The Substance Use and Health Risk Intervention (SUHRI) for Justice-involved Youth

This investigation project adapts and pilot tests an integrated health risk-reduction and motivational enhancement intervention for justice-involved youth that, after full testing through a subsequent large-scale randomized clinical trial or RCT, will culminate in a sustainable intervention that can be implemented within a JJ supervision/case management context to teach and facilitate positive, prosocial, and expected behaviors. The intervention will use graphical approaches to encourage introspection and problem identification, enhance self-regulation, improve analytical problem-solving skills, and promote healthy behaviors in two interrelated target areas: substance use and risky sex practices. Existing evidence-based intervention materials will be incorporated and delivered through a web-based application. Sessions will be self-directed (e.g., require minimal instruction/interaction assistance) and include a service-referral piece whereby youth are provided with a list of treatment and health agencies at the end of their sessions that address specific topics. Research activities are carried out in two pilot studies: (1) Intervention Adaptation and Feasibility and (2) Protocol Feasibility and Preliminary Efficacy Trial. More specifically, this study aims to examine intervention feasibility and acceptability, test the feasibility of the study examine the preliminary efficacy of the intervention for addressing health-related behavior change. Proximal outcomes are based on improvements in change mechanisms (e.g., problem recognition, decision making, intention to reduce personal risk) and service initiation (SU or STI-related services). Distal outcomes are based on a reduction in risky behaviors, including substance use (self-report and urinalysis) and sexual health risks (self-reported risky sex practices). Research questions, preliminary hypotheses, and successful completion of the aims will result in an intervention that is appropriate and feasible for use with justice-involved youth, will provide important information regarding the feasibility of a full-scale RCT, will inform future study design (and a subsequent R01 application), and will provide preliminary information regarding the efficacy of the intervention. The study has considerable potential to address an important vulnerable population—justice- involved youth—and focuses on a significant problem—youth behaviors that are
self-detrimental and unhealthy.

Target Population: Juvenile justice youth that will participate in an intervention within a JJ supervision/case management context.
Pilot 1: Intervention content will be adapted from existing evidence-based interventions so that it is developmentally appropriate for the target population and suitable for a web-based format (N = 30; 20 youth, 10 JJ staff).
Pilot 2: A scaled-down version of the intervention efficacy RCT will be tested, comparing the web-based intervention to a time-matched, information-only group using a two-arm, randomized design whereby 120 youth from one juvenile probation department are enrolled and randomly assigned to a condition.