iHeLP: Interactive Technology to Prevent Substance Use in Foster Youth

描述（由申请人提供）每年，大约有30，000名青少年因18岁时"老龄化"而退出寄养系统，失去了获得支持服务的机会，同时也对自己的财务，健康，就业和住房需求完全负责。从家庭进展不成比例地高忽视，虐待，和父母的物质使用，这些新兴的成年人面临独立与发展物质使用障碍的可能性增加。一旦脱离寄养家庭，这些青少年获得的医疗服务远远少于非寄养家庭的同龄人。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的可用性，可及性和使用的物质使用服务的青年老龄化的寄养系统。基于计算机和移动的电话的干预措施有能力提供循证治疗内容，同时减少与为寄养青年提供药物使用服务有关的许多障碍。拟议的研究将开始一项研究计划，以综合这些方法的好处，以解决面临许多护理障碍的弱势群体的需求。更具体地说，该项目涉及制定预防性干预措施（iHeLP）并进行试点数据收集，目的是减少因年老而失去照料的寄养青年使用问题药物的情况。iHeLP植根于动机访谈、跨理论模型和社会认知理论，是一种一次性的计算机化筛查和简短干预（SBI），并辅以六个月的量身定制的短信，这些短信是基于参与者的SBI结果和随后的变化波动。这项试验性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分析。将进行焦点小组讨论， 四名17岁的寄养青年将提供关于预期效用、使用可能性以及对拟议干预组件的内容、界面和功能的偏好的定性反馈。结果将用于修改干预内容/格式，然后将在iHeLP的开放试验中提供给16名寄养青年。开放试验的定性和定量结果可能会导致进一步的变化。最后，30名年轻人将参加一项试点随机对照试验，测试iHeLP对接触控制条件的有效性。每天发短信是一种提供干预助推器的新方法。低强度、高频率的互动是传统干预措施的一个显著变化，很有可能扩大最初的成果。此外，通过与参与者进行动态的、基于文本的交流来定制这些信息也是一种创新。鉴于以低成本广泛传播到多个高危人群的潜力，拟议的研究具有很高的潜在公共卫生和临床意义。

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.