Brief Individual and Parent Interventions for Marijuana Misuse in Truant Adolescents

吸食大麻和逃学的青少年是患有 物质使用障碍的可能性增加，刑事司法参与，以及长期 职业、家庭和同龄人领域的障碍。这个应用程序建议测试一个理论-- 通过罗德确定的青少年早期吸食大麻、逃学青少年的驱动干预 岛屿逃学和家庭法庭。此应用程序的基础是最近完成的 大麻使用、逃学青少年(n=67)的治疗发展研究(R34 DA0029871)， 在其中，我们比较了我们的理论驱动的短暂干预，青少年动机 增强治疗(MET)加上家庭体检(FCU)，这是一种基于父母的MET，以 青少年和家长的心理教育(体育)。有一些中等效应有利于 MET+FCU关于前3个月吸食大麻天数(d=49)和吸食大麻天数的条件 每天吸食大麻次数(d=.53)。也有一些小的影响有利于 MET+FCU条件对大麻的渴求(d=.36)，其他毒品使用(d=.38)，次数 每次饮酒次数超过5次(d=.35)和缺课(d =.30)。在机制方面，检测到中等效应大小有更大的改进 在家长监控质量(d=.58)以及家长(d=.42)和青少年(d=.66)问题上- 与PE相比，在MET+FCU中解决讨论。我们的试点结果表明，MET+FCU 有可能成为对逃学、吸食大麻的短暂而有效的干预措施 青少年，但需要在更大规模的全功率试验中得到证实。加快翻译的速度 将研究成果付诸实践，本申请建议进行I型混合动力 有效性-实施试验，我们严格测试两种干预条件，同时 同时收集将阻碍或促进执行的因素的数据。这 申请计划招收200名逃学、吸食大麻的青少年，年龄从6岁到10岁 通过逃学法庭或家庭参与少年司法系统的年级 宫廷。青少年将被随机分配到两种情况中的一种：MET+FCU和PE。 我们将收集关于效力(具体目标1)和假定调解人(具体目标2)的数据， 以及与执行有关的数据(探索性目标)。此应用程序具有创新性，并且 有潜力通过以下方式推动该领域的发展：评估综合模型(同时 针对两个问题以及父母和青少年的风险因素)，使用简短和高度的 可传播的方法，审查假定的调解人，并测试 在现实世界条件下的干预。

Adolescents who use marijuana and are truant from school are a high-risk population with increased likelihood of substance use disorders, criminal justice involvement, and long-term impairments in vocational, family, and peer domains. This application proposes to test a theory- driven intervention for early adolescent marijuana using, truant youth identified through Rhode Island Truancy and Family Courts. The foundation for this application is a recently completed treatment development study (R34 DA0029871) for marijuana using, truant adolescents (n=67), in which we compared our theory-driven brief intervention, adolescent motivational enhancement therapy (MET) plus the Family Check-Up (FCU), a parent-based MET, to adolescent and parent psychoeducation (PE). There were medium effects favoring the MET+FCU condition on number of marijuana use days in prior 3 months (d = 49) and number of times marijuana was used per day (d= .53). There were also small effects favoring the MET+FCU condition on marijuana craving (d=.36), other drug use (d = .38), number of times more than 5 drinks were consumed per drinking occasion (d=.35), and school absences (d =.30). With respect to mechanisms, medium effect sizes were detected for greater improvement in quality of parent monitoring (d =.58) as well as parent (d = .42) and teen (d = .66) problem- solving discussions in MET + FCU compared to PE. Our pilot results suggest that MET+FCU has the potential to serve as a brief and effective intervention for truant, marijuana using adolescents, but confirmation in a larger, fully powered trial is needed. To speed translation of research findings to practice, this application is proposing to conduct a Type I Hybrid Effectiveness-Implementation trial in which we rigorously test two intervention conditions, while simultaneously gathering data on factors that will impede or facilitate implementation. This application proposes to enroll 200 truant, marijuana using, adolescents in 6th through 10th grades, who are involved in the juvenile justice system through either Truancy Court or Family Court. Adolescents will be randomly assigned to one of the 2 conditions: MET+FCU vs. PE. We will collect data on effectiveness (Specific Aim 1) and putative mediators (Specific Aim 2), as well as data pertinent to implementation (Exploratory Aim). This application is innovative and has the potential to advance the field by: evaluating an integrated model (simultaneously targeting two problems and both parent and teen risk factors), using a brief and highly disseminable approach, examining putative mediators, and testing effectiveness of the interventions under real-world conditions.