Neighborhood perceptions and response to a technology-assisted parenting intervention for youth substance use

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PROJECT SUMMARY An adolescent’s neighborhood is associated with their likelihood of developing a substance use disorder. Technology-assisted interventions (TAIs) have been touted to enhance the reach of substance use treatment for youth and families living in underserved communities. A key question is whether neighborhood characteristics (e.g., neighborhood violence, safety, access to community resources) impact the effectiveness of TAIs as such interventions are typically embedded within a youth’s natural environment. The parent grant supporting this Diversity Supplement is a fully powered evaluation of Parent SMART, a TAI for parents of youth recently discharged from residential substance use treatment (R37DA052918; PI: Becker). Under the primary mentorship of Dr. Sara Becker, the candidate, Dr. Zabin Patel, will extend the aims of the parent grant by conducting a multi-respondent and multi-dimensional evaluation on the impact of youth and parent neighborhood perceptions on TAI effectiveness. Aim 1 will identify neighborhood characteristics most predictive of response to Parent SMART using both youth and parent reports. Aim 2 will then explore whether engagement with Parent SMART acts as a putative mechanism of action explaining the relationship between neighborhood characteristics and TIA outcomes. The candidate for this Diversity Supplement has prior expertise in public health and clinical science and is committed to a career as an independently funded researcher focused on improving the effectiveness of substance use services for youth and families. This Diversity Supplement will support the candidate’s career transition from postdoctoral fellow to an independent investigator via mentored training in three areas: (a) conducting pragmatic effectiveness trials with youth substance use populations; (b) evaluating the role of TAIs in increasing equitable access to and engagement in substance use care; and (c) multi-level longitudinal data analysis. The candidate’s prior work has demonstrated that place of residence affects treatment response among youth. Contextual neighborhood factors, majorly understudied in clinical effectiveness trials of TAIs, may also impact intervention engagement and response. However, the predictive relationships between neighborhood characteristics and TAI response have not been previously investigated and the assumption that TAIs improve substance use outcomes for families living in underserved neighborhoods is rarely tested. Results hold strong potential to advance public health by pinpointing key contextual factors that influence response to TAIs like Parent SMART and to inform whether TAIs require tailoring to address the unique needs of youth living in underserved neighborhoods. Further, this study will support the career trajectory of Dr. Patel, a promising scholar with a background that is underrepresented in NIH research. Preliminary data from this Diversity Supplement will inform an R34 application focused on adapting Parent SMART for high-need families living in underserved neighborhoods and launch the candidate’s career as an independent researcher in addiction science.