A Technology Assisted, Family-Centered Intervention for Alcohol Use Among Court-Involved Youth

About This Grant

PROJECT SUMMARY Four out of five youth in the juvenile legal system (JLS) show evidence of being under the influence of alcohol or other drugs during their offenses and over half test positive at the time of their arrest. Alcohol use is associated with rearrest and the future development of substance use disorders among diverted youth, those with first time offenses or low-level second offenses living in the community. There is an opportune window to engage diverted youth and their families in alcohol treatment when they make initial contact with the JLS because they are motivated to avoid continued legal involvement. Yet only ~25% of adolescents in need of substance use treatment receive such services, in part due to limited treatment options and barriers associated with accessing treatment in the community. Diverse youth are even less likely to access treatment. Existing interventions for JLS-involved youth who use alcohol are designed for incarcerated youth; they are overly intensive and too long to be feasibly implemented in the 3-month court supervision period for diverted youth. Delivering alcohol intervention within the court, where families already obtain services, makes care more accessible and increases the potential for effectiveness and scalability. Interactive, counselor-augmented electronic protocols meet these needs, as they can be delivered at a low cost, with low demand on staff, protocol fidelity, portability, and ease of use. The goal of this study is to develop and pilot a brief, moderate intensity, motivation-enhancing, culture responsive intervention for youth alcohol use that can be delivered within the court and falls within the court supervision period of ~3 months. The target population is adolescents, ages 14-18, with past-month alcohol use recruited from the juvenile diversion program at the Rhode Island Family Court, the site of our prior work. In Phase 1 of the study, N=10 families will be recruited into an open trial to test the intervention. Exit interviews will be conducted, with a focus on cultural responsivity, and the protocol will be refined. In Phase 2, N=80 families will be randomly assigned to one of two conditions: 1) a computer-assisted, counselor-augmented motivational enhancement intervention + change plan development for youth and caregivers; or 2) active psychoeducation. A family session will occur 1-week post-baseline and a booster session will occur 1-month post-baseline. Outcomes will be examined at 1- and 3-months post-baseline. This trial will provide initial evidence for whether a fully powered trial is indicated. Developing an intervention that is brief, low barrier, easy to implement/scale, and culture responsive is innovative. The public health significance of the proposed research is reflected by the fact that it addresses four alcohol-related Healthy People 2030 objectives. Moreover, this project aligns with NIAAA’s 2024-2028 strategic plan, to develop targeted interventions to improve and reduce alcohol misuse across the life course and in different settings (Goal 3, Objective 2).