Braciszewski JM, Wernette GKT, Moore RS, Bock BC, Stout RL, Chamberlain P. (2018). A pilot randomized controlled trial of a technology-based substance use intervention for youth exiting foster care. Children and Youth Services Review. doi: 10.1016/j.childyouth.2018.08.011
Researchers recruited 33 young adults (ages 18-19) with moderate or severe substance use who had recently exited foster care (≤ 2 years) using fliers and staff referrals at a post-foster care support agency. Participants were randomly assigned to complete computerized interventions targeting substance use (iHeLP) or general health (control). iHeLP is a stage of change-tailored intervention that uses motivational interviewing principles to target a user-identified primary substance of abuse. The control intervention matched structure and delivery of iHeLP. After completing the computerized intervention, participants received daily text messages for 3 months and every other day for another 3 months. iHeLP text messages addressed substance use based on stage of change and control text messages consisted of general motivational messages. iHeLP participants also received weekly text messages assessing substance use and readiness to change. Participants completed assessments of substance use frequency and consequences, abstinence self-efficacy, and depression symptoms at baseline, and 3, 6, 9, and 12 months. After each intervention component, participants provided feedback about intervention acceptability. iHeLP participants chose to address marijuana (n=12) and alcohol use (n=2). iHeLP participants reported significantly more abstinent days and had significantly greater increases in abstinence self-efficacy over time than control. iHeLP participants’ self-reported readiness to change, as assessed by weekly text messages, improved over the course of the intervention; suggesting that participants significantly increased readiness to change over time. Participants were satisfied with intervention content and delivery, but reported that the computerized user-interface seemed dated. Participants suggested the program include more content focusing on mental health, anonymous communication with peers and clinicians, and options to customize the frequency of text messages.