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

项目摘要/摘要 拟议的R34研究将整合用于JJ人群的现有工具，并审查其可行性， 旨在增加SU治疗的照顾者-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 这包括三个以证据为基础的部分：1)评估动机和与联系有关的障碍 通过个性化反馈，2)映射增强的咨询(MEC)，以提高应对变化的准备和 人际沟通，以及3)主动联系(AL)，用于解决服务启动的后勤障碍。 使用序贯多任务随机试验(SMART)，80名青年照顾者将被 随机分配接受初始剂量(2，1小时疗程)的MEC或AL。30天后，参与者 将被分类为响应者(1个或多个发起的服务)或非响应者(无服务发起)。 应答者将得到继续SU服务的鼓励，但不会再有MEC或AL；非应答者 将被随机分为两种干预措施之一：额外剂量(2，1小时疗程)的初始 干预(MEC或AL)或不同剂量(2次，1小时的另一次)。具体目标为1) 整合和调整适当的循证干预组成部分，作为一种二元干预方法 针对JJ青年和照顾者；2)测试二元组的可行性、可接受性和最优配置 干预内容和用于评估有效性的方案(包括招募的可行性， 实施、测量)；以及3)初步探讨a)MEC或AL的初始剂量是否 足以促进早期启动，b)无论是额外的MEC或AL剂量还是改变剂量 对非应答者有效，以及c)哪个分量序列对非应答者最有效。主要 结果包括青年(开始评估或咨询；咨询服务)和照顾者。 (参加评估、第一次咨询和/或家庭会议)措施。次要结果包括 青年和照顾者的态度(问题认识、对帮助的渴望)、规范信念(SU规范)、感知 控制(压力源和障碍)和青年SU(UA结果证实的自我报告)。建议进行的研究 通过解决家庭参与问题，解决JJ青少年在接受服务方面的巨大差距，并将重点放在 关于提高改变的动力、与服务的联系和治疗参与度。

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.