Neighborhood perceptions and response to a technology-assisted parenting intervention for youth substance use

项目摘要 青少年的邻居与他们发展物质使用障碍的可能性有关。 技术辅助干预（TAI）被吹捧为扩大物质使用治疗的范围 为生活在服务不足社区的青年和家庭提供服务。一个关键问题是， 特性（例如，邻里暴力、安全、获得社区资源）影响有效性 由于这种干预措施通常植根于青年的自然环境中，父母补助金 支持这一多样性补充是一个充分的动力评估家长智能，一个TAI的父母的青年 最近从住宅物质使用治疗中出院（R37 DA 052918; PI：Becker）。在主 萨拉·贝克尔博士的指导，候选人扎宾·帕特尔博士，将通过以下方式扩大父母补助金的目标： 就青少年及家长的影响进行多层面的评估， 社区对TAI有效性的看法。Aim 1将识别最多的邻域特征 使用青少年和家长报告预测对家长SMART的反应。Aim 2将探讨 与父母SMART的互动是一种假定的作用机制，解释了 邻里特征和TIA结果。此多样性补充的候选人具有先前 在公共卫生和临床科学的专业知识，并致力于作为一个独立资助的职业生涯 研究人员侧重于提高为青年和家庭提供的药物使用服务的有效性。这 多样性补充将支持候选人从博士后研究员到独立研究员的职业过渡 调查员通过三个领域的辅导培训：（a）对青年进行实际有效性试验 （B）评价技术援助机构在增加公平获得和参与药物使用方面的作用; 药物使用护理;（c）多层次纵向数据分析。候选人之前的工作 研究表明，居住地影响青年人的治疗反应。上下文邻域 在TAIs临床有效性试验中研究不足的因素也可能影响干预参与 和回应。然而，邻里特征和TAI反应之间的预测关系， 以前没有调查过，假设TAIs改善物质使用结果， 生活在服务水平低下的社区的家庭很少接受测试。结果具有强大的潜力，以推动公众 通过精确定位影响对TAI（如家长SMART）反应的关键环境因素， TAIs是否需要量身定制，以满足生活在服务不足的社区的年轻人的独特需求。 此外，这项研究将支持帕特尔博士的职业轨迹，他是一位有前途的学者， 在NIH研究中的代表性不足。本多样性补充的初步数据将告知R34 应用程序的重点是调整家长智能为高需求的家庭生活在服务不足的社区 并开启候选人作为成瘾科学独立研究员的职业生涯。

PROJECT SUMMARY An adolescent’s neighborhood is associated with their likelihood of developing a substance use disorder. Technology-assisted interventions (TAIs) have been touted to enhance the reach of substance use treatment for youth and families living in underserved communities. A key question is whether neighborhood characteristics (e.g., neighborhood violence, safety, access to community resources) impact the effectiveness of TAIs as such interventions are typically embedded within a youth’s natural environment. The parent grant supporting this Diversity Supplement is a fully powered evaluation of Parent SMART, a TAI for parents of youth recently discharged from residential substance use treatment (R37DA052918; PI: Becker). Under the primary mentorship of Dr. Sara Becker, the candidate, Dr. Zabin Patel, will extend the aims of the parent grant by conducting a multi-respondent and multi-dimensional evaluation on the impact of youth and parent neighborhood perceptions on TAI effectiveness. Aim 1 will identify neighborhood characteristics most predictive of response to Parent SMART using both youth and parent reports. Aim 2 will then explore whether engagement with Parent SMART acts as a putative mechanism of action explaining the relationship between neighborhood characteristics and TIA outcomes. The candidate for this Diversity Supplement has prior expertise in public health and clinical science and is committed to a career as an independently funded researcher focused on improving the effectiveness of substance use services for youth and families. This Diversity Supplement will support the candidate’s career transition from postdoctoral fellow to an independent investigator via mentored training in three areas: (a) conducting pragmatic effectiveness trials with youth substance use populations; (b) evaluating the role of TAIs in increasing equitable access to and engagement in substance use care; and (c) multi-level longitudinal data analysis. The candidate’s prior work has demonstrated that place of residence affects treatment response among youth. Contextual neighborhood factors, majorly understudied in clinical effectiveness trials of TAIs, may also impact intervention engagement and response. However, the predictive relationships between neighborhood characteristics and TAI response have not been previously investigated and the assumption that TAIs improve substance use outcomes for families living in underserved neighborhoods is rarely tested. Results hold strong potential to advance public health by pinpointing key contextual factors that influence response to TAIs like Parent SMART and to inform whether TAIs require tailoring to address the unique needs of youth living in underserved neighborhoods. Further, this study will support the career trajectory of Dr. Patel, a promising scholar with a background that is underrepresented in NIH research. Preliminary data from this Diversity Supplement will inform an R34 application focused on adapting Parent SMART for high-need families living in underserved neighborhoods and launch the candidate’s career as an independent researcher in addiction science.