Family Assessment Motivation, and Linkage Intervention (FAMLI)

Texas Christian University

Status: Completed

Conditions: Active Linkage (AL); Mapping Enhanced Counseling (MEC)

Treatments: Behavioral: Active Linkage; Behavioral: Mapping Enhanced Counseling

Study type: Interventional

Funder types: Other

Identifiers

NCT04604236

1R34DA049079-01

Details and patient eligibility

About

The R34 study will integrate existing tools for use with JJ populations and examine the feasibility, acceptability, and preliminary efficacy of a caregiver-youth intervention aimed at increasing SU treatment initiation. The adaptive intervention incorporates three evidence-based components: 1) assessment of motivation and linkage-related barriers with personalized feedback, 2) Mapping-Enhanced Counseling (MEC) for improving readiness for change and interpersonal communication, and 3) Active Linkage (AL) for addressing logistical barriers to service initiation. Youth-caregiver dyads will be randomly assigned to receive an initial dose (2, 1-hr sessions) of either MEC or AL. After 30 days, participants will be classified as Responders (1 or more services initiated) or Non-responders (no service initiation). All participants will be randomized to one of two intervening interventions: an additional dose (2, 1-hr sessions) of the initial intervention (MEC or AL) or a different dose (2, 1-hr sessions of the other). The specific aims are to 1) integrate and adapt appropriate evidence-based intervention components as a dyadic intervention approach for JJ youth and caregivers; 2) test the feasibility, acceptability, and optimal configuration of the dyadic intervention components and the protocol used to evaluate effectiveness (including feasibility of recruitment, implementation, measurement); and 3) preliminarily explore a) whether an initial dose of MEC or AL is sufficient for promoting early initiation and engagement, b) whether an additional dose of MEC or AL or a change in dose is more effective, and c) which component sequence is most effective. Primary outcomes include youth (initiation of assessment or counseling; counseling attendance) and caregiver (attendance at assessment, first counseling, and/or family sessions) measures. Secondary outcomes include youth and caregiver attitudes (problem recognition, desire for help), normative beliefs (SU norms), perceived control (stressors and obstacles), and youth SU (self-report corroborated by UA results). The study addresses the sizeable gap in service receipt among JJ youth by addressing family engagement, and focuses on improving motivation to change, linkage to services, and treatment engagement.

Enrollment: 150 patients

Sex: All

Ages: 12 to 18 years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• pre or post adjudicated or deferred prosecution
• have an identified SU need within the past 12 months (confirmed by the TCU Drug Screen-5 during initial assessment)
• speak English
• no indication of active suicide risk
• can identify one parent/guardian/responsible adult (caregiver) that is willing to participate who speaks Spanish or English

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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150 participants in 2 patient groups

Mapping Enhanced Counseling (MEC)

Experimental group

Description:

MEC will target attitudes and norms. Attitudes include motivation for change, such as problem recognition and a belief that treatment will help. Subjective norms include normative beliefs about SU in adolescence (e.g., belief that it is ok to allow SU with parental supervision; experimentation is normal) and expectations about treatment.

Treatment:

Behavioral: Mapping Enhanced Counseling

Active Linkage (AL)

Experimental group

Description:

AL will target perceived control. Perceived control includes perceived logistical barriers and the degree to which individuals feel they can overcome them.

Treatment:

Behavioral: Active Linkage