Friday, May 10, 2024
5/10/2024
PROJECT SUMMARY/ABSTRACT Childhood maltreatment is a major public health problem that is a risk factor for substance use across the lifespan. Emotion regulation (ER) is a modifiable mechanism underlying the impact of maltreatment on substance use but is often impaired in youth with a maltreatment history due to the neurotoxic effects of early trauma and/or neglect. Interventions to support the development of adaptive ER in youth with a maltreatment history have the potential to interrupt trajectories of risk and enhance health outcomes, yet this population is often difficult to reach and frequently faces structural and psychosocial barriers to engagement in intervention. Furthermore, the child welfare system, which is designed to protect and support youth with maltreatment histories, is under resourced and often unable to meet the critical needs for prevention in this population. Interventions targeting substance use with this population must be acceptable, easily accessible, and low resource for the child welfare system. iTRAC is a tablet-based ER skills training intervention for early adolescents that previously demonstrated good feasibility and acceptability, as well as increases in emotional self-efficacy, emotional awareness, and use of ER strategies with community samples of urban adolescents. iTRAC’s approach of delivering ER content through a technological platform may effectively engage and promote ER and prevent substance use among youth with maltreatment histories. This tablet-based approach may also be more sustainable in child welfare settings than approaches that require a trained clinician. However, no prior work has examined iTRAC with this vulnerable population. In collaboration with the Rhode Island Department of Children, Youth, and Families, the proposed research will innovate and enhance the existing iTRAC intervention to integrate substance use content with the goal of reducing substance use among child welfare involved youth. This work will occur in two phases. During the Planning and Intervention Enhancement Phase (Phase I), we will interview adolescents, caregivers, and child welfare professionals to obtain their diverse perspectives regarding the integration of ER and substance use. We will subsequently create and program this content within the iTRAC framework, followed by acceptability testing to ensure usability and understanding. Upon completion of Phase I, we will begin Phase II, during which a real-world efficacy (hybrid efficacy-effectiveness) trial of youth with maltreatment histories will test the impact of the iTRAC for Substance Use (iTRAC-SU) intervention over an 8-month follow-up period. We will also assess the feasibility, acceptability, uptake, and costs of this approach. Trial results, and qualitive interviews with child welfare professionals at the end of the project, will inform sustainability planning beyond the project period.
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