服务的机会就少得多。此外，寄养系统内提供的药物使用服务往往难以获得。拟议的试点干预研究旨在解决这些差距，在可获得性，可及性和使用的物质使用服务的青年寄养系统老化。基于计算机和移动电话的干预措施能够提供基于证据的治疗内容，同时减少与向被寄养青年提供药物使用服务有关的许多障碍。拟议的研究将启动一个研究项目，综合这些方法的好处，以解决有许多护理障碍的弱势群体的需求。更具体地说，该项目涉及制定和收集预防性干预措施（iHeLP）的试点数据，旨在减少正在失去照顾的寄养青年中有问题的物质使用。基于动机访谈、跨理论模型和社会认知理论，iHeLP是一种一次性的计算机筛选和简短干预（SBI），辅以六个月的定制短信，根据参与者的SBI结果和随后他们改变意愿的波动。这项初步研究的目的是获得关于可接受性、可行性和初步疗效的初步数据。焦点小组将在20个

DESCRIPTION (provided by applicant Each year, roughly 30,000 youth exit the foster care system due to "aging out" at age 18, losing access to support services while also becoming fully responsible for their own financial, health, employment, and housing needs. Progressing from homes disproportionately high in neglect, maltreatment, and parental substance use, these emerging adults face independence with an increased likelihood of developing substance use disorders. Once removed from foster care, these youth have far less access to health services compared to their non- foster care peers. Moreover, substance use services offered within the foster care system are often difficult to access. The proposed pilot intervention study seeks to address these gaps in availability, accessibility, and use of substance use services for youth aging out of the foster care system. Computer- and mobile phone-based interventions have the capacity to provide evidence-based treatment content while reducing many of the barriers relevant to substance use service delivery for foster youth. The proposed study will begin a program of research to synthesize the benefits of these approaches in a way that addresses the needs of a vulnerable population with many barriers to care. More specifically, this project involves the development and pilot data collection of a preventive intervention (iHeLP) targeting the reduction of problematic substance use among foster youth who are aging out of care. Rooted in motivational interviewing, the transtheoretical model, and social cognitive theory, iHeLP is a one-time computerized screening and brief intervention (SBI), supplemented by six months of tailored text messaging based on participants' SBI results and subsequent fluctuations in their readiness to change. The goal of this pilot study is to obtain preliminary daa on acceptability, feasibility, and initial efficacy. Focus groups will be conducted in which twenty four 17-year old foster youth will provide qualitative feedback on the perceived utility, likelihoo of use, and preferences for the content, interface, and functionality of the proposed intervention components. Results will be used to modify the intervention content/format, which then will be delivered to sixteen foster youth in an open trial of iHeLP. Further alterations may result from the qualitative and quantitative results of the open trial. Finally, thirty youth will participate n a pilot randomized controlled trial, testing the efficacy of iHeLP against a contact-control conditio. The use of daily text messaging represents a novel method for delivering intervention boosters. Low-intensity, high-frequency interactions are a marked change from traditional interventions and have high potential for extending initial gains. In addition, tailoring of these messages through dynamic, text-based communication with participants is innovative. Given the potential of wide dissemination to multiple at-risk populations at low cost, the proposed study has high potential public health and clinical significance.