Tolou-Shams M, Folk JB, Del Cid MV, et al. Advancing access to substance use prevention for foster youth through digital innovation: an open trial of fostrspace with court appointed special advocate programs. BMC Health Serv Res. 2025;25(1):676. doi:10.1186/s12913-025-12811-9
This study examined whether a mobile app and a training program for Court Appointed Special Advocates (CASAs) could help prevent substance use among youth in foster care. The researchers adapted the FostrSpace app to include more substance use prevention content and developed the ECHO-FostrSpace (ECHO-FS) training curriculum for CASA volunteers. The goal was to determine whether these tools were practical, acceptable, and useful before testing them in a larger study. The researchers used a participatory design process over three months, working with foster youth, CASA representatives, and advisory groups to refine both the app and the training. They then conducted a three-month open trial with 14 participants, including seven foster youth and seven CASA volunteers. Youth received access to the FostrSpace app, while CASAs attended a 30-minute introductory session and six 90-minute online training sessions held every two weeks. The referral-to-enrollment rate was 70%, with seven youth-CASA pairs enrolling. All CASA volunteers reported discussing alcohol and cannabis with their assigned youth at least once, although fewer had discussed other drugs. CASAs attended an average of 88% of training sessions, and 83% reported high satisfaction. Most participants (71.4%, 5 of 7) said the training improved their ability to discuss substance use by increasing their knowledge and confidence. Among the seven youth, six (86%) registered for the app, and four (57%) actively used it. The most frequently used features were mood check-ins, missions, and in-app messaging. Five youth provided positive feedback about the app and emphasized the importance of content created with input from people who had experienced foster care. Although no participants used the app’s clinical services during the study, the findings suggest that both the app and the training program were feasible and acceptable. The lessons learned will guide a larger trial designed to improve digital behavioral health support and substance use prevention for youth in foster care.