Development and Preliminary Testing of an Adjunct Smartphone App to Reduce Marijuana Use in Court-Involved, Non-Incarcerated Adolescents

开发和初步测试辅助智能手机应用程序，以减少涉及法庭的非监禁青少年吸食大麻

• 批准号: 9890581
• 负责人: Sarah Ashley Helseth
• 金额: $ 19.48万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-15 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9890581
• 关键词: Address; Adolescent; Adolescent marijuana use; Adult; Age; Alcohol or Other Drugs use; Alcohols; Area; Behavior Therapy; Behavioral; Bypass; Caring; Cellular Phone; Clinical; Collaborations; Communities; Data; Development; Development Plans; Drug Screening; Early Intervention; Enrollment; Evidence based practice; Face; Family; Funding; Future; Goals; Health; Hour; Imprisonment; Intervention; Intervention Studies; Interview; Justice; Knowledge; Link; Maps; Marijuana; Measures; Mediator of activation protein; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentorship; Modeling; Modernization; Motivation; National Institute of Drug Abuse; Notification; Outcome; Parents; Persons; Phase; Population; Procedures; Public Health; Publishing; Qualitative Methods; Randomized; Research; Research Activity; Research Personnel; Research Training; Resources; Rhode Island; Risk; Series; Structure; Substance Use Disorder; System; Technology; Teenagers; Testing; Time; Training; Training Activity; Training Support; Withdrawal; Work; Youth; addiction; adolescent substance use; barrier to care; behavior change; behavioral health; career; career development; community setting; computerized; control trial; cost; court; design; digital; early onset; efficacy research; empowerment; evidence base; health application; high risk; high risk behavior; improved outcome; juvenile justice system; marijuana use; mobile application; motivational enhancement therapy; motivational intervention; multidisciplinary; novel; peer; peer influence; peer networks; preference; primary outcome; prototype; public health relevance; reduce marijuana use; reduced substance use; secondary outcome; skills; smartphone Application; technology development; theories; therapy development; tool; treatment as usual; university student

PROJECT SUMMARY/ABSTRACT Through the research and training described in this K23 proposal, the PI (Dr. Helseth) will acquire the necessary skills to become an independent clinical researcher focused on designing and evaluating early, substance use (SU) interventions for youth on risky developmental trajectories. Marijuana (MJ) use accounts for 92% of positive drug screens among teens in the juvenile justice system (JJ) and has been linked to future arrests and SU disorders. Due to JJ capacity constraints, court-involved, non-incarcerated (CINI) youth are often referred out for treatment and encounter multiple barriers to community care. Technology-assisted interventions would enable the JJ system to treat CINI youth in-house, without overextending its workforce or resources. Brief, computerized motivational interventions are inexpensive and easy to deliver, and have been shown to reduce teens’ MJ and SU. However, effects typically fade after a few months, indicating the need for an adjunct intervention to sustain behavior change. Smartphone apps are an ideal treatment platform for teens: 95% of teens own one, which they use nearly 3 hours each day. Yet the potential of smartphone apps as a means of reducing MJ use in high-risk youth has not been realized. With this 5-year K23, the PI aims to establish the needs and preferences of CINI youth ages 14-17 for an adjunctive smartphone app; examine the app’s feasibility and acceptability; and establish its preliminary efficacy. The Teen Empowerment through Computerized Health (TECH) app, which targets putative intrapersonal and interpersonal mechanisms to promote MJ-related behavior change, will serve as an adjunct to treatment-as-usual (TAU) in the Rhode Island Family Court. Following the Behavior Intervention Theory (BIT) model, qualitative interviews with key stakeholders (n=30) will inform how clinical goals (knowledge, skills, motivation) will map on to TECH usage goals (goal-setting, peer networking), features (expert-moderated forum, notifications) and workflow. Next, 10 CINI youth will beta test the TECH prototype for 1 month, to guide its refinement. Finally, a pilot randomized control trial with 60 CINI youth will test the app for 6 months as an adjunct to TAU (TAU+TECH vs. TAU-only) on MJ and other SU-related outcomes, putative mechanisms of change (i.e., intrapersonal and interpersonal factors), and high-risk behaviors. The PI will work with an accomplished, multidisciplinary mentorship team (Drs. Spirito, Barnett, Becker, and Clark) to master four relevant areas of training: 1) effective MJ and SU interventions for CINI youth; 2) interpersonal mechanisms of adolescent SU; 3) development of technology- assisted behavioral interventions; and 4) qualitative methods for treatment development. The research and training activities outlined in this K23 award contribute to both an important public health concern and the development of a productive and independent research career for the PI. Completion of this study has the potential to advance the field by demonstrating the feasibility, acceptability, and preliminary efficacy of an adjunct technology-assisted intervention to improve outcomes among high-risk, MJ-using CINI youth.

项目摘要/摘要 通过本K23提案中描述的研究和培训，PI（Helseth博士）将获得 必要的技能，成为一个独立的临床研究人员专注于设计和评估早期， 对处于危险发展轨迹的青年进行物质使用干预。马里亚诺（MJ）使用帐户 在少年司法系统（JJ）中，92%的青少年药物筛查呈阳性， 逮捕和SU障碍。由于JJ能力的限制，法院参与，非监禁（CINI）青年 他们经常被转诊接受治疗，在社区护理方面遇到多重障碍。技术辅助 干预措施将使JJ系统能够在内部治疗CINI青年，而不会过度扩大其劳动力， 资源简短的、计算机化的激励干预措施价格低廉，易于实施， 降低青少年的MJ和SU。然而，效果通常在几个月后消退，表明需要 一种辅助干预措施来维持行为改变。智能手机应用程序是青少年的理想治疗平台： 95%的青少年拥有一个，他们每天使用近3小时。然而，智能手机应用程序作为一种 减少高风险青年使用MJ的方法尚未实现。通过这5年的K23，PI的目标是 确定14-17岁CINI青少年对智能手机应用程序的需求和偏好; 应用的可行性和可接受性，并建立其初步疗效。青少年赋权通过 计算机化健康（TECH）应用程序，其目标是假定的自我和人际机制， 促进MJ相关的行为改变，将作为罗得岛常规治疗（TAU）的辅助治疗 家事法庭。遵循行为干预理论（BIT）模型，定性访谈与关键 利益相关者（n=30）将告知临床目标（知识、技能、动机）如何映射到TECH使用 目标（目标设定、同行网络）、功能（专家主持的论坛、通知）和工作流程。下一个，10 CINI青年将测试1个月的技术原型，以指导其完善。最后，一名飞行员随机 60名CINI青少年的对照试验将测试该应用程序6个月，作为TAU的辅助手段（TAU+TECH与仅TAU） 关于MJ和其他SU相关结果，假定的变化机制（即，自我与人际 （三）高风险行为。PI将与一个有成就的多学科导师团队合作 (Drs.斯皮里托，巴内特，贝克尔和克拉克）掌握四个相关领域的培训：1）有效的MJ和SU CINI青少年的干预措施; 2）青少年SU的人际机制; 3）技术开发- 辅助行为干预;和4）治疗开发的定性方法。研究与 K23奖项中概述的培训活动有助于解决重要的公共卫生问题， 为PI发展富有成效和独立的研究生涯。完成这项研究， 通过证明一种药物的可行性、可接受性和初步疗效， 辅助技术辅助干预，以改善高风险，MJ使用CINI青年的结果。