Testing a Multilevel Preventive Intervention in Youth Courts
Condition: Drug Abuse
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      The proposed research is designed to adapt and test an evidence-based drug abuse prevention
      approach for use in youth courts among first-time, non-violent, adolescent offenders. The
      ultimate goal is to reduce the adverse health, legal, and social consequences of youth drug
      abuse, violence, and delinquency. Planned project activities include conducting: 1) key
      informant interviews of youth court directors regarding logistical and intervention features
      of effective youth court programming; and, 2) a randomized controlled efficacy trial of an
      adapted version of Life Skills Training, an evidence-based drug and violence prevention
      program. It is anticipated that the findings will provide critical information on
      implementing evidence-based prevention programs for new populations and settings and will
      support preparations for a large-scale effectiveness trial in youth peer courts.
    

Detailed description: 
      Adolescents in under-served, urban communities are disproportionately involved in the
      juvenile justice system. This early engagement has been shown to be a strong predictor of
      more serious offenses in adulthood, such that youth involvement in the court system is a
      significant public health concern. Juvenile justice approaches have traditionally emphasized
      individualized treatment efforts combined with discipline and punishment. More recently,
      however, juvenile justice professionals have questioned the adequacy of this approach and are
      increasingly adopting an asset-based perspective referred to as "positive youth justice"
      (PYJ). The PYJ approach encourages youth court participants to build upon their existing
      strengths, while learning and mastering new life skills, through development of pro-social
      relationships within their peer group, family, and community. These "core assets" are posited
      to promote the successful entry into young adulthood. For this project, the investigative
      team will adapt and test a multilevel, multi-component, intervention that has strong
      potential to reduce substance use and delinquency while correspondingly promoting positive
      youth justice among youth court participants and staff. The first component of the current
      project involves interviewing program directors from a representative sample of youth courts
      throughout the U.S to gain formative feedback about logistical and programming concerns. The
      second component of the project is designed to promote individual-level change among youth
      participants and consists of an adapted version of the Life Skills Training (LST) program, an
      evidence-based drug and violence prevention program which teaches personal self-management
      skills, social skills, drug refusal skills, and other life skills needed to successfully
      navigate developmental tasks, increase resilience, and facilitate healthy psycho-social
      development. Several youth courts have used the Life Skills Training program, suggesting that
      it meets a perceived need and is feasible in this setting. However, LST has never been
      rigorously tested in the youth court setting. The proposed research will involve a randomized
      efficacy trial with 560 adolescents in youth court. The investigative team will examine
      intervention effects on substance use, delinquent behavior, school performance, and
      recidivism rates using mixed qualitative (assessment of dosage, fidelity, and provider and
      participant feedback to determine their impact on program efficacy) and quantitative (survey
      assessments at pretest, post-test, and six-month follow-up) methods to estimate the effect
      size of the adapted and combined program. By intervening with both youth court participants
      and youth court staff, the proposed multilevel intervention can have a broad impact on risk
      and protective factors at multiple levels of influence. The ultimate goal of this research is
      to promote the use of an evidence-based prevention approach adapted specifically for
      implementation in youth courts in order to reduce the adverse consequences of drug abuse,
      violence, and delinquency among youth offenders.

      The specific aims of this project will be to:

        1. Conduct key informant interviews with a diverse sample of youth court program
           coordinators;

        2. Conduct expert review of the LST intervention materials to ensure accuracy and
           appropriateness for the youth court setting and revise appropriately for an efficacy
           trial;

        3. Evaluate the efficacy of the combined youth court intervention (staff training plus LST)
           in preventing substance use, delinquency and violence, improving hypothesized mediators
           of intervention effects, including knowledge, attitudes and life skills, and promoting
           effective youth placements in community settings;

        4. Examine the degree to which process variables such as dosage and fidelity moderate
           intervention effects;

        5. Examine all recruitment, incentive, consent, tracking and assessment procedures in
           preparation for a subsequent national effectiveness trial.
    

Intervention name(s): Life Skills Training
Intervention type(s): Behavioral
Intervention description(s): The Life Skills Training (LST) program is a comprehensive competence enhancement prevention approach that teaches resistance skills while also emphasizing generic personal and social skills training. The LST program content and skills training is delivered to youth participants by trained providers through instruction, demonstration, behavioral rehearsal with feedback and social reinforcement, extended practice through homework assignments, and didactic teaching methods.
Other intervention name(s): LST
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Prevention