iKinnect Mobile Technology to Reduce Teen Substance Misuse and Health Disparities

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PROJECT SUMMARY/ABSTRACT Adolescent substance abuse (SA) has been called America’s #1 public health problem, affecting as many as 16% of all youth under age 18 and often resulting in serious consequences such as criminal involvement, health problems, and suicide. Given that adolescent SA is associated with high rates of comorbidity with mental health (MH) problems and increased suicide risk, integrated SA-MH treatment involving cognitive- behavioral and family therapy-based approaches, as well as early intervention, is critical. Yet few adolescents receive any treatment for SA, and unmet needs for services are likely to increase following COVID-19-related stressors, which disproportionately affected Black, Indigenous, and other youth of color. Developing culturally- appropriate mobile app technology to effectively address adolescent SA, MH symptoms, and suicide risk, delivering it in novel universal settings, and using direct-to-consumer and family peer support specialist techniques could potentially have a large-scale and highly cost-effective public health impact. iKinnect is a paired mobile app platform that supports parents (in delivering) and youth (in receiving) evidence-based practices to reduce youth problem behaviors. Based on Multisystemic Therapy principles, iKinnect1.0 was originally designed to help youth with serious conduct problems. Results from a randomized controlled trial (RCT; N=72) demonstrated its efficacy in reducing externalizing behaviors and improving parenting effectiveness in youth with serious conduct disorder. iKinnect is currently being adapted for more severely disordered suicidal youth involved in the juvenile justice system as well as their parents. We now seek to significantly adapt iKinnect for use with a general population of teens with problematic substance use and their parents to reduce SA, its harmful effects, opioid overdoses, and progression to substance use disorders, as well as other behavioral health problems that are exacerbated by SA and/or interfere with SA treatment. This 34-month fast track seeks to address SA and co-occurring MH problems in teens by significantly adapting iKinnect to deliver evidence-based SA and MH interventions to general-population youth engaging in SA. We will pursue regulatory pathways for iKinnect-SA as a mobile medical device to achieve Food and Drug Administration (FDA) approval by the project’s end to pave the way for successful Phase III commercialization. The proposal is defined by three project stages which include: (1) a proof-of-concept formative evaluation stage where we will iteratively design, test, and build a prototype (Phase I; Months 1-10); (2) a product design-and-build formative evaluation stage, where we will design, build, and test all remaining features and apps (Phase II; Months 11-22); and (3) a summative evaluation stage involving a pilot test (N=25 dyads) and a RCT (N=300 dyads) comparing iKinnect-SA to an enhanced condition that combines iKinnect-SA with Peer Support Specialists and an active control condition app (Phase II; Months 23-34).