Reducing Parenting Stress to Facilitate Justice-Involved Youth’s Treatment Engagement

项目摘要/摘要 与正义有关的年轻人表现出很高的药物使用率和心理健康症状，但很少有人 拘留或重返社区期间的待遇。一旦被释放到社区，照顾者必须促进 青年参与治疗，调动大量资源，面临许多障碍(例如，交通、 不信任)这样做。育儿压力在青少年拘留和重返社区期间加剧， 与更大的感知治疗障碍有关，在整个治疗过程中较少的年轻人治疗变化， 以及过早放弃治疗。应对育儿压力提高青少年治疗参与度和 在表现出反社会行为的年轻人中的结果，但考虑到治疗的许多障碍，是新的 需要干预的方法；移动健康(MHealth)技术是一种很有前途的方法。 参与司法的青年照顾者和系统利益攸关方对移动健康治疗和移动健康感兴趣 解决治疗的工具性障碍(例如，运输)。技术和社区的进步 参与式研究允许在mHealth应用程序开发中进行积极的利益相关者协作，而不需要 通过参与性信息学所需的技术专长；照顾者的参与增加了 有可能干预将是相关的和有效的。这项混合方法K23研究的目的是 1)利用参与式信息学开发mHealth育儿压力干预；2)评估可行性和 参与式信息学方法和干预措施的可接受性；3)评估干预措施 在减轻育儿压力和提高青少年对物质使用或双重用途的参与度方面的初步效果 通过试点RCT进行拘留后的诊断和治疗；以及4)了解系统层面的因素 影响最终的系统采用和可持续性。此K23应用程序的总体目标是提供 受保护、有指导的时间来扩大约翰娜·福克博士(PI)作为独立物质使用的能力 具有专业知识的卫生服务研究人员使用参与式研究方法开发和评估新的 采取干预措施，使涉及司法的青年和家庭参与青少年药物使用治疗。福克博士将 与经验丰富、知识渊博的导师团队(Tolou-Shams博士、Aguera博士、Knight博士、Arevian博士、 和卓别林)提高她在以下方面的能力：1)物质使用服务研究；2)参与性研究 方法；3)移动健康方法论。拟议的研究性研究是福克博士的合乎逻辑的延伸 到目前为止的研究计划，已经跨越了发展的光谱，并专注于复合体 司法介入、物质使用、心理健康和人际关系之间的相互作用。这 早期职业发展奖将为更大规模的R01提供必要的候选人培训和基础 混合设计临床试验测试mHealth育儿压力干预的有效性 K23，推动一项联邦资助的研究计划，旨在增加物质使用治疗 参与并改善涉及正义的青年和家庭的行为健康结果。

PROJECT SUMMARY / ABSTRACT Justice-involved youth exhibit high rates of substance use and mental health symptoms, yet few receive treatment during detention or community re-entry. Once released into the community, caregivers must facilitate youth's treatment engagement, mobilizing significant resources and facing many barriers (e.g., transportation, mistrust) to do so. Parenting stress, which is heightened during youth detention and community reentry, is associated with greater perceived barriers to treatment, less youth therapeutic change throughout treatment, and premature treatment dropout. Addressing parenting stress improves youth treatment engagement and outcomes among youth exhibiting antisocial behavior, yet given the many barriers to treatment, novel approaches to intervention are needed; mobile health (mHealth) technology is one promising approach. Caregivers of justice-involved youth and system stakeholders are interested in mHealth treatment and mHealth addresses instrumental barriers (e.g., transportation) to treatment. Advances in technology and community engaged research allow for active stakeholder collaboration in mHealth application development, with no technological expertise required, through participatory informatics; caregiver involvement increases the likelihood the intervention will be relevant and efficacious. The purpose of this mixed-methods K23 study is to 1) develop a mHealth parenting stress intervention using participatory informatics; 2) assess the feasibility and acceptability of the participatory informatics approach and the intervention; 3) evaluate the intervention's preliminary efficacy in reducing parenting stress and increasing youth engagement in substance use or dual diagnosis treatment post-detention through a pilot RCT; and 4) understand systems-level factors that could influence eventual system adoption and sustainability. The overall goal of this K23 application is to provide protected, mentored time to expand Dr. Johanna Folk's (PI) capacities as an independent substance use health services researcher with expertise using participatory research methods to develop and evaluate novel interventions to engage justice-involved youth and families into youth substance use treatment. Dr. Folk will work with a team of experienced and knowledgeable mentors (Drs. Tolou-Shams, Aguilera, Knight, Arevian, and Chaplin) to increase her competency in: 1) substance use services research; 2) participatory research methods; and 3) mHealth methodology. The proposed research study is a logical extension of Dr. Folk's program of research to date which has spanned the developmental spectrum and focused on the complex interplay between justice involvement, substance use, mental health, and interpersonal relationships. This early career development award will provide the necessary candidate training and foundation for a larger R01 hybrid design clinical trial testing the efficacy of the mHealth parenting stress intervention designed during the K23, propelling a federally-funded program of research designed to increase substance use treatment engagement and improve behavioral health outcomes for justice-involved youth and families.