Brief Individual and Parent Interventions for Marijuana Misuse in Truant Adolescents

吸食大麻和逃学的青少年是高危人群， 物质使用障碍的可能性增加，刑事司法参与， 职业、家庭和同伴方面的障碍。本申请旨在验证一个理论- 对早期青少年大麻使用的驱动干预，通过罗德确定的逃学青年 岛屿逃学和家庭法院。该应用程序的基础是最近完成的 大麻使用、逃学青少年（n=67）的治疗开发研究（R34 DA 0029871）， 我们比较了我们的理论驱动的简短干预，青少年动机， 增强治疗（MET）加上家庭检查（FCU），一种基于父母的MET， 青少年和家长心理教育（PE）。有中等影响，有利于 MET+FCU条件下前3个月大麻使用天数（d = 49）和 每天使用大麻的次数（d= 0.53）。也有小的影响，有利于 MET+FCU对大麻渴望（d=.36）、其他药物使用（d = .38）、次数的影响 每次饮酒超过5杯（d= 0.35），缺课（d= 0.35）， =.30）。关于机制，检测到中等效应量的更大改善 在父母监控质量（d =.58）以及父母（d = .42）和青少年（d = .66）问题方面- 与PE相比，MET + FCU解决讨论。我们的初步结果表明，MET+FCU 有可能作为一个简短而有效的干预逃学，大麻使用 青少年，但需要在更大的，充分的试验中确认。加快翻译速度 研究结果的实践，本申请建议进行I型混合 强制性-实施试验，我们严格测试两种干预条件， 同时收集关于阻碍或促进执行的因素的数据。这 申请书建议在第六至第十届招收200名逃学、吸食大麻的青少年 通过逃学法庭或家庭法庭参与少年司法系统的学生 法院青少年将被随机分配到两种情况之一：MET+FCU与PE。 我们将收集关于有效性（具体目标1）和假定介质（具体目标2）的数据， 以及与实施有关的数据（探索性目标）。该应用程序具有创新性， 具有通过以下方式推进该领域的潜力：评估综合模型（同时 针对两个问题和父母和青少年的风险因素），使用简短和高度 传播的方法，检查假定的调解人，并测试的有效性， 现实世界条件下的干预。

Adolescents who use marijuana and are truant from school are a high-risk population with increased likelihood of substance use disorders, criminal justice involvement, and long-term impairments in vocational, family, and peer domains. This application proposes to test a theory- driven intervention for early adolescent marijuana using, truant youth identified through Rhode Island Truancy and Family Courts. The foundation for this application is a recently completed treatment development study (R34 DA0029871) for marijuana using, truant adolescents (n=67), in which we compared our theory-driven brief intervention, adolescent motivational enhancement therapy (MET) plus the Family Check-Up (FCU), a parent-based MET, to adolescent and parent psychoeducation (PE). There were medium effects favoring the MET+FCU condition on number of marijuana use days in prior 3 months (d = 49) and number of times marijuana was used per day (d= .53). There were also small effects favoring the MET+FCU condition on marijuana craving (d=.36), other drug use (d = .38), number of times more than 5 drinks were consumed per drinking occasion (d=.35), and school absences (d =.30). With respect to mechanisms, medium effect sizes were detected for greater improvement in quality of parent monitoring (d =.58) as well as parent (d = .42) and teen (d = .66) problem- solving discussions in MET + FCU compared to PE. Our pilot results suggest that MET+FCU has the potential to serve as a brief and effective intervention for truant, marijuana using adolescents, but confirmation in a larger, fully powered trial is needed. To speed translation of research findings to practice, this application is proposing to conduct a Type I Hybrid Effectiveness-Implementation trial in which we rigorously test two intervention conditions, while simultaneously gathering data on factors that will impede or facilitate implementation. This application proposes to enroll 200 truant, marijuana using, adolescents in 6th through 10th grades, who are involved in the juvenile justice system through either Truancy Court or Family Court. Adolescents will be randomly assigned to one of the 2 conditions: MET+FCU vs. PE. We will collect data on effectiveness (Specific Aim 1) and putative mediators (Specific Aim 2), as well as data pertinent to implementation (Exploratory Aim). This application is innovative and has the potential to advance the field by: evaluating an integrated model (simultaneously targeting two problems and both parent and teen risk factors), using a brief and highly disseminable approach, examining putative mediators, and testing effectiveness of the interventions under real-world conditions.