Computerized Stage-Matched Intervention for Juvenile Offenders

描述（由申请人提供）：青少年犯罪给受害者、社会和青少年罪犯本身带来了巨大的代价。然而，评估对青少年罪犯干预效果的研究表明，平均而言，对累犯、药物滥用和其他行为结果的影响很小。现有干预措施的一个主要问题是，它们往往忽视了个人在动机和做出积极改变的准备方面的差异。我们建议使用一个经验验证的行为改变模型，跨理论模型（TTM）和专家系统技术来开发一个计算机化的干预，作为传统少年司法项目的辅助。干预将提供评估和个性化的反馈，以使其与远离法律麻烦和减少药物使用的准备相匹配。它还将生成咨询师报告，总结青少年的反馈，并提出具体的、易于实施的策略，咨询师可以使用这些策略来强化与阶段相匹配的概念。第一阶段项目的目标是制定和验证减少少年犯使用大麻和酒精的TTM措施（补充已经制定的避免触犯法律的措施）；开发计算机管理的交互式多媒体专家系统程序的基础部分；并测试这种干预方法的可行性。少年犯将参与焦点小组，为TTM措施提供意见（n=32），并就干预材料提供反馈（n=32）；认知访谈，以确保TTM指令和问题按预期解释（n=8）；可用性测试，以确保专家系统干预易于导航，并提供连贯的干预体验（n=8）；以及用于度量开发和验证的匿名调查（n=200）。最后，60名与法院和系统有关的青年将参加可行性试验并接受干预；他们的辅导员会收到辅导员报告。如果满足以下条件，这种方法的可行性将得以确立：1)我们能够按计划将干预措施提供给一系列少年司法项目和环境中至少90%的审判参与者；2)参与者对互动会话的可接受性和有用性给出了积极的评价；3)咨询师对咨询报告的有用性给予积极评价；4)干预产生了统计上显著的前后变化，即青少年对远离法律麻烦的好处的评估，以及减少物质使用的好处。公共卫生相关性：青少年犯罪给受害者、社会和青少年罪犯本身带来了巨大的代价。我们建议使用一个经验验证的行为改变模型，跨理论模型（TTM）和专家系统技术来开发一个计算机化的干预，作为传统少年司法项目的辅助。干预，提供评估，个性化的反馈，以及与青少年准备远离法律麻烦和减少物质使用相匹配的顾问报告，有可能增加项目对青少年需求的响应；更有效地利用稀缺的项目资源；并改善结果。

DESCRIPTION (provided by applicant): Juvenile crime imposes enormous costs on victims, on society, and on juvenile offenders themselves. However, research assessing the efficacy of interventions for young offenders show, on average, only small effects on recidivism, substance abuse, and other behavioral outcomes. A major problem with existing interventions is that they tend to neglect individual differences in motivation and readiness to make positive changes. We propose to use an empirically validated model of behavior change, the Transtheoretical Model (TTM), and expert system technology to develop a computerized intervention designed as an adjunct to traditional juvenile justice programs. The intervention will deliver assessments and individualized feedback matched to readiness to stay out of trouble with the law and reduce substance use. It will also generate counselor reports that summarize the youth's feedback and present concrete, easy-to-implement strategies counselors can use to reinforce stage-matched concepts. The goals of this Phase I project are to develop and validate TTM measures for reducing marijuana and alcohol use among juvenile offenders (to supplement measures already developed for staying out of trouble with the law); to develop the baseline portion of a computer-administered, interactive, multimedia expert system program; and to test the feasibility of this approach to intervention. Juvenile offenders will participate in focus groups to generate ideas for the TTM measures (n=32) and to provide feedback on the intervention materials (n=32); cognitive interviews to ensure TTM instructions and questions are interpreted as intended (n=8); usability tests to ensure that the expert system intervention is easily navigable and provides a coherent intervention experience (n=8); and an anonymous survey for measure development and validation (n=200). Finally, 60 court- and system-involved youth will participate in a feasibility trial and receive the intervention; their counselors will receive the counselor reports. The feasibility of this approach will be established if: 1) we are able to deliver the intervention as planned to at least 90 percent of trial participants in a range of juvenile justice programs and settings; 2) participants provide positive ratings of the acceptability and usefulness of the interactive session; 3) counselors provide positive ratings of the helpfulness of the counselor reports; and 4) the intervention yields statistically significant pre-post changes on proximal measures of change-namely, youths' assessments of the benefits of staying out of trouble with the law, and the benefits of reducing substance use. PUBLIC HEALTH RELEVANCE: Juvenile crime imposes enormous costs on victims, on society, and on juvenile offenders themselves. We propose to use an empirically validated model of behavior change, the Transtheoretical Model (TTM), and expert system technology to develop a computerized intervention designed as an adjunct to traditional juvenile justice programs. The intervention, which delivers assessments, individualized feedback, and counselor reports matched to youths' readiness to stay out of trouble with the law and reduce substance use, has the potential to increase programs' responsivity to youths' needs; make more efficient use of scarce program resources; and improve outcomes.