Using Technology to Reduce Youth Substance Use (TEXT2)

The research project will focus on conducting a trial of whether a tailored SMS text-messaging intervention is efficacious in improving justice-involved youths' substance use or dual diagnosis treatment attendance and engagement.

The study will demonstrate how delivery of motivational/coaching messages to justice-involved youth and their caregivers will lead to greater youth substance use treatment attendance and engagement. The study will start with identifying the feasibility and acceptability of the SMS text-messaging intervention with community-supervised justice-involved youth. Then, the study will determine whether the tailored dyadic (youth and caregiver) SMS text-messaging intervention improves justice-involved youth substance use or dual diagnosis treatment attendance and engagement relative to standard of care (not receiving motivational/coaching messages). Finally, the study will characterize patterns of key justice and behavioral health system-level factors that promote or hinder eventual adoption and sustainability of mHealth technology as a tool to improve treatment attendance for justice-involved youth.

This is a hybrid 1 effectiveness-implementation design in which the investigators will test a theory-driven digital health (i.e., SMS text-messaging) treatment engagement intervention while also collecting data on the text messaging platform's potential implementation and adoption within juvenile justice and behavioral health settings.

SMS text messaging intervention for a period of 90 days to encourage attendance at community-based substance use or dual diagnosis treatment appointments through motivational messages.

Standard of care engagement practices, such as communicating with youth and caregivers, as needed, through texting but frequency of contact and content of messaging varies according to individual needs.

SMS text messaging intervention for a period of 90 days to promote attendance at community-based substance use or dual diagnosis treatment appointments through motivational messages.

Standard of care engagement practices, such as communicating with youth and caregivers, as needed, through texting but frequency of contact and content of messaging varies according to individual needs.

The Adolescent Risk Behavior Assessment (ARBA) is used to assess quantity and frequency of previous (lifetime and past 90 days) alcohol use.

The Adolescent Risk Behavior Assessment (ARBA) is used to assess quantity and frequency of previous (lifetime and past 90 days) alcohol use.

The Adolescent Risk Behavior Assessment (ARBA) is used to assess quantity and frequency of previous (lifetime and past 90 days) cannabis and other drug use.

The Adolescent Risk Behavior Assessment (ARBA) is used to assess quantity and frequency of previous (lifetime and past 90 days) cannabis and other drug use.

The Texas Christian University (TCU) Drug Screen with Opioid Supplement is used to gather detailed information about drug and opioid use.

The Texas Christian University (TCU) Drug Screen with Opioid Supplement is used to gather detailed information about drug and opioid use.

Global Appraisal of Individual Needs-Short Screener (GAIN-SS) is used to identify people with recent and lifetime internalizing and externalizing mental health disorders, substance use disorders and crime/violence problems. GAIN-SS responses are given in terms of the recency of the problem described in the questions: 3 = past month; 2 = 2 to 12 months ago; 1 = 1+ years ago; 0 = never. The number of past-month symptoms (number of 3s) is used as a measure of change; the number of past-year symptoms (number of 3s or 2s) is used to identify who is likely to have a current diagnosis; and the number of lifetime symptoms (number of 3s, 2s, or 1s) is used as a covariate measure of lifetime severity.

Global Appraisal of Individual Needs-Short Screener (GAIN-SS) is used to identify people with recent and lifetime internalizing and externalizing mental health disorders, substance use disorders and crime/violence problems. GAIN-SS responses are given in terms of the recency of the problem described in the questions: 3 = past month; 2 = 2 to 12 months ago; 1 = 1+ years ago; 0 = never. The number of past-month symptoms (number of 3s) is used as a measure of change; the number of past-year symptoms (number of 3s or 2s) is used to identify who is likely to have a current diagnosis; and the number of lifetime symptoms (number of 3s, 2s, or 1s) is used as a covariate measure of lifetime severity.

The Working Alliance Inventory (WAI) is used to assess youth's perception of therapeutic alliance (with treatment provider) over time. Scores range from 12 to 84 with higher scores indicating greater perceived therapeutic alliance.

The Working Alliance Inventory (WAI) is used to assess youth's perception of therapeutic alliance (with treatment provider) over time. Scores range from 12 to 84 with higher scores indicating greater perceived therapeutic alliance.

The Working Alliance Inventory (WAI) is used to assess youth's perception of therapeutic alliance (with treatment provider) over time. Scores range from 12 to 84 with higher scores indicating greater perceived therapeutic alliance.

The Working Alliance Inventory (WAI) is used to assess youth's perception of therapeutic alliance (with treatment provider) over time. Scores range from 12 to 84 with higher scores indicating greater perceived therapeutic alliance.

The Working Alliance Inventory (WAI) is used to assess youth's perception of therapeutic alliance (with treatment provider) over time. Scores range from 12 to 84 with higher scores indicating greater perceived therapeutic alliance.

Questions on communication characteristics will identify the preferred modes and patterns of communication between caregivers/youth and probation officers/treatment providers.

Questions on communication characteristics will identify the preferred modes and patterns of communication between caregivers/youth and probation officers/treatment providers.

Questions on communication characteristics will identify the preferred modes and patterns of communication between caregivers/youth and probation officers/treatment providers.

Questions on communication characteristics will identify the preferred modes and patterns of communication between caregivers/youth and probation officers/treatment providers.

Questions on communication characteristics will identify the preferred modes and patterns of communication between caregivers/youth and probation officers/treatment providers.

Inclusion Criteria: English-speaking youth with willing adult caregiver Ages 13-18 Justice-involved while living in the community Own a mobile phone or tablet Are willing to send and receive text messages Are referred to community-based substance use and/or mental health treatment Exclusion Criteria: -