PROJECT SUMMARY/ABSTRACT
An increasing number of youth involved in the legal system (YILS) use cannabis, which can lead to cannabis
use disorder and associated legal, social, and educational impairment. Prevention of cannabis use disorder
among YILS is rare and there are many barriers to successful implementation. Mobile health technology holds
promise to identify ecological vulnerabilities for cannabis use among YILS and to intervene in their natural
environment. Ecological Momentary Assessment/Intervention (EMA/EMI) have been effectively used with other
populations to measure substance use and intervene in the natural environment. Additionally, individualized
constellations of antecedents to substance use derived from EMA data have accurately predicted prospective
use, suggesting that targeted, individualized EMI is a promising approach to prevent cannabis use disorder.
The purpose of this mixed-methods K23 study is to 1) assess the feasibility, usability, and acceptability of using
EMA to measure ecological antecedents to cannabis use, 2) co-develop and pilot test an EMI to deliver
Personalized Feedback content to reduce cannabis use and prevent progression to cannabis use disorder
among YILS, and then 3) evaluate the EMI’s preliminary efficacy to prevent cannabis use disorder among YILS
who have initiated use. The overall goal of this application is to provide protected, mentored time to expand Dr.
Evan Holloway’s (PI) capacity to become an independent health services researcher with expertise at the
intersection of digital health, cannabis use, and health services interventions for YILS. Dr. Holloway will work
with a team of experienced and knowledgeable mentors (Drs. Tolou-Shams, Borsari, Ling, Rizzo, & Santos) to
develop expertise in EMA/EMI, cannabis use, secondary prevention of substance use, Personalized Feedback,
and mobile health technologies, with youth involved in the legal system to support his achievement of these
research and career goals. The proposed research study is a logical extension of Dr. Holloway’s program of
research to date, which has focused on the complex interplay between behavioral health service delivery
systems, individual, peer, family, and environmental influences on behavioral health and legal outcomes for
YILS. 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 EMI designed and tested during the
K23, propelling a federally-funded program of research designed to prevent cannabis use disorder for YILS.