Train Your Brain: A Pilot Project to Improve Memory and Decision Making

The goal of this clinical trial is to pilot a computer-based working memory training program to improve delay discounting (DD) and prevent substance use among at-risk adolescents in a traditionally underserved area. Results from the study will inform future efforts substance use prevention efforts targeted at youth exposed to adverse childhood experiences. Findings will also refine future models of intervention delivery in traditionally underserved communities.

The main question\[s\] it aims to answer are:

* Determine if the intervention can be delivered feasibly, acceptability, and at sufficient dosage
* Evaluate the utility of the recruitment and retention procedures as well as identify barriers to participation

Youth exposed to early childhood adversity are at increased risk for engaging in problematic substance use, leading to myriad negative health outcomes, including HIV exposure, injury, and impaired driving. Adolescents from low-resource communities evidence elevated rates of exposure to adverse childhood experiences, yet have limited access to evidence-based preventative interventions. Thus, there is a critical need for services that can feasibly target specific mechanisms linking early adversity to the onset and escalation of substance use in traditionally underserved communities.

One such target is delay discounting (DD), the tendency to select small, immediately available rewards at the expense of larger, delayed, rewards. DD has been linked to early substance use initiation and more frequent and severe use across adolescence. Moreover, youth exposed to early childhood adversity evidence more problematic levels of DD, indicating that DD may be a pathway by which early trauma exposure leads to drug and alcohol use.

Iterative pilot trials of approximately 10 youth participants + their parents/guardians will be conducted to examine effectiveness of procedures and initial implementation outcomes.

Research from our team suggests that computer-based interventions targeting proximal cognitive skills, specifically working memory, can improve rates of DD. Moreover, computerized interventions are highly transportable and scalable, making them ideal for dissemination in low-resource communities. The current project proposes to pilot a computer-based working memory (WM) training program to improve DD and prevent substance use among at-risk adolescents in a traditionally underserved area.

Eligibility Criteria:
Youth Inclusion Criteria:

1. Youth must be between the ages of 12 and 14 and have a parent/guardian willing to provide consent for their participation
2. Youth must be proficient in English in order to validly complete all assessment measures and take part in the computer-based training
3. Youth must be willing to commit to participate in two to three 20-30-minute computer-based trainings for five to seven weeks
4. Youth must be willing to take part in assessments before and immediately following the intervention as well as a confidential interview with researchers after completing the computer sessions

Youth Exclusion Criteria:

1. Currently psychotic
2. Currently suicidal or evidence active suicidal ideation
3. Currently diagnosed with a substance use disorder

Parent Inclusion Criteria:

1. Parent of child participating in intervention and willing to provide consent for themselves and their children to participate
2. Proficient in English in order to validly complete all assessment measures
3. Willing to take part in assessments

Parent Exclusion Criteria:

1. Currently psychotic
2. Currently suicidal or evidence active suicidal ideation
3. Currently diagnosed with a substance use disorder