Staying Off Substances: A Tailored Early Recovery Program for Teens

描述(由申请人提供)：在早期康复期间，大多数努力避免使用药物的青少年也在应对许多其他问题(例如，同伴关系)，他们需要持续的支持。我们建议为青少年开发一个在线复发预防计划，称为远离物质(SOS)。该计划中的具体内容将根据客户的a)年龄、b)当前的动机水平以及c)在青少年综合健康评估(Chat(R))上报告的需求和强项推荐给咨询师，该评估是一种用于治疗环境的启用网络的交互式青少年自我报告评估。虽然目前针对青少年的在线计划是面向初级预防的，但CHAT(R)：SOS将是用于临床人群的干预措施。顾问将根据他们的临床判断分配客户的用户名以访问该内容和/或其他内容的权限。我们预计，Chat(R)：SOS最终将有6个模块与Chat(R)子量表(即心理健康、家庭关系、同伴关系、吸烟、酗酒、吸毒)相对应。Chat(R)：SOS将包括通过在线互动练习、写作活动和访问支持性在线社区来加强青少年在治疗中学习的技能和理念的机会。这一资源将在治疗期间和治疗后向他们提供，以帮助他们应对早期康复中的挑战。青少年将获得量身定制的推荐和个性化的用户体验，因为Chat(R)：SOS将使用名为Ektron的创新内容管理和逻辑解决方案。Chat(R)：SOS还将为咨询师提供指导，指导他们如何与客户一起使用该程序(例如，在治疗过程中、在后续护理期间)以及定制用户报告。为了论证该计划概念的可行性，第一阶段的研究重点放在同伴关系领域。所有的可行性标准都得到了满足，调查结果表明：(1)建议的内容是基于概念图的高度积极的发现，以及客户和专家的可用性和接受性测试。对潜在效果和吸引力的评价很高。(2)可用性测试表明，该程序可被目标受众使用，其技能和结果与目标受众相关，并且该程序被认为可能对治疗过程非常有帮助。我们超过了客户和专家的可行性基准。(3)我们的技术/设计团队a)制作了一个演示程序，该演示程序被主要利益相关方视为高度可用和引人入胜的多媒体程序，b)确定了在第二阶段制作完整程序所需的技术。在第二阶段，我们将开发该程序，然后在现场试验中测试其效果。现场试验将检验基本假设，即相对于控制条件(仅限ChAT(R))，Chat(R)：SOS将与显著更高的动机、更高的自我效能、更多的复发应对和更少的药物使用有关。 公共卫生相关性：青少年滥用药物是一个重大的公共卫生问题。不幸的是，2005年联邦治疗事件数据集表明，接受治疗的青少年不到15万人。通常情况下，接受治疗的患者中有75%会在接下来的一年内复发。为了满足对成本效益评估的需求，Inflexion公司开发了青少年综合健康评估(ChAT(R))，这是一种用于治疗环境的网络互动自我报告评估。我们建议开发一个补充的在线复发预防计划，名为Chat(R)：远离物质(SOS)。Chat：SOS将使用青少年的1)年龄，2)动机水平，以及3)对Chat(R)评估的反应，以推荐基于网络的复发预防内容，以满足青少年的个人需求。这一资源将在治疗期间和治疗后向青少年提供，以帮助他们应对早期康复中的挑战。

DESCRIPTION (provided by applicant): The majority of adolescents struggling to avoid substance use during early recovery are also coping with many other issues (e.g., peer relationships) for which they require consistent support. We propose to develop an online relapse prevention program for adolescents called Staying Off Substances (SOS). Specific content in the program will be recommended to counselors based on their client's a) age, b) current motivation level, and, when available, c) reported needs and strengths on the Comprehensive Health Assessment for Teens (CHAT(R)), a Web-enabled interactive adolescent self-report assessment for use in treatment settings. Whereas current online programs for adolescents are geared for primary prevention, CHAT(R): SOS will be an intervention for use in clinical populations. Counselors will assign the client's user name to access privileges for that content and/or other content per their clinical judgment. We expect that CHAT(R): SOS will ultimately have six modules corresponding with the CHAT(R) subscales (i.e., Psychological Health, Family Relationships, Peer Relationships, Tobacco Use, Alcohol Use, Drug Use). CHAT(R): SOS will include opportunities to reinforce the skills and philosophies that adolescents learn in treatment through online interactive exercises, writing activities, and access to a supportive, online community. This resource will be available to them during treatment and post-treatment to help them navigate challenges in early recovery. Adolescents will receive tailored recommendations and an individualized user experience because CHAT(R): SOS will utilize an innovative content management and logic solution called Ektron. CHAT(R): SOS will also provide counselors with guidelines on how to use this program with their clients (e.g., in sessions, during aftercare) and custom user reports. To demonstrate the feasibility of the program concept, the Phase I study focused on the Peer Relationships domain. All feasibility criteria were met and findings indicated: (1) Proposed content was based on highly positive findings from concept mapping, as well as usability and acceptance testing with clients and experts. Ratings of potential effectiveness and appeal were high. (2) Usability testing indicated that the program was usable by the target audience, the skills and outcomes were relevant to the target audience, and the program was regarded as potentially very helpful to the treatment process. We surpassed feasibility benchmarks for both clients and experts. (3) Our technical/design team a) produced a demonstration program that was perceived by key stakeholders as highly usable and engaging multimedia program and b) determined the necessary technologies to produce the complete program in Phase II. In Phase II we will develop the program then test its efficacy in a field trial. The field trial will examine the primary hypotheses that, relative to the control condition (CHAT(R) only), CHAT(R): SOS will be associated with significantly higher motivation, higher self-efficacy, more relapse coping, and lower substance use. PUBLIC HEALTH RELEVANCE: Adolescent substance abuse is a significant public health issue. Unfortunately, the 2005 federal Treatment Episode Data Set indicated that less than 150,000 adolescents received treatment. Typically, 75% of those who receive treatment relapse within the following year. To address the need for cost-effective assessment, Inflexxion, Inc. developed the Comprehensive Health Assessment for Teens (CHAT(R)), a Web-enabled interactive self report assessment for use in treatment settings. We propose developing a supplemental online relapse prevention program called CHAT(R): Staying Off Substances (SOS). CHAT: SOS will use an adolescent's 1) age, 2) motivational level, and, when available, 3) responses to the CHAT(R) assessment to recommend Web-based relapse prevention content to address the adolescent's individual needs. This resource will be available to adolescents during treatment and post-treatment to help them navigate challenges in early recovery.