A Culturally Informed Tele-Intervention for Minority High Risk Youth and Parents

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DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (01) Behavior, Behavioral Change, and Prevention and specific Challenge Topic, 06-MD-101* Development of Telehealth Tools to Promote Health and Connect At-Risk Youth to the Health System via Low-Cost, Mobile, and Wireless Technologies. The proposed study is designed to enhance, refine, and test a culturally informed and flexible/tailored intervention for high risk minority adolescents and their parents that is delivered primarily via a mobile/wireless system. This study focuses on high risk African American and Hispanic adolescents and their parents. Rates of HIV, AIDS, STIs, depression and suicide attempts, point to some of the major health disparities that result from an untreated high risk developmental trajectory. The proposed research brings together two teams with strong programs of innovation and research, one with expertise in the use of technology to deliver psychosocial interventions and the PI who has expertise in the development and testing of culturally informed treatments for high risk minority youth. This unique collaboration promises to accelerate each team's individual trajectories and converge on a high innovative tele-intervention for high risk youth. The study: 1) refines and enhances the original Culturally Informed and Flexible Family-Based Treatment for Adolescents (CIFFTA) to meet the needs of African American and Hispanic high risk youth, 2) refines an innovative wireless mobile technology to deliver the intervention in a multi-media format that includes text, audio, video and graphics, 3) pilot tests the new intervention and its delivery system by implementing the intervention with 10 families and conducting focus groups to identify refinements, and 4) conducts a medium-sized randomized trial of 80 African American and Hispanic adolescents ages 12-15 to test for feasibility, acceptability, and to obtain preliminary effect size estimates on key risk factors (conduct problems, academic failure, risky sexual behavior, family conflict). The original CIFFTA was designed to address unique stressors faced by minority youth in a flexible format that leads to the selection of interventions that best "fit" the clinical needs and cultural characteristics of the youth. It targets: 1) reducing family risk (e.g., poor parenting practices, family conflict) and increasing protective factors (e.g., Parent-child attachment), 2) teaching adolescent and parents skills, 3) delivering culturally congruent material (e.g., handling discrimination), and 4) using a flexible treatment manual to tailor of the treatment to the unique characteristics and needs of minority families (Santisteban & Mena, in press). By modifying and enhancing the original CIFFTA that has shown promising preliminary data, and adapting it for a wireless and mobile technology that is user friendly for adolescents, the intervention has the potential to mitigate issues of underutilization of services and the inability of interventions to be accessible to youth in the moments they need them most. The intervention will seek to identify the high risk people, times of the day, and locations in the adolescents' lives so that contact is made with youth at those most vulnerable times and interventions can be tailored. Rates of HIV, AIDS, STIs, depression and suicide attempts among African American and Hispanic adolescents, point to some of the major health disparities that can result from an untreated high risk developmental trajectory. The proposed research brings together two teams with strong programs of innovation and research, one with expertise in the use of technology to deliver psychosocial interventions and the PI with expertise in the development and testing of culturally informed and tailored treatments for high risk minority youth. The proposed study is designed to enhance, refine, and test using a randomized trial, a culturally informed and tailored intervention for high risk minority adolescents and their parents that will be delivered primarily via a mobile/wireless system using a multi-media format that includes text, audio, video and graphics.