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 Motivational Interviewing for Incarcerated Teens
      (R01 DA-13375)

Principal Investigator: Dr. L.A.R. Stein              

Funding Source: NIDA  ($1.26 million)              

Terms: August, 2000- July, 2006

Detailed Description:
The objective of this research is to investigate ways to enhance motivation for treatment and effectively reduce substance abuse among juvenile offenders. Motivational Intervention (MI) as preparation for residential treatment and for persons (including teens) with little motivation to change has been effective in reducing substance use. Thus, MI designed for delinquent youths who are required to attend substance abuse treatment may prove efficacious. In this proposed randomized trial, a one-way design (MI + Standard Care (SC) v. Attention Control (AC) + SC) will be used to determine whether MI enhances subsequent treatment participation and reduces substance-related problems post discharge in substance using, delinquent youth. Teens will also receive a booster session of MI or AC prior to discharge. Primary outcome variables include alcohol and marijuana use, as well as related behaviors (illegal activity, sex or injuries while drunk or high). It is hypothesized that in comparison to teens receiving AC, youths receiving MI will participate more (by therapist and teen ratings) in SC and will show the lowest levels of heavy substance use and related problems after discharge. It is hypothesized that these effects will be mediated by stage of change, drug effect expectancies and self-efficacy. This study will extend previous research by evaluating the use of MI with substance abusing teens in a correctional facility, and by expanding outcome measures to include alcohol and marijuana-related behavior (such as injuries and illegal activity when drunk or high) in this population. The development of effective interventions for substance using juvenile offenders has the potential to reduce substance use and crime in this population.

Eligibility:
Ages Eligible for Study: 14 Years to 19 Years
Genders Eligible for Study: Both
Accepts Healthy Volunteers: Yes
Inclusion Criteria: Adjudicated teens 12-19 yrs. old, 4-12 month sentence, English speaking .
Exclusion Criteria: Those teens sentenced for less than 4 months or greater than 12 months will be excluded from participation. Teens falling outside of 14-19 years are excluded, as are those who have not used alcohol or marijuana.

 

 

  

Motivation and Skills for THC/ETOH+ Teens in Jail
(R01 DA-018851)

Principal Investigators: Dr. L.A.R. Stein & Dr. Rosemarie Ann Martin

Funding Source:  NIDA  ($3,776,805)                   

Terms: September, 2004 – August, 2011                  
                                                      
(Analyses in Progress)

Detailed Description:
This study will focus on treating substance abusing incarcerated teens using two individually administered Motivational Interviewing (MI) sessions followed by ten group sessions of Cognitive Behavior Therapy (CBT). Motivational Interviewing is conceptualized as preparation for group CBT. The control group receives two individualized Relaxation Training (RT) sessions followed by ten group sessions of Substance Education Training (SET). Currently, there is little research regarding effective group treatments for incarcerated teens and this study will address this gap in our knowledge base. We seek to reduce substance use and associated risky behaviors post-release (including driving under the influence, risky sexual behaviors, etc.). In this proposed randomized trial, a one-way design (MI/CBT vs. RT/SET) will be used to determine whether MI/CBT enhances group therapy participation and reduces substance use and related problems (such as crime, injuries and unprotected sex) post discharge in substance-involved juvenile delinquents. RT/SET is based on the 12-step model and includes psycho-educational components. Participants are followed during incarceration and for 6 months post incarceration. Primary outcome variables include alcohol and marijuana use, as well as related behaviors (illegal activity, sex or injuries while drunk or high). It is hypothesized that in comparison to teens in RT/SET, youth receiving MI/CBT will participate more in therapy (according to teen, facility staff, and counselor ratings) and will show lower levels of substance use and related problems after discharge.
Frequently, substance abuse treatment is unavailable to youths in the juvenile justice system, and when treatment is available, it may be provided in group format using untested therapies. A motivation/skills-based intervention (delivered in group format) may prove efficacious in enhancing motivation and in reducing substance abuse and related problems. This study extends previous research by rigorously evaluating group treatment for incarcerated teens. We will examine processes contributing to the efficacy of group MI/CBT, and the influence of race and ethnicity on treatment effects. The development of effective interventions for substance using juvenile offenders has the potential to reduce substance abuse and crime in this population.

Eligibility:
Ages: 14 Years to 19 Years
Genders:    Both
Accepts Healthy Volunteers:  Yes
Inclusion Criteria: Teens will be included if they meet any of the following criteria: 1) in the year prior to incarceration they used marijuana regularly (at least monthly); 2) in the year prior to incarceration they drank regularly (at least monthly) or binged (>=5 for boys; >=4 for girls); 3) they used marijuana or drank in the 4 weeks before the offense for which they were incarcerated; or 4) they used marijuana or drank in the 4 weeks before they were incarcerated.
Exclusion Criteria:Those teens sentenced for less than 4 months or greater than 12 months will be excluded from participation, as will adolescents younger than 14 or older than 19 years. We will exclude adolescents who have not used alcohol or marijuana.

