PROJECT SUMMARY / ABSTRACT
Justice-involved youth exhibit high rates of substance use and mental health symptoms, yet few receive
treatment during detention or community re-entry. Once released into the community, caregivers must facilitate
youth's treatment engagement, mobilizing significant resources and facing many barriers (e.g., transportation,
mistrust) to do so. Parenting stress, which is heightened during youth detention and community reentry, is
associated with greater perceived barriers to treatment, less youth therapeutic change throughout treatment,
and premature treatment dropout. Addressing parenting stress improves youth treatment engagement and
outcomes among youth exhibiting antisocial behavior, yet given the many barriers to treatment, novel
approaches to intervention are needed; mobile health (mHealth) technology is one promising approach.
Caregivers of justice-involved youth and system stakeholders are interested in mHealth treatment and mHealth
addresses instrumental barriers (e.g., transportation) to treatment. Advances in technology and community
engaged research allow for active stakeholder collaboration in mHealth application development, with no
technological expertise required, through participatory informatics; caregiver involvement increases the
likelihood the intervention will be relevant and efficacious. The purpose of this mixed-methods K23 study is to
1) develop a mHealth parenting stress intervention using participatory informatics; 2) assess the feasibility and
acceptability of the participatory informatics approach and the intervention; 3) evaluate the intervention's
preliminary efficacy in reducing parenting stress and increasing youth engagement in substance use or dual
diagnosis treatment post-detention through a pilot RCT; and 4) understand systems-level factors that could
influence eventual system adoption and sustainability. The overall goal of this K23 application is to provide
protected, mentored time to expand Dr. Johanna Folk's (PI) capacities as an independent substance use
health services researcher with expertise using participatory research methods to develop and evaluate novel
interventions to engage justice-involved youth and families into youth substance use treatment. Dr. Folk will
work with a team of experienced and knowledgeable mentors (Drs. Tolou-Shams, Aguilera, Knight, Arevian,
and Chaplin) to increase her competency in: 1) substance use services research; 2) participatory research
methods; and 3) mHealth methodology. The proposed research study is a logical extension of Dr. Folk's
program of research to date which has spanned the developmental spectrum and focused on the complex
interplay between justice involvement, substance use, mental health, and interpersonal relationships. This
early career development award will provide the necessary candidate training and foundation for a larger R01
hybrid design clinical trial testing the efficacy of the mHealth parenting stress intervention designed during the
K23, propelling a federally-funded program of research designed to increase substance use treatment
engagement and improve behavioral health outcomes for justice-involved youth and families.