iHeLP: Interactive Technology to Prevent Substance Use in Foster Youth

(由申请人提供，每年大约有30,000名青年由于18岁时“衰老”而退出寄养系统，失去获得支助服务的机会，同时也完全负责自己的经济、健康、就业和住房需求。这些新出现的成年人从忽视、虐待和父母物质使用不成比例的高比例发展而来，面临独立，发展成物质使用障碍的可能性增加。一旦离开寄养家庭，与非寄养家庭的同龄人相比，这些青少年获得医疗服务的机会要少得多。此外，寄养系统内提供的物质使用服务往往很难获得。拟议的试点干预研究旨在解决寄养系统之外的青年老龄化服务在可获得性、可及性和使用物质方面的这些差距。以计算机和移动电话为基础的干预措施有能力提供循证治疗内容，同时减少为寄养青年提供物质使用服务方面的许多障碍。这项拟议的研究将启动一项研究计划，以综合这些方法的好处，以满足面临许多护理障碍的弱势群体的需求。更具体地说，该项目涉及制定和试行预防性干预措施(IHeLP)，其目标是减少无人照料的寄养青年中有问题的物质的使用。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选和短暂干预(SBI)，辅之以六个月的量身定制的短信，基于参与者的SBI结果和随后的变化准备。这项先导性研究的目标是获得关于可接受性、可行性和初步疗效的初步DAA。将开展20个重点小组 四名17岁的寄养青少年将就感知的效用、使用的可能性以及对拟议干预组件的内容、界面和功能的偏好提供定性反馈。结果将用于修改干预内容/形式，然后将在iHeLP的公开试验中提供给16名寄养青年。公开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在接触控制条件下的疗效。日常短信的使用代表了一种提供干预助推器的新方法。低强度、高频率的互动与传统干预措施相比是一个显著的变化，有很大潜力扩大最初的收益。此外，通过与参与者进行动态、基于文本的交流来定制这些信息也是一种创新。考虑到以低成本向多个高危人群广泛传播的潜力，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.