SafERteens M-Coach
Condition: Alcohol Drinking; Violence
MeSH terms: Alcohol Drinking
Study type: Interventional

Summary: 
      This study will use a SMART (Sequential, Multiple Assignment Randomized Trial) design to
      optimize adaptive interventions (AIs) for adolescents reporting alcohol misuse and violent
      behaviors. The study will test the efficacy of state-of-the-art adaptive intervention
      delivery approaches (text messaging, remote therapy) for reducing alcohol use and violent
      behaviors among urban teens. Given the morbidly/mortality associated with alcohol use and
      violence, this study will have significant impact by using a SMART design to identify the
      optimal intervention strategy to produce and sustain outcomes among at-risk youth.
    

Detailed description: 
      The specific aims are to: 1) Compare the efficacy of adaptive interventions (AIs) that begin
      with BI+TM (brief intervention + text messaging) vs. BI+HC (brief intervention + remote
      health coach) on reducing alcohol misuse and violent behaviors among youth while in the
      Emergency Department (ED); and, 2) Identify the most efficacious second-stage strategy
      post-ED visit for those who initially respond and for those who do not. Specifically, 700
      youth (ages 14-20) in the ED screening positive for alcohol use and violent behaviors will be
      randomly assigned to: BI+TM or BI+HC. After receiving the SafERteens BI in the ED, youth will
      complete weekly assessments over an 8 week period to tailor intervention content and measure
      mechanisms of change, with one month determination of participant response (e.g., binge
      drinking, violence). Responders in each arm will be re-randomized to continued condition
      (e.g., stay the course or maintenance), or reduced condition (e.g., stepped down).
      Non-responders will be re-randomized to continued condition (e.g., stay the course or
      maintenance), or intensified condition (e.g., stepped up). Follow-up assessments will take
      place at 4 and 8 months post-baseline.
    

Intervention name(s): Step 1 Treatment BI+HC; Step 1 Treatment BI+TM; Step 2 Treatment Responders; Step 2 Treatment Non-Responders
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): Participants in the Brief intervention + Health Coach (BI+HC) will receive a BI in the ED, followed by weekly sessions with the Health Coach for 4 weeks, which will occur by phone or in person. During sessions, the HC will review the prior week's progress, and discuss goals and plans for the following week.; Participants in the Brief intervention + Text messages (BI+TM) will receive a BI in the ED, followed by daily TMs for 4 weeks. TM's are tailored based on weekly surveys and focus on motives for alcohol and violence and strategies to reduce involvement.; Participants in the BI+HC assigned to stay the course (e.g., continue to receive the HC) will have 4 more weekly sessions with the HC.
Participants in the BI+TM assigned to stay the course (e.g., continue to receive the TM) will receive 4 more weeks of TM.
Participants in the BI+HC or BI+TM assigned to stepped down control will receive a brochure containing community resources.; Participants in the BI+HC assigned to be stepped up will receive HC+, which will consist of weekly sessions as well as on daily TMs from the HC.
Participants in the BI+HC assigned to stay the course (e.g., continue to receive the HC) will have 4 more weekly sessions with the HC.
Participants in the BI+TM assigned to be stepped up will receive the HC, which consists of 4 weekly sessions with the HC.
Participants in the BI+TM assigned to stay the course (e.g., continue to receive the TM) will receive 4 more weeks of TM.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment