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iTRAC Emotion Regulation + Substance Use Prevention

iTRAC Emotion Regulation + Substance Use Prevention

Klein Buendel Investigators, Ms. Julia Berteletti and Dr. W. Gill Woodall, are collaborating with Dr. Chris Houck from Rhode Island Hospital and Dr. Stephanie Parade from Brown University on a new 5-year project to integrate substance use content with iTRAC emotion regulation material to reduce substance use among child welfare involved youth. The web-based intervention is being developed and evaluated in partnership with the Rhode Island Department of Children, Youth, and Families.

Nearly 700,000 children experience maltreatment each year, and youth with a maltreatment history are at heightened risk for substance use across the lifespan. Emotion regulation is a modifiable mechanism underlying the impact of maltreatment on risk behaviors but is often impaired in youth with a maltreatment history due to the neurotoxic effects of early trauma/neglect and inconsistent modeling of adaptive emotion regulation strategies. Emotion regulation is related to substance use in adolescence, and interventions to support the development of adaptive emotion regulation in youth with a maltreatment history have outstanding potential to interrupt trajectories of risk and prevent substance use. However, youth with a maltreatment history often face structural and psychosocial barriers to engagement. 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.

During the Planning and Intervention Enhancement Phase (R61), the investigators will interview adolescents, caregivers, and child welfare professionals to obtain diverse perspectives regarding the integration of emotion regulation and substance use. They will create and program this content within the iTRAC framework, followed by acceptability testing to ensure usability and understanding. Upon completion of Phase 1, the team will begin Phase 2 (R33), during which a Stage III real-world efficacy (hybrid efficacy-effectiveness) trial of 200 youth with maltreatment histories will evaluate the iTRAC for Substance Use (iTRAC-SU) intervention.

Phase 1 – Planning and Intervention Enhancement (R61) Specific Aims

Aim 1: To create and integrate digital content linking substance use with ER into existing iTRAC modules. Information gathered via qualitative interviews with adolescents, caregivers, and staff in the child welfare system will be used to develop the substance use content.

Aim 2: To assess acceptability and usability with 10 adolescents (representing diverse backgrounds) over two iterative rounds of feedback.

Aim 3: To ensure successful completion of the Phase 2 Aims, planning activities with Rhode Island Department of Children, Youth, and Families. will take place to establish procedures