 

 

     

Motivation and Skills for Detained Teen Smokers
(R01 DA-020731)

Principal Investigators: Dr. L.A.R. Stein & Dr. Rosemarie Ann Martin

Funding Source:  NIDA  ($3,776,805)                   

Terms: September, 2007 – August, 2014                  
                                                      
Team Members:
PI: Dr. L.A.R Stein                      
Project DirectorDr. Mary Clair                                             
Research Assistants: Kelly Doyle, Laurel Murphy, Shayna Soenksen
Treatment Provider: Rick Palumbo

(Study in Progress)

Detailed Description:
This study will focus on treating tobacco using detained teens. Using urn randomization, the teen will be administered one individual treatment in either Motivational Interviewing (MI) or Relaxation Training (RT). This will be followed by two group sessions in either Cognitive Behavior Therapy (CBT) or Self-Help Programming (SHP). Currently, there is little known about mechanisms of smoking cessation in adolescents. We seek to increase our understanding of effective smoking interventions for under studied adolescents.
This is a randomized clinical trial using a 2x2 between groups design to investigate MI vs. RT and CBT vs. SHP. We will study main effects for treatment as well as whether the combination of MI/CBT is more effective than the other treatment combinations in enhancing quit rates among teens. Participants are followed-up twice while detained, and for 12 months post incarceration. The moderating and mediating effects of motivation, anger, and self efficacy will also be examined.

Eligibility:
Ages: 13 Years to 19 Years
Genders:    Both
Accepts Healthy Volunteers:  Yes
Inclusion Criteria: Teens will be included if they smoke > 5 cigarettes per day, detained for 4-7 weeks and are never adjudicated.
Exclusion Criteria: Those teens who are detained for longer than 7 weeks, who are adjudicated, or who have already participated in this study.

 

 

 

   CJDATS-2

Criminal Justice and Drug Abuse Treatment Studies-2
(U01-DA-016191)

Principal Investigators: Dr. L.A.R. Stein & Dr. Peter Friedmann

Funding Source:  NIDA ($3,500,000)                   

Terms: February, 2009 – March, 2014                  
                                                      
Team Members:
PI: Dr. L.A.R Stein                      
Project DirectorDr. Mary Clair                                             
Local Change Team Facilitator: Dr. Mary Clair
Research Assistant: Cecilia Murgo, Shayna Soenksen

(Study in Progress)

Detailed Description:
The Criminal Justice Drug Abuse Treatment Studies is a five‐year research cooperative funded by National Institute of Drug Abuse. The purpose of the CJDATS II is to conduct research studies on effective organizational and professional change strategies to implement evidence based approaches to treating drug abuse within criminal justice settings.  The focus of the research to be conducted in CJDATS II is on organizational and personnel strategies that promote the adoption and utilization of innovative, evidence based approaches to the treatment and management of offenders. As such, the focus of this research is on the correctional organization and its employees, programs, and referral linkages rather than on the offenders. In contrast to clinical research that seeks to document the effects of treatment strategies on service recipients, the focus of the research in CJDATS II is upon effective program implementation strategies.   The focus is on three primary areas:  1) substance abuse assessment and case planning, 2) medicated assisted approaches to opioid addiction, 3) continuity of care for HIV and AIDS infected offenders.

Eligibility:
A variety of justice organizations are eligible.  Since the level of analyses is the organization, the usual descriptors of eligibility with respect to age, gender, and the like are not applicable.

 

 

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careheart Project Teen Care

Contraceptive Awareness and Reproductive Education for Teens
(R01HD065942)

Principal Investigator:  Dr. LAR Stein
Funding Source:  NICHD ($3,100,000)
Terms:  Sept, 2011 - June, 2016

Team Members:
PI:  Dr. LAR Stein
Proj. Dir:  Dr. Mary Clair
Assessment Coordinator:  Laurel Murphy
Research Assistants: Kelly Doyle, Cecilia Murgo
Treatment Providers:  Amy Moore, Nicole Theroux-Kocharek

(Study in Progress)

 

