Using Mobile Technology to Enhance MST Outcomes

描述(申请人提供)：美国每年有200多万青少年被捕[4]，更多的青少年(占所有青少年的9%-18%)从事严重的犯罪行为，如酗酒、使用非法药物和辍学[5]。解决这些问题最有效的干预措施是以家庭为基础的，在临床上着重于通过更好地监测活动和对适当和越轨行为持续使用应急措施来帮助父母重新控制青少年的行为[6]。21世纪的年轻人在技术上是“有线的”(75%的人现在拥有一部手机[1]，平均每天花33分钟聊天和1.5个小时发短信；[2]此外，93%的有孩子的家庭现在可以上网[45])，这为父母提供了一个机会，使他们能够更准确地监测青少年，并比以前更频繁地对良好的行为给予偶然的奖励。这个应用程序的主要目标是开发和评估一个复杂的多组件技术套件，旨在增强父母管理青少年行为的能力。这款VillageWhere套件的核心是一款面向青少年手机的手机应用程序，它使用情景智能(通知父母青少年活动并提示青少年改变行为)和游戏化(奖励青少年并保持青少年参与度)。这款应用程序将与一个基于互联网的家长仪表盘(www.vilagewhere.com)集成，该仪表盘将显示年轻人的下落，并整合对家长管理至关重要的信息。该套件将在多系统疗法(MST)的背景下开发，MST是一种针对青少年反社会行为的经验性支持和广泛传播的干预措施，专为目标人群中最严重的一部分设计。当纳入MST等干预措施时，VillageWhere可以改善临床结果，同时减少治疗时间和成本，并扩大治疗机会。我们将在原型开发的所有阶段使用迭代开发过程，包括来自最终用户的反馈。鉴于VillageWhere的新颖性，在第一阶段，我们将进行广泛的形成性评估，以确认和确保概念的证明，并进行总结性评估，以检查产品的可用性、可接受性和可行性。在整个第一阶段，我们将从来自MST提供者的广泛网络中收集来自父母、青年和临床医生的深入的定性和定量数据。如果第一阶段形成性评估成功，我们将提出第二阶段计划，进行受试者之间的随机对照试验，将MST内交付的完整的VillageWhere系统与MST照常进行比较，并检查一系列青年、家长和治疗师级的结果。

DESCRIPTION (provided by applicant): Each year over 2 million adolescents are arrested in the U.S.[4], and many more (9-18 percent of all youth) engage in serious delinquent behavior, such as heavy drinking, illicit drug use, and school drop-out[5]. The most effective interventions to address these problems are family-based, with a strong clinical emphasis on helping parents regain control of youth behavior through better monitoring of activities and consistent use of contingencies (rewards and punishments) for appropriate and deviant behavior[6]. The fact that 21st century youth are technologically "wired" (75 percent now own a cell phone[1], spending an average of 33 minutes talking and 1.5 hours texting each day;[2] in addition, 93 percent of households with children now have Internet access[45]) offers an opportunity for parents to monitor youth more accurately and to provide more frequent, contingent rewards for good behavior than previously possible. The primary aim of this application is to develop and evaluate a sophisticated multi-component technology suite designed to enhance parents' ability to manage youth behavior. At the core of this VillageWhere suite is a mobile phone app for youth cell phones that uses contextual intelligence (notifies parents of youth activities and prompts youth to change behavior) and gamification (rewards youth and maintains youth engagement). The app will integrate with an Internet-based dashboard for parents (www.villagewhere.com) that will show youth whereabouts and consolidate information critical for parental management. This suite will be developed within the context of Multisystemic Therapy (MST), an empirically-supported and widely-disseminated intervention for youth antisocial behavior designed for the most serious subset of the target population. When incorporated into interventions such as MST, VillageWhere could enhance clinical outcomes while reducing treatment length and cost and expanding treatment access. We will use an iterative development process involving feedback from end-users during all stages of prototype development. Given the novelty of VillageWhere, in Phase I we will conduct an extensive formative evaluation to confirm and ensure proof of concept, and a summative evaluation to examine the product's usability, acceptability, and feasibility. Throughout Phase I we will gather in-depth qualitative and quantitative data from parents, youth, and clinicians drawn from an extensive network of MST providers. In the event of a successful Phase I formative evaluation, we will propose a Phase II plan to conduct a between subjects RCT comparing the fully completed VillageWhere system delivered within MST to MST as usual and examine a range of youth-, parent-, and therapist-level outcomes.