Development of the Cannabis Actions and Practices (CAP): A Parent-Focused Intervention to Address Adolescent Marijuana Use - The expanding map of 33 states and the District of Columbia with legalized medical marijuana reflects an
increased normalization of adult cannabis use. Legal use by adults is beginning to shift perceptions of risk among
youth and adults alike, with perceptions of the harmfulness of marijuana use decreasing. Adolescent attitudes
toward marijuana are becoming more positive and rates of marijuana use are rising in many states where
cannabis has been legalized. Within this context, treating adolescent marijuana use is likely to become
increasingly difficult and the need for more effective intervention strategies more urgent. The context in which
parents are legal users of medical marijuana (MM) may pose an additional set of risks for their offspring. The
proposed Stage 1A/1B treatment development research will involve a mixed-methods approach to formulating
the Cannabis Actions and Practices (CAP) intervention. CAP is a parent-focused intervention to help parent MM
users address adolescent marijuana use. The study will occur in two phases. In Phase I, 3 focus groups will be
conducted to inform the structure, content, and context for the interventions’ delivery, to obtain feedback from
parents who are currently legal users of MM, to obtain feedback from adolescents, and for dispensary personnel
to obtain information about the feasibility of dispensary-supported dissemination. In Phase II, a pilot evaluation
of CAP will be conducted, with 60 MM parents randomly assigned to CAP (n=30) or to a delayed CAP wait-list
(WL) condition (n=30). Parents and their adolescents will be assessed at baseline and 3, and 6 months after
baseline. Primary outcomes will be adolescent marijuana use and perceptions of marijuana harmfulness.
Secondary outcomes will include parenting behaviors such as youth exposure to marijuana, communications
discouraging adolescent marijuana use, and setting expectations. We hypothesize that CAP will be associated
with significantly more positive pre-to-post outcomes, compared to the WL condition. We will also examine key
targets of change, including changes in parent perceptions of marijuana harmfulness, parent monitoring, parent
sense of competence, and parent behavioral intentions. The multi-method, multi-source data collection will
include parent and youth report and biological urine assays. The study is designed to evaluate the promise of
CAP, a novel theory-guided, empirically based, brief early intervention, for helping parent legal medical
marijuana users support marijuana abstinence in their marijuana-involved adolescents.