Detailed Description:
Unplanned pregnancies (pregnancies that are either mistimed or unwanted) and sexually transmitted infections (STIs) are important and costly public health problems in the United States resulting from unprotected sexual activity. Currently, 80% of teen pregnancies are unplanned and are the result of no or improper use of contraceptives. Teenage girls involved in the justice system are at increased risk for these problems given the high rates of substance abuse and commercial sex work in this population. Unplanned pregnancies can be prevented through highly effective (less than 2% annual failure rate with typical use) reversible contraceptive methods which are readily available through Title X clinics. The long-term objectives of this research are to develop effective treatments to reduce unplanned pregnancy and STIs for a highly under-served population in great need. This proposal will evaluate a Motivational Interviewing (MI) intervention designed to improve contraceptive use and decrease STIs for girls involved with the justice system for both those who do and do not want a pregnancy. Those interested in becoming pregnant will be counseled in the risks associated with teen pregnancy and what it means to have a healthy pregnancy and raise a child. We will utilize Title X programs in Rhode Island to provide reproductive health services in the community. Building upon program experience and prior evaluations, we have adapted Computer Assisted Motivational Interviewing (CAMI), and plan to implement and evaluate CAMI for increasing the initiation and continuation of highly effective contraceptive methods among girls at risk for an unplanned pregnancy or STI. We will recruit 250 girls from juvenile probation and randomize them to two interventions: two sessions of personalized CAMI combined with one session of skill building or three sessions of Didactic Educational Counseling (DEC), both delivered individually by trained counselors. CAMI is based on the principles of the Transtheoretical Model (TTM) and on MI, an empirically supported counseling technique designed to enhance readiness to change targeted behaviors. The DEC provides didactic information about contraception, STI prevention and abstinence, and is intended to control for the effects of assessment and attention. The proposal is consistent with the funding agency’s mission to promote healthy and wanted pregnancy, reduce harmful reproductive processes, and support children in achieving healthy and productive lives.

Eligibility:
Ages:  14 - 18 years.
Genders:  Girls.
Accepts Healthy Volunteers:  Yes.
Inclusion Criteria:  English speaking, potentially sexually active.
Exclusion Criteria:  Organic brain dysfunction or psychosis, currently pregnant.

 

 

 

easyEnhancement and Screening for Youth
(1R01AA021855)

 

Principal Investigator:  Dr. LAR Stein
Funding Source:  NIAAA ($3,230,000)
Terms:  Sept, 2012 - May, 2017

Team Members:
PI:  Dr. LAR Stein
Proj. Dir:  Dr. Mary Clair
Assessment Coordinator:  Laurel Murphy
Research Assistants: 

(Study in Progress)

 

Detailed Description:

This proposal is in response to RFA-AA-12-008, Evaluation of NIAAA’s Alcohol Screening Guide for Children and Adolescents. Of particular interest to the agency are evaluation of the Screener in clinical and/or other settings to predict alcohol-related consequences including use disorder; its use as an initial screen for drug use, cigarette smoking, conduct disorder, and unprotected sex; and its performance in making predictions concurrently and prospectively. This proposal targets these areas of interest. In addition, we will study implementation of the Brief Intervention (BI) associated with the Screener. There is a great need for both screening and BI in juvenile probation settings as many of these youths have great need but are underserved. Many probation departments are turning to BI to work with probationers and parolees. Screening and BI has demonstrated efficacy in these settings, and yet no randomized control trials have been conducted to evaluate effectivess in juvenile probation settings. The long-term objective of this research is to enhance detection and service delivery to underserved youth. Probation Officers (POs; n=40) are randomized to Screener (S), Screener+BI (SBI), or coaching (CSBI). Youths (N=1000) are randomized to 1 of these 3 conditions, and all receive usual services (US). US consist of regular check-in with PO and access to referral services as needed (counseling, academic tutoring, etc.). Research staffers conduct in-depth assessment at baseline, 6- and 12-months. Sensitivity, specificity, and positive and negative predictive powers (SN, SP, PP, NP) are calculated to predict alcohol risk and consequences, as well as other risky behaviors concurrently and prospectively across age-groups. A 1-way design (S vs SBI vs CSBI) will be used to determine whether SBI and CSBI enhance youth services-use and reduce risks (e.g., alcohol use, risky sex). We examine moderators of outcomes (youth age, PO characteristics) and whether coaching (an important consideration in implementation science) in use of BI improves outcomes. This study will be the first randomized controlled trial evaluating the effectiveness of SBI in a juvenile probation setting. This study has significance in that juvenile probationers are at high risk for alcohol use and other problem behaviors; the justice setting offers a key opportunity to identify and access services for youths who are often otherwise undetected and underserved. Importantly, this trial would be the first in this setting to evaluate both the 2-question Screener and use of BI as presented in NIAAA's Practice Guide. It is crucial to evaluate the Guide in a variety of settings where youth at risk for alcohol problems may benefit from it.

Eligibility:
Ages:  Youths-9 to 18 years.  Staff-Those working directly with youth
Genders:  Youths-Girls, boys.  Staff-Men, women
Accepts Healthy Volunteers:  Yes.
Inclusion Criteria:  Youth-English speaking, involved in justice system (on probation).  Staff-English speaking, works with at risk youth (probation officer)
Exclusion Criteria:  Youth-Organic brain dysfunction or psychosis; Staff-None.

 

 

 

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