R01DA050670

Choices-Teen: Efficacy of a Bundled Risk Reduction Intervention for Juvenile Justice Females - Project Summary/Abstract

Not-DA-19-048

Adolescent females in juvenile justice settings engage in multiple health risk behaviors that place them at risk for HIV and pregnancy affected by alcohol and marijuana. Specifically, they engage in frequent sexual risk behaviors, placing them at risk of pregnancy, STIs, and HIV, while also using marijuana and alcohol. With nearly half of U.S. pregnancies being unplanned, females unaware of their pregnancy will continue to drink or use marijuana during the early and critical weeks of gestation, which places them at risk of substance-exposed pregnancy.

The long-term goal of this proposed line of research is to develop efficient and opportunistic interventions that reduce the risk of substance-exposed pregnancy (SEP) and HIV/STIs for justice-involved female youth. Therefore, the overall objective of this study is to test the efficacy of Choices-Teen (CT) for reducing the risks of SEP and HIV/STI in young women involved in community probation or diversion programs.

CT was adapted from the Choices preconception intervention and its shorter version, Choices-Plus, which have a robust history of efficacy in reducing the risk of alcohol and tobacco-exposed pregnancy with high-risk adult women. CT utilizes motivational interviewing (MI), which has demonstrated significant promise with adolescents and criminal justice populations.

Our recent pilot study (R03DA034099; Choices-Teen; CT-P), in which we adapted Choices for teens and tested its feasibility with youth on community probation, produced promising results. CT was modified based on this pilot work to 1) focus on marijuana (reported by 89% in CT-P study) rather than tobacco given the low prevalence and sporadic nature of nicotine use reported by the teens; 2) add a mobile health application to increase engagement with the daily journal; and 3) incorporate a post-CT self-regulation component targeting behavioral processes of change (POC).

This study will move the field vertically by elucidating important factors influencing youth health behavior change while testing an intervention designed to reduce individual and societal costs for this high-risk, underserved adolescent population. The next logical step is to conduct a rigorous RCT to assess the efficacy of this gender-responsive, tailored bundled risk reduction intervention for young, primarily minority, women involved in a community-based juvenile justice diversion or probation program.

A Stage II behavioral intervention efficacy trial will:

1) Primary aim: Test the efficacy of Choices-Teen (CT) on reducing the risk of substance-exposed pregnancy (SEP) and HIV/STI among high-risk female youth involved with the juvenile justice system by reducing alcohol use, increasing marijuana cessation, reducing pregnancy risk, and increasing condom use.

2) Aim 2: Test the efficacy of CT, compared to standard care (SC), in increasing cognitive self-regulation abilities.

3) Aim 3: Test proposed intervention mediators/mechanisms of action for CT overall and by race/ethnicity.

4) Aim 4: Test the moderating effect of initial readiness to change on risk of SEP and risk of HIV/STI.

If efficacious, CT is readily scalable and has the potential for dissemination not only to juvenile justice settings but to a wealth of settings that serve young adolescent women at risk of substance-exposed pregnancies and HIV/STI.

University Of Texas At Austin

TO SUPPORT BASIC AND CLINICAL NEUROSCIENCE, BIOMEDICAL, BEHAVIORAL AND SOCIAL SCIENCE, EPIDEMIOLOGIC, HEALTH SERVICES AND HEALTH DISPARITY RESEARCH. TO DEVELOP NEW KNOWLEDGE AND APPROACHES RELATED TO THE PREVENTION, DIAGNOSIS, TREATMENT, ETIOLOGY, AND CONSEQUENCES OF DRUG ABUSE AND ADDICTION, INCLUDING HIV/AIDS. TO SUPPORT RESEARCH TRAINING AND RESEARCH SCIENTIST DEVELOPMENT. TO SUPPORT DISSEMINATION OF RESEARCH FINDINGS. SMALL BUSINESS INNOVATION RESEARCH (SBIR) LEGISLATION IS INTENDED TO EXPAND AND IMPROVE THE SBIR PROGRAMS TO EMPHASIZE AND INCREASE PRIVATE SECTOR COMMERCIALIZATION OF TECHNOLOGY DEVELOPED THROUGH FEDERAL SBIR RESEARCH AND DEVELOPMENT, INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN THE SBIR PROGRAM. THE LEGISLATION INTENDS THAT THE SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.279 - Drug Abuse and Addiction Research Programs

National Institute on Drug Abuse (NIDA) [HHS - NIH]

Austin, Texas 787054823 United States

Single Zip Code

Research Project Grant (Parent R01 Clinical Trial Required) (PA-20-183)

Amendment Since initial award the total obligations have increased 439% from $704,242 to $3,793,984.