Development and Preliminary Testing of an Adjunct Smartphone App to Reduce Marijuana Use in Court-Involved, Non-Incarcerated Adolescents

开发和初步测试辅助智能手机应用程序，以减少涉及法庭的非监禁青少年吸食大麻

• 批准号: 10754759
• 负责人: Sarah Ashley Helseth
• 金额: $ 18.98万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-15 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10754759
• 关键词: Address; Adolescent; Adolescent marijuana use; Adult; Age; Alcohols; Area; Behavior Therapy; Behavioral; Bypass; Cellular Phone; Clinical; Collaborations; Community Healthcare; Data; Development; Development Plans; Drug Screening; Early Intervention; Enrollment; Evidence based practice; Face; Family; Future; Goals; Health; Hour; Imprisonment; Intervention; Intervention Studies; Interview; Justice; Knowledge; Link; Manuals; Maps; Marijuana; Measures; Mediator; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentorship; Modeling; Modernization; Motivation; National Institute of Drug Abuse; Notification; Outcome; Parents; Persons; Phase; Population; Procedures; Productivity; Public Health; Publishing; Qualitative Methods; Randomized, Controlled Trials; Research; Research Activity; Research Personnel; Resources; Rhode Island; Risk; Series; Structure; Substance Use Disorder; System; Technology; Teenagers; Testing; Time; Training; Training Activity; Training Support; Withdrawal; Work; Youth; acceptability and feasibility; addiction; adolescent substance use; barrier to care; behavior change; behavioral health; career; career development; community setting; computerized; cost; court; design; digital; early onset; efficacy research; empowerment; evidence base; health application; health equality; high risk; high risk behavior; improved outcome; juvenile justice system; marijuana use; mobile application; motivational enhancement therapy; motivational intervention; multidisciplinary; novel; peer; peer influence; peer networks; preference; primary outcome; prototype; public health relevance; rearrest; reduce marijuana use; reduced substance use; secondary outcome; skills; smartphone application; substance use; substance use treatment; technology development; theories; therapy development; tool; treatment as usual; university student

PROJECT SUMMARY/ABSTRACT Through the research and training described in this K23 proposal, the PI (Dr. Helseth) will acquire the necessary skills to become an independent clinical researcher focused on designing and evaluating early, substance use (SU) interventions for youth on risky developmental trajectories. Marijuana (MJ) use accounts for 92% of positive drug screens among teens in the juvenile justice system (JJ) and has been linked to future arrests and SU disorders. Due to JJ capacity constraints, court-involved, non-incarcerated (CINI) youth are often referred out for treatment and encounter multiple barriers to community care. Technology-assisted interventions would enable the JJ system to treat CINI youth in-house, without overextending its workforce or resources. Brief, computerized motivational interventions are inexpensive and easy to deliver, and have been shown to reduce teens’ MJ and SU. However, effects typically fade after a few months, indicating the need for an adjunct intervention to sustain behavior change. Smartphone apps are an ideal treatment platform for teens: 95% of teens own one, which they use nearly 3 hours each day. Yet the potential of smartphone apps as a means of reducing MJ use in high-risk youth has not been realized. With this 5-year K23, the PI aims to establish the needs and preferences of CINI youth ages 14-17 for an adjunctive smartphone app; examine the app’s feasibility and acceptability; and establish its preliminary efficacy. The Teen Empowerment through Computerized Health (TECH) app, which targets putative intrapersonal and interpersonal mechanisms to promote MJ-related behavior change, will serve as an adjunct to treatment-as-usual (TAU) in the Rhode Island Family Court. Following the Behavior Intervention Theory (BIT) model, qualitative interviews with key stakeholders (n=30) will inform how clinical goals (knowledge, skills, motivation) will map on to TECH usage goals (goal-setting, peer networking), features (expert-moderated forum, notifications) and workflow. Next, 10 CINI youth will beta test the TECH prototype for 1 month, to guide its refinement. Finally, a pilot randomized control trial with 60 CINI youth will test the app for 6 months as an adjunct to TAU (TAU+TECH vs. TAU-only) on MJ and other SU-related outcomes, putative mechanisms of change (i.e., intrapersonal and interpersonal factors), and high-risk behaviors. The PI will work with an accomplished, multidisciplinary mentorship team (Drs. Spirito, Barnett, Becker, and Clark) to master four relevant areas of training: 1) effective MJ and SU interventions for CINI youth; 2) interpersonal mechanisms of adolescent SU; 3) development of technology- assisted behavioral interventions; and 4) qualitative methods for treatment development. The research and training activities outlined in this K23 award contribute to both an important public health concern and the development of a productive and independent research career for the PI. Completion of this study has the potential to advance the field by demonstrating the feasibility, acceptability, and preliminary efficacy of an adjunct technology-assisted intervention to improve outcomes among high-risk, MJ-using CINI youth.

项目摘要/摘要 通过这份K23提案中描述的研究和培训，PI(Helseth博士)将获得 成为一名专注于早期设计和评估的独立临床研究人员所需的技能， 针对青少年危险发展轨迹的物质使用干预。大麻(MJ)使用帐户 在青少年司法系统(JJ)中，92%的青少年进行了阳性药物筛查，并与未来 逮捕和苏族骚乱。由于JJ能力的限制，参与法庭的非监禁(CINI)青年 经常转院接受治疗，并在社区护理方面遇到多重障碍。技术辅助 干预措施将使JJ系统能够在内部治疗CINI青年，而不会过度扩张其员工队伍或 资源。简短、计算机化的动机干预成本低廉，易于实施，并已成为 显示可以降低青少年的MJ和SU。然而，效果通常会在几个月后消退，这表明需要 为维持行为改变而进行的辅助干预。智能手机应用是青少年理想的治疗平台： 95%的青少年拥有一台手机，他们每天使用近3个小时。然而，智能手机应用程序作为 在高危青年中减少MJ使用的手段尚未实现。通过这份5年期的K23，PI的目标是 建立14-17岁CINI年轻人对辅助智能手机应用程序的需求和偏好；查看 APP的可行性和可接受性；并建立其初步疗效。通过青少年赋权 计算机化的健康(技术)应用程序，其目标是假定的个人内部和人际机制 促进MJ相关行为改变，将作为罗德岛州照常治疗(TAU)的辅助措施 家事法庭。遵循行为干预理论(BIT)模式，与KEY进行定性访谈 利益相关者(n=30)将告知临床目标(知识、技能、动机)将如何与技术使用相对应 目标(目标设定、同行网络)、功能(专家主持的论坛、通知)和工作流程。下一步，10 Cini Young将对这款技术原型进行为期1个月的Beta测试，以指导其改进。最后，一名飞行员随机 对60名CINI青年进行的对照试验将测试这款应用作为TAU的辅助应用6个月(TAU+技术与仅TAU) 关于MJ和其他与SU相关的结果、假定的变化机制(即个人内部和人际关系 因素)和高危行为。PI将与一支有成就的、多学科的指导团队合作 (斯皮里托、巴尼特、贝克尔和克拉克博士)掌握四个相关的培训领域：1)有效的MJ和SU 对CINI青少年的干预；2)青少年SU的人际机制；3)技术的发展-- 辅助性行为干预；以及4)治疗发展的定性方法。该研究和 这项K23奖项中概述的培训活动既有助于一个重要的公共卫生问题，也有助于 为PI发展富有成效和独立的研究事业。完成这项研究后， 通过展示A/S的可行性、可接受性和初步效果来推动该领域的发展 辅助技术辅助干预以改善使用MJ的高危CINI青年的预后。