Increasing Family Engagement and Treatment Initiation Through Family Assessment, Motivation,and Linkage Intervention (FAMLI)

项目总结/摘要 拟议的R34研究将整合现有工具用于JJ人群，并检查可行性， 旨在增加SU治疗的青少年干预的可接受性和初步疗效 入会仪式家庭评估、动机和联系干预（FAMLI）是一种适应性干预 它包括三个基于证据的组成部分：1）评估动机和与联系有关的障碍 2）映射增强咨询（MEC），以提高对变化的准备， 人际沟通，和3）主动链接（AL）解决后勤障碍，服务启动。 使用序贯多分配随机试验（SMART），将对80名青少年-护理人员进行配对， 随机分配接受MEC或AL的初始剂量（2，1小时会话）。30天后，参与者 将被分类为响应者（启动了1个或多个服务）或非响应者（未启动服务）。 响应者将得到鼓励继续SU服务，但没有进一步的MEC或AL;无响应者 将被随机分配到两种干预措施之一：初始剂量的额外剂量（2，1小时疗程） 干预（MEC或AL）或不同剂量（另一种2小时，1小时）。具体目标是：（1） 整合和调整适当循证干预组成部分，作为一种二元干预方法 2）测试二元结构的可行性，可接受性和最佳配置 用于评估有效性的干预成分和方案（包括招募的可行性， 实施、测量）;以及3）初步探索a）MEC或AL初始剂量是否 B）额外剂量的MEC或AL或剂量的改变是否更有效， 对无应答者有效，和c）哪种组分序列对无应答者最有效。初级 结果包括青年（评估或咨询的开始;咨询出席）和照顾者 （参加评估、第一次咨询和/或家庭会议）措施。次要结局包括 青年和照顾者的态度（问题识别，帮助的愿望），规范信念（SU规范），感知 控制（压力源和障碍），和青年SU（自我报告证实的UA结果）。拟定研究 通过解决家庭参与问题，解决JJ青年在服务接收方面的巨大差距，并重点关注 改善改变的动机，与服务的联系，以及治疗参与。

Project Summary/Abstract The proposed R34 study will integrate existing tools for use with JJ populations and examine the feasibility, acceptability, and preliminary efficacy of a caregiver-youth intervention aimed at increasing SU treatment initiation. The Family Assessment, Motivation, and Linkage Intervention (FAMLI) is an adaptive intervention that incorporates three evidence-based components: 1) assessment of motivation and linkage-related barriers with personalized feedback, 2) Mapping-Enhanced Counseling (MEC) for improving readiness for change and interpersonal communication, and 3) Active Linkage (AL) for addressing logistical barriers to service initiation. Using a Sequential Multiple Assignment Randomized Trial (SMART), 80 youth-caregiver dyads will be randomly assigned to receive an initial dose (2, 1-hr sessions) of either MEC or AL. After 30 days, participants will be classified as Responders (1 or more services initiated) or Non-responders (no service initiation). Responders will receive encouragement to continue SU services, but no further MEC or AL; Non-responders will be randomized to one of two intervening interventions: an additional dose (2, 1-hr sessions) of the initial intervention (MEC or AL) or a different dose (2, 1-hr sessions of the other). The specific aims are to 1) integrate and adapt appropriate evidence-based intervention components as a dyadic intervention approach for JJ youth and caregivers; 2) test the feasibility, acceptability, and optimal configuration of the dyadic intervention components and the protocol used to evaluate effectiveness (including feasibility of recruitment, implementation, measurement); and 3) preliminarily explore a) whether an initial dose of MEC or AL is sufficient for promoting early initiation, b) whether an additional dose of MEC or AL or a change in dose is more effective for Non-responders, and c) which component sequence is most effective for Non-responders. Primary outcomes include youth (initiation of assessment or counseling; counseling attendance) and caregiver (attendance at assessment, first counseling, and/or family sessions) measures. Secondary outcomes include youth and caregiver attitudes (problem recognition, desire for help), normative beliefs (SU norms), perceived control (stressors and obstacles), and youth SU (self-report corroborated by UA results). The proposed study addresses the sizeable gap in service receipt among JJ youth by addressing family engagement, and focuses on improving motivation to change, linkage to services, and treatment engagement.