Project IntERact Study
Condition: Violence; Substance Use; Criminal Behavior
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      This study will use a randomized control trial design (RCT) to pilot test a multisession
      remote therapy behavioral intervention for risky firearm behaviors and associated
      behaviors/consequences among adolescents. The study will pilot a state-of-the-art
      intervention delivery approaches (e.g., remote therapy, smartphone-based APP intervention
      content delivery) for reducing violence and associated behaviors among urban youth. Given the
      significant morality and mortality associated with firearm violence, the study will have
      significant impact by identifying optimal intervention strategies for future large-scale
      behavioral intervention trials.
    

Detailed description: 
      The specific aim of this pilot study is to pilot test an m-health intervention, as compared
      to enhanced usual care [n=70; 35/group], with eligible youth to assess intervention
      acceptability, feasibility, and fidelity, as well as trends towards decreased risky firearm
      behaviors, substance use, and criminal justice involvement. Specifically, 70 youth (ages
      16-24) in the ED screening positive for firearm carriage and smartphone ownership will be
      randomly assigned (stratified by age/gender) to either the IntERact group or the control
      group. IntERact group participants will receive an Emergency Department (ED) session of
      behavioral therapy, followed by five additional remote therapy sessions of behavioral therapy
      delivered over the 5 weeks following their ED visit. Behavioral therapy will be comprised of
      motivational interviewing (MI), cognitive behavioral therapy (CBT), and strengths-based care
      management (CM). In addition, youth in the IntERact group will also receive a smartphone APP
      that will be downloaded to their phone. The APP will deliver daily surveys, daily tailored MI
      and CBT messages in response to survey results, one-touch access to pro-social supports,
      psycho-educational materials, GPS-enabled message alerts, and facilitated access to CM
      resources. Youth enrolled in the control group will receive a pamphlet with local violence,
      substance use, and mental health resources. A follow-up assessment will be completed in each
      group at 4 months post-ED visit. Pilot data will aid in refining and clarifying content and
      clinical trial design elements for a future fully powered randomized control trial of the
      intervention (i.e., R01 proposal).
    

Intervention name(s): IntERact
Intervention type(s): Behavioral
Intervention description(s): This intervention integrates motivational interviewing, cognitive behavioral skills therapy, and care management into a single behavioral counseling intervention delivered by a therapist. The intervention is delivered either in the emergency department or remotely over the subsequent 5 weeks for a total of six therapy sessions (~30 min each). A smartphone app is also loaded on the participant's phone and delivers additional behavioral intervention content, including tailored MI+CBT messages (tailored by daily survey responses), one-touch pro-social contact encouragement, psycho-educational materials, GPS-enabled "just-in-time" tailored alerts, and facilitated access to care management resources.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment