The Substance Use and Health Risk Intervention (SUHRI) for Justice-involved Youth

项目摘要/摘要 这项调查将采用和试点测试综合健康风险降低和激励增强 对少年司法(JJ)青年的干预最终将(在通过随后的大型- Scale RCT)在JJ监督/案例管理背景下实施的可持续干预措施 促进积极的、亲社会的和预期的行为。干预将使用图形方法来 鼓励自省和发现问题，加强自律，改进分析问题- 解决技能，并在两个相互关联的目标领域促进健康行为：药物使用和危险性行为 练习。现有的循证干预材料将被纳入并通过网络提供- 基于应用程序。课程将是自我指导的(只需要最少的指导/互动帮助)，而且 包括一项服务转介项目，向青年提供一份治疗和健康机构清单 结束讨论特定主题的会议。研究活动将分两项先导研究进行：(1) 干预适应和可行性；(2)方案可行性和初步疗效试验。在第一集中， 干预内容将根据现有的循证干预措施进行调整，以使其具有发展性 适合目标人群，适合网络形式(N=30；青年20人，少年团工作人员10人)。飞行员2 将测试干预效果随机对照试验(RCT)的缩小版本，比较网络- 使用双臂随机设计对时间匹配、仅限信息的组进行基于干预(120 从一个少年感化部门招收的青年被随机分配到监狱)。具体目标 拟议调查的目的是检查干预的可行性和可接受性，测试 与参与JJ的青少年一起研究协议(遵守、主题保留、工具)，并检查 干预对解决健康相关行为改变的初步效果。近期结果将 改进变革机制(例如，问题识别、决策、减少的意图 个人风险)和服务启动(SU或STI相关服务)。远端结果将是风险降低 行为，包括药物使用(自我报告和尿检)和性健康风险(自我报告的危险性行为 实践)。明确研究问题和初步假设，并成功完成 AIMS将导致适当和可行的干预措施，用于JJ参与的青少年，提供 关于全面随机对照试验可行性的重要信息，告知未来研究设计(以及随后的 R01申请)，并提供有关干预效果的初步信息。这项研究已经 有相当大的潜力来解决一个重要的弱势群体--参与司法的青年--和重点 关于一个重要的问题--青少年自我伤害和不健康的行为。

Project Summary/Abstract This investigation will adapt and pilot test an integrated health risk-reduction and motivational enhancement intervention for Juvenile Justice (JJ) youth that will ultimately be (after full testing through a subsequent large- scale RCT) a sustainable intervention implemented within a JJ supervision/case management context to teach and facilitate positive, prosocial, and expected behaviors. The intervention will use graphical approaches to encourage introspection and problem identification, enhance self-regulation, improve analytical problem- solving skills, and promote healthy behaviors in two inter-related target areas: substance use and risky sex practices. Existing evidence-based intervention materials will be incorporated and delivered through a web- based application. Sessions will be self-directed (require minimal instruction/interaction assistance), and also include a service referral piece whereby youth are provided with a list of treatment and health agencies at the end of sessions that address specific topics. Research activities will be carried out in two pilot studies: (1) Intervention Adaptation and Feasibility and (2) Protocol Feasibility and Preliminary Efficacy Trial. In Pilot 1, intervention content will be adapted from existing evidence-based interventions so that it is developmentally appropriate for the target population and suitable for a web-based format (N = 30; 20 youth, 10 JJ staff). Pilot 2 will test a scaled-down version of an intervention efficacy randomized control trial (RCT), comparing the web- based intervention to a time-matched, information-only group using a 2-arm, randomized design (whereby 120 enrolled youth from one juvenile probation department are randomly assigned to condition). The specific aims of the proposed investigation are to examine intervention feasibility and acceptability, test the feasibility of the study protocol (adherence, subject retention, instrumentation) with JJ-involved youth, and examine the preliminary efficacy of the intervention for addressing health-related behavior change. Proximal outcomes will be improvements in change mechanisms (e.g., problem recognition, decision making, intention to reduce personal risk) and service initiation (SU or STI-related services). Distal outcomes will be reduction in risky behaviors, including substance use (self-report and urinalysis) and sexual health risk (self-reported risky sex practices). Research questions and preliminary hypotheses are specified, and successful completion of the aims will result in an intervention that is appropriate and feasible for use with JJ-involved youth, provide important information regarding feasibility of a full-scale RCT, inform future study design (and a subsequent R01 application), and provide preliminary information regarding the efficacy of the intervention. The study has considerable potential to address an important vulnerable population—justice-involved youth—and focusses on a significant problem—youth behaviors that are self-detrimental and unhealthy.