Improving Outcomes of Adolescents in Residential Substance use Treatment via a Technology-Assisted Parenting Intervention

通过技术辅助育儿干预改善青少年住宅药物滥用治疗的结果

• 批准号: 10666175
• 负责人: Sara J. Becker
• 金额: $ 69.76万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10666175
• 关键词: Address; Adolescent; Behavioral; Caring; Child Rearing; Clinical Trials; Communication; Controlled Environment; Data; Development; Distal; Drug usage; Effectiveness; Evaluation; Exhibits; Family; Follow-Up Studies; Funding; Goals; Intervention; Legal; Measurement; Measures; Mediating; Mediator of activation protein; Methods; Mind; Modeling; Monitor; Motivation; National Institute of Drug Abuse; Notification; Outcome; Parents; Patient Self-Report; Problem behavior; Process; Public Health; Randomized; Relapse; Research; Residential Treatment; Risk; Schools; Substance Use Disorder; Technology; Testing; Time; Truancy; Underserved Population; Urine; Youth; acceptability and feasibility; adolescent binge drinking; adolescent substance use; base; binge drinking; computer program; computerized; design; effectiveness evaluation; evidence base; experience; externalizing behavior; follow up assessment; high risk; high risk sexual behavior; improved; improved outcome; in vivo; new technology; parent-adolescent communication; parental monitoring; pilot trial; psychologic; relapse risk; skills; substance misuse; substance use; substance use treatment; substance using adolescents; telehealth; treatment as usual; treatment center

Project Description Adolescents in residential substance use (SU) treatment have the most serious SU disorders and the highest rates of psychological, behavioral, legal, environmental, and vocational problems. Adolescents in residential SU treatment are also at high risk of relapse, with follow-up studies demonstrating that 60% of discharged adolescents relapse within 90 days. Parenting practices, including parental monitoring and parent-adolescent communication, have been established as key predictors of adolescent SU outcomes and likelihood of relapse, but parents are notoriously difficult to engage in adolescent SU treatment. Accordingly, there is a clear need for effective, accessible, and scalable interventions for parents of adolescents receiving residential SU treatment. Building upon our successful NIDA-funded R34, this study evaluates a technology-assisted parenting intervention called Parent SMART (Substance Misuse among Adolescents in Residential Treatment), which has evidence of high feasibility and acceptability, as well as preliminary evidence of effectiveness, as an adjunct to short-term residential treatment as usual (TAU). Parent SMART centers around an off-the-shelf computerized intervention, Parenting Wisely (PW), which has demonstrated robust evidence of improving parenting skills and reducing youth behavior problems in multiple clinical trials. We conducted extensive formative research with parents, adolescents, and residential staff to guide the development and delivery of two highly scalable enhancements: 1) access to a state-of-the-art mobile networking app; and 2) up to four telehealth coaching sessions to tailor PW content. Our networking app allows parents to submit questions to an SU expert and connect with other parents of adolescents in residential SU treatment in real-time, while reinforcing parenting skills via “Tip of the Day!” push notifications. In our pilot trial, Parent SMART was highly feasible and acceptable, and demonstrated evidence of effectiveness in improving parental monitoring and communication, reducing days of adolescent binge drinking and all other drug use, and reducing school-related problems, among parents in short-term residential treatment. This R01 proposes a fully powered evaluation of Parent SMART. Adolescent-parent dyads (n = 220 dyads; 440 in total) will be randomized to receive either TAU only or Parent SMART + TAU. Multi-method follow-up assessments (i.e., self-report parent and adolescent measures, parent-adolescent in vivo interaction task, 8-panel urine screens) will be conducted 6-, 12-, and 24-weeks post-discharge, to examine parenting skills, adolescent SU, and adolescent problem behaviors. Exploratory analyses will test whether improvements in parenting skills partially mediate reductions in adolescent SU. The proposed research has the potential to advance the field by: serving a high-need, underserved population during a vital treatment juncture; targeting parenting practices (putative mediators) that have been shown to predict adolescent SU outcomes; addressing barriers to accessing continuing care; and testing a highly scalable intervention model informed by extensive formative research.

项目描述 住宅用品使用（SU）治疗中的青少年患有最严重的SU疾病和最高的疾病 心理，行为，法律，环境和出版问题的速度。居民的青少年 SU治疗也处于退休的高风险，随访研究表明，有60％的出院 青少年在90天内传递。育儿惯例，包括父母监测和父母青少年 沟通已被确定为青少年苏糖果成果和退休可能性的关键预测指标， 但是众所周知，父母很难从事青春期治疗。据此，明确需要 有效，可访问且可扩展的干预措施，为接受住所治疗的青少年父母提供干预措施。 在我们成功获得NIDA资助的R34的基础上，这项研究评估了技术协助的育儿 干预措施称为父母Smart（青少年在住院治疗中滥用药物），这是 具有高可行性和可接受性的证据，以及有效性的初步证据 像往常一样（TAU）的短期居民治疗的辅助手段。家长智能围绕现成的中心 计算机干预，明智的育儿（PW），这证明了改善的可靠证据 在多个临床试验中，育儿技能和减少青年行为问题。我们进行了广泛的作用 与父母，青少年和居民工作人员的形成性研究，以指导和交付 两个高度可扩展的增强功能：1）访问最先进的移动网络应用程序； 2）最多四个 远程医疗教练会议量身定制PW内容。我们的网络应用程序允许父母提交问题 SU专家，并与其他青少年的父母实时治疗，而 通过“一天的小费！”来增强育儿技能推送通知。在我们的试点审判中，父母Smart很高 可行和可接受，并证明了在改善父母监测和 交流，减少青少年饮酒的日子和所有其他药物的使用，并减少与学校有关的 在短期居民治疗的父母中，问题。 R01提出了对 父母聪明。青少年 - 父母的二元组（n = 220二二二二二二二二聚体；总共440个）将被随机分配给接受 仅tau或父母智能 + tau。多方法后续评估（即自我报告父母和 青少年措施，体内相互作用任务，8面板尿液筛选）将进行6-，6-，，， 12岁和24周的分期后，以检查育儿技能，青少年SU和青少年问题 行为。探索性分析将测试育儿技能的提高是否部分调解降低 在青春期。拟议的研究有可能通过：服务高需求的， 在重要的治疗关头期间服务不足的人群；针对育儿惯例（推定的调解人） 已被证明可以预测青少年的结果；解决持续护理的障碍；和 通过广泛的格式研究来测试高度可扩展的干预模型。