Computer-Assisted Brief Intervention

Study Overview
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Brief Summary
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Due to the unmet needs of substance abuse treatment among court involved but non-incarcerated (CINI) adolescents and their parents, reaching and engaging CINI adolescents in intervention programs addressing marijuana use is important given the significant risk that continued substance use poses for re-arrest and detention. This study will examine the feasibility of implementing one potential model for increasing access to substance use interventions in a juvenile justice setting by using: 1) a computer- assisted intervention addressing marijuana use for adolescents, and 2) a computer program on strategies to improve management of teens who misuse drugs for parents.

Detailed Description
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Four out of five youth in the juvenile justice system show evidence of being under the influence during their offenses, and over half test positive for substances at the time of their arrest. Further, 92% of arrested juveniles who tested positive for drugs tested positive for marijuana. Although some treatment programs for juvenile offenders exist, most have focused on detained and incarcerated juveniles, who only represent one third of arrested youth. As a result, little is known about how to improve the continuum of care for the remaining two-thirds of this population, which consists of court involved but non-incarcerated youth (CINI). Court recommendations and referrals for CINI have mostly relied on outside community-based services, thus decreasing the likelihood CINI youth and their families will take the additional steps to seek intervention. Given that motivational interventions (MI) are brief, relatively easy to implement and have a greater reach than typical substance use treatment programs, researchers have recently directed their focus to interactive, computer-delivered MI protocols to further increase their reach as well as facilitate their implementation. Online interventions can be delivered at a lower cost, with less demand on staff time for training, and increased protocol fidelity, portability, and ease of use. While counselor-delivered MIs for adolescent substance use have been tested fairly widely, only a few studies have been published on the efficacy of computer-assisted MIs. Further, little research has focused on the efficacy of such interventions with marijuana using adolescents in general, and more specifically with CINI adolescents. In addition, combining such interventions for adolescents with brief parenting interventions is important but yet rarely implemented. Therefore, this application proposes to examine the feasibility and acceptability of integrating a computer-assisted,, brief intervention protocol into the juvenile intake procedures at the Rhode Island Family Court (RIFC) for marijuana using adolescents and their parents. Following an open trial of the brief protocol, , 80 adolescents who screen positive for marijuana use at juvenile intake will be recruited from the RIFC and randomly assigned to one of two conditions: 1) a computer-assisted adolescent MI plus an online parenting program ; or 2) usual care. Outcomes will be examined at 3 and 6-month follow-ups. This small trial will provide some initial evidence regarding utility of this protocol with CINI youth and whether a larger, fully powered trial is indicated in the future.

Official Title
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Computer-Assisted Brief Intervention Protocol for Marijuana Using Juvenile Offenders

Conditions
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Substance Abuse

Intervention / Treatment
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* Behavioral: Computer Counseling
* Behavioral: Standard Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: teen age 14 to 17, inclusive, living at home with at least one parent/guardian teen report of history of marijuana use and a positive brief screen during intake procedures * parental consent/ child assent; and, 4) one parent willing to participate in intervention Exclusion Criteria: developmental delay teen or parents are not able to adequately speak and understand English or Spanish.

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: a computer-assisted adolescent motivational interview plus an online parenting program for substance abuse will be compared to usual care.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Computer counseling<br>a computer-assisted adolescent motivational intervention called e-toke plus an online parenting program - Parenting Wisely | Behavioral: Computer Counseling<br>* two computer counseling online programs for a teen and a parent<br>|
| Active Comparator: Standard care<br>Standard care is typically referral to counseling for substance use | Behavioral: Standard Care<br>* A referral for substance use counseling<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time Line Follow Back Interview (TLFB) | The Timeline Follow-back Interview is a widely used research tool with good reliability and validity for various groups of individuals. Marijuana and alcohol consumption information is collected using a calendar format with temporal cues (e.g., holidays) to assist in recall of days when marijuana and alcohol were used. Data from the TLFB will be summarized to yield the total number of marijuana and alcohol use days. | 90 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Marijuana and alcohol problems | Marijuana and alcohol use problems will be assessed using items from the Add Health longitudinal study on symptoms of abuse and dependence including problems at school, home; physical fights; and physical symptoms such as vomiting and hang over. | 90 days |