A Randomized Controlled Trial to Compare Computer-assisted Motivational Intervention with Didactic Educational Counseling to Reduce Unprotected Sex in Female Adolescents

Study Objective: To examine a computer-assisted, counselor-guided motivational intervention (CAMI) aimed at reducing the risk of unprotected sexual intercourse. Design, Setting, Participants, Interventions, and Main Outcome Measures: We conducted a 9-month, longitudinal randomized controlled trial with a multisite recruitment strategy including clinic, university, and social referrals, and compared the CAMI with didactic educational counseling in 572 female adolescents with a mean age of 17 years (SD = 2.2 years; range = 13-21 years; 59% African American) who were at risk for pregnancy and sexually transmitted diseases. The primary outcome was the acceptability of the CAMI according to self-reported rating scales. The secondary outcome was the reduction of pregnancy and sexually transmitted disease risk using a 9-month, self-report timeline follow-back calendar of unprotected sex. Results: We conducted a 9-month, longitudinal randomized controlled trial with a multisite recruitment strategy including clinic, university, and social referrals, and compared the CAMI with didactic educational counseling in 572 female adolescents with a mean age of 17 years (SD = 2.2 years; range = 13-21 years; 59% African American) who were at risk for pregnancy and sexually transmitted diseases. The primary outcome was the acceptability of the CAMI according to self-reported rating scales. The secondary outcome was the reduction of pregnancy and sexually transmitted disease risk using a 9-month, self-report timeline follow-back calendar of unprotected sex. Conclusion: Among those who completed the intervention, the CAMI reduced unprotected sex among an at-risk, predominantly minority sample of female adolescents. Modification of the CAMI to address methodological issues that contributed to a high drop-out rate are needed to make the intervention more acceptable and feasible for use among sexually active predominantly minority, at-risk, female adolescents

A Double‐Blind Randomized Placebo‐Controlled Trial of Oral Naltrexone for Heavy‐Drinking Smokers Seeking Smoking Cessation Treatment

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137315/1/acer13396.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137315/2/acer13396_am.pd

LoTTS parent-infant interaction coding scale: Ease of use and reliability in a sample of high-risk mothers and their infants

Reliable and valid measurement of parent-infant interactions is necessary to demonstrate parental skill acquisition, but existing observational coding schemes are too complex for practical use in most human service settings. The LoTTS Parent-Infant Interaction Coding System (LPICS) was developed specifically to require minimal training and to be maximally useful for human service (rather than research) settings. The LPICS consists of three global scales and four behavioral counts. Undergraduate students participated in approximately 9 h of training and coding using the LPICS. Low inter-rater reliability scores initially necessitated modifications to the LPICS in order to enhance reliability. The revised scoring procedure showed more promise, particularly for three behavior counts: talking to the infant (ICC = .86, excellent), touching the infant (ICC = .90, excellent), and smiling at the infant (ICC = .66, good), and one global scale: parental warmth (ICC = .58, fair). The revised LPICS may have utility as a brief, simple, and easy-to-teach observational measure of parent-infant interactions.Parent-infant interaction Coding systems Inter-rater reliability Ease of use

Developing a tailored substance use intervention for youth exiting foster care

Youth who are aging out of the foster care system face significant barriers to accessing substance use treatment. Mobile interventions have shown efficacy for several mental and physical health issues and may be helpful in overcoming barriers facing foster youth with substance use problems. A program (iHeLP) for substance use reduction was developed that used a computerized screening and brief intervention (SBI) followed by six months of dynamically-tailored text messages. The program was shown to focus groups of youth (N = 24) ages 18-19 who recently left foster care and had moderate to severe substance use risk. Focus group feedback was used to modify iHeLP prior to delivery in an open trial (N = 16). Both study phases included assessments of feasibility and acceptability; the open trial also included assessments of substance use outcomes at 3 and 6 months. Focus groups indicated a high level of acceptability for the proposed intervention components. Of those screened for the open trial, 43% were eligible and 74% of those eligible enrolled, indicating good feasibility. Retention through the final follow-up was 59%, and drop out was associated with involvement in the criminal justice system. Participant ratings for liking, ease of working with, interest in and respectfulness of the SBI were high. Satisfaction ratings for the texting component were also high. A computerized brief screening intervention for substance use risk reduction together with tailored text messaging is both feasible and highly acceptable among youth who have recently aged-out of foster care

Feeling heard and not judged: Perspectives on substance use services among youth formerly in foster care

Youth in foster care have limited access to substance use services for a variety of reasons. Attempts to unpack this health disparity have focused on foster care systems, administrators, providers, and foster parents. This study seeks to understand the perspectives of youth themselves, with the hope of understanding their experiences with and preferences for such services. Analyses of focus groups with youth who had recently left foster care suggested concrete and perceptual facilitators/barriers to treatment. Concrete facilitators/barriers included the need for expanding social support, access to multiple service options, and tailored intervention approaches. Perceptual concerns revolved around understanding each individual\u27s readiness to change, feeling judged by authority figures, and desiring help from people with lived experience. Participants also described novel intervention ideas, including a focus on technology-based approaches. By relying on youth voices, we can improve upon the current state of substance use interventions within foster care