Neurological Influences on Drug Prevention Intervention
Condition: Youths At-risk for Drug Use/Abuse
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      In this R01 study, a randomized clinical trial is proposed to evaluate the efficacy of a drug
      abuse prevention intervention for indicated middle school youth that coordinates family and
      teen-based components. The Family Management Intervention is comprised of a parent-focused
      curriculum to foster parenting skills followed by brief family therapy to foster adaptive
      family communication and age-appropriate roles. The Teen Achievement Intervention is
      comprised of a clinician-delivered learning strategy curriculum to foster academic
      achievement followed by a similar yet peer-facilitated curriculum to foster self-efficacy and
      prosocial peer networks. In the first study aim, we seek to evaluate the separate and
      possibly synergistic effects of the Family Management and Teen Achievement components on post
      intervention drug use, problem behavior, psychological distress, and academic achievement of
      indicated youth. Innovative analytic strategies are subsequently used to elucidate mediated
      pathways by which the interventions might reduce drug involvement and problem behavior by
      promoting changes in targeted skills and behavior change processes. The possibility of
      effect-modification also is considered, with a focus on neurocognitive,
      internalizing/externalizing, and demographic factors, in an effort to discern why
      interventions work for some youth but not others. This application revision has sought to
      address well-taken concerns cited by the reviewers while maintaining proposal strengths. In
      response to a key limitation, this revision includes further specification of anticipated
      relationships between neurocognitive variables, skill acquisition levels, and prevention
      intervention outcomes among indicated youth. Study hypotheses on specific neurocognitive
      effects are informed by empirical findings and the clinical experience of investigative team
      members specializing in neuropsychology. If successful, this project should improve
      prevention practices by identifying malleable behavior change processes fostered by effective
      interventions. Improving our understanding of how individual characteristics of indicated
      youth, such as neurocognitive deficits or externalizing problems, influence the development
      of skills during interventions and subsequent outcomes may also help to improve existing
      prevention interventions. The significance of the proposed study is underscored further by
      the substantial size of the targeted population of indicated youth, and the range of
      morbidities and mortality that often result when early warning signs of drug abuse are not
      addressed.
    


Intervention name(s): Integrated Family and Cognitive-Behavioral Drug Prevention Intervention; Psychoeducation
Intervention type(s): Behavioral; Other
Intervention description(s): The family therapy component of IFCBT includes engagement, active treatment, and maintenance phases. The cognitive program focuses on harmful effects of drugs and strategies to better manage drug abuse risks. The cognitive-behavioral program introduces youths to problem-solving behavior change principles and study skills to promote school achievement.; Drug education curriculum was delivered to participants assigned to this condition.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: drug prevention; adolescence; middle school; randomized trial; family therapy; cognitive-behavioral; efficacy; selected youth; indicated youth