Adolescent Screening and Personalized Intervention Resource for Mild/Moderate Substance Abuse and Co-Occurring Problems

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Project Summary We propose to design and pilot-test a technology-based, multicomponent behavioral health intervention for JIY. The design and functionality of the mobile health intervention is grounded in two pivotal developmental frameworks. First, the intervention will address the well-established bidirectional relationship between substance use (SU) and co-occurring problems (CP), a defining characteristic of JJS-involved youth (JIY). Second, in keeping with contemporary patient- and youth-centered health care delivery models, the mobile health intervention will have an interactive design permitting youth to receive feedback and make active choices about the care they receive. This youth-centered approach is a clear departure from traditional JJS service models. These conceptually informed design features and functionalities will optimize youth engagement, empowerment, and agency in order to maximize clinical outcomes. A digital health resource scalable to any smart phone would avert the need for delivery by highly trained professionals, and could be easily accessed across the JJS, including rural settings. The goal of the proposed Stage 1a/1b Treatment Development research is to refine and pilot test “ePACE” (eHealth Personalized Approach for Change Efficacy), designed as a JJS- and JIY-friendly personalized, youth-centered, mobile health resource. ePACE is composed of a multi-problem screener to guide the implementation of a set of key integrated behavior change modules (Drug Abuse, Interpersonal Relations, Negative Emotions, Stress) providing a cohesive focus on SU and CPs. The specific aims of are: Aim 1: Finalize ePACE development by: 1) Conducting separate focus groups with JJS staff and JIY to seek input on the functionality, feasibility, and initial acceptability of the resource’s screening tool and initial version of the behavior change modules, and 2) Revise program features based on focus group results and new research literature. Aim 2: Evaluate the impact of ePACE and a “fixed” non-personalized version (eFACE) counterpart for JIY with co- occurring problems, relative to a waiting list group (WLG) on SU and CP outcomes. We expect better SU and CP outcomes for both ePACE and eFACE vs WLG over the 6-month follow-up and expect that ePACE vs WLG effects will be larger than eFACE vs WLG effects. Aim 3: Evaluate the direct effects of ePACE and eFACE on targeted areas of functioning and skill development hypothesized to produce change in SU and CP. We expect youth assigned to ePACE and eFACE to exhibit greater improvements compared to those assigned to WLG, with the effects of ePACE larger than those of eFACE. Aim 4: Examine factors associated with successful implementation of ePACE, including participant ratings of usability, acceptability, and satisfaction. The proposed brief, personalized, youth-centered, early intervention approach, web and smart-phone friendly, offers a promising solution for the JJS to address the underserved needs of youth, potentially mitigating the need for more intensive, costly interventions later and potentially accommodating a youth-serving system that often lacks accessible and affordable behavior health services.