PROJECT SUMMARY/ABSTRACT
Many evidence-based preventative interventions have been developed to prevent substance use, physical and
mental illness, and promote positive educational and social outcomes among adolescents. Among these,
caregiver-mediated interventions boast strong effects that are mediated by effective parenting skills. However,
the impact of these interventions is severely limited by low rates of home practice of intervention skills among
caregivers. To address this research-to-practice gap, researchers have been investigating barriers and
facilitators of caregiver engagement, focusing in large part on intervention attendance. Strategies for increasing
caregivers' home practice of skills remain underexamined. Yet, caregiver home practice is a key component of
theorized intervention effectiveness and has been found to impact parenting behaviors and subsequent child
outcomes over and above that of attendance. Therefore, the next important step in supporting parenting
behavior change is to develop implementation support strategies for evidence-based interventions that target
caregiver home practice specifically.
This proposed K01 Mentored Research Scientist Development Award will develop and pilot a digital behavior
change intervention for use as an adjunct to an evidence-based preventative intervention. The “Modular
Engagement and Skills Augmentation” (MESA) aims to increase caregivers' home practice of intervention
skills. Informed by the theory of planned behavior, habit formation principles, and relapse prevention theory,
MESA will leverage mobile health technologies (mHealth) to circumvent and problem solve common barriers to
home practice including home practice intention, frequency of practice, home practice competence, and
maintenance of intervention skills. MESA will be developed as a smartphone application (i.e., “app”). MESA
components will be informed by a qualitative assessment of barriers to caregiver home practice and refined
through direct stakeholder input on design requirements to optimize acceptability and feasibility. MESA will be
piloted with 48 caregiver participants as an adjunct to Bridges, an evidence-based intervention for adolescent
substance use prevention and mental health promotion. Cluster randomized controlled design will be utilized
such that Bridges intervention groups will be randomly assigned to receive MESA (n = 32) or an active control
(n = 16). Findings from this study have the potential to improve caregiver home practice, intervention
engagement broadly, and ultimately boost effectiveness and public health impact of numerous caregiver-
mediated interventions.