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Principal Investigator: Sarah Ashley Helseth
Organization: NORTHWESTERN UNIVERSITY AT CHICAGO
Fiscal Year: 2024
Award: $188,705
Funding agency: National Institute on Drug Abuse
PROJECT SUMMARY/ABSTRACT
Through the research and training described in this K23 proposal, the PI (Dr. Helseth) will acquire the
necessary skills to become an independent clinical researcher focused on designing and evaluating early,
substance use (SU) interventions for youth on risky developmental trajectories. Marijuana (MJ) use accounts
for 92% of positive drug screens among teens in the juvenile justice system (JJ) and has been linked to future
arrests and SU disorders. Due to JJ capacity constraints, court-involved, non-incarcerated (CINI) youth are
often referred out for treatment and encounter multiple barriers to community care. Technology-assisted
interventions would enable the JJ system to treat CINI youth in-house, without overextending its workforce or
resources. Brief, computerized motivational interventions are inexpensive and easy to deliver, and have been
shown to reduce teens’ MJ and SU. However, effects typically fade after a few months, indicating the need for
an adjunct intervention to sustain behavior change. Smartphone apps are an ideal treatment platform for teens:
95% of teens own one, which they use nearly 3 hours each day. Yet the potential of smartphone apps as a
means of reducing MJ use in high-risk youth has not been realized. With this 5-year K23, the PI aims to
establish the needs and preferences of CINI youth ages 14-17 for an adjunctive smartphone app; examine the
app’s feasibility and acceptability; and establish its preliminary efficacy. The Teen Empowerment through
Computerized Health (TECH) app, which targets putative intrapersonal and interpersonal mechanisms to
promote MJ-related behavior change, will serve as an adjunct to treatment-as-usual (TAU) in the Rhode Island
Family Court. Following the Behavior Intervention Theory (BIT) model, qualitative interviews with key
stakeholders (n=30) will inform how clinical goals (knowledge, skills, motivation) will map on to TECH usage
goals (goal-setting, peer networking), features (expert-moderated forum, notifications) and workflow. Next, 10
CINI youth will beta test the TECH prototype for 1 month, to guide its refinement. Finally, a pilot randomized
control trial with 60 CINI youth will test the app for 6 months as an adjunct to TAU (TAU+TECH vs. TAU-only)
on MJ and other SU-related outcomes, putative mechanisms of change (i.e., intrapersonal and interpersonal
factors), and high-risk behaviors. The PI will work with an accomplished, multidisciplinary mentorship team
(Drs. Spirito, Barnett, Becker, and Clark) to master four relevant areas of training: 1) effective MJ and SU
interventions for CINI youth; 2) interpersonal mechanisms of adolescent SU; 3) development of technology-
assisted behavioral interventions; and 4) qualitative methods for treatment development. The research and
training activities outlined in this K23 award contribute to both an important public health concern and the
development of a productive and independent research career for the PI. Completion of this study has the
potential to advance the field by demonstrating the feasibility, acceptability, and preliminary efficacy of an
adjunct technology-assisted intervention to improve outcomes among high-risk, MJ-using CINI youth.
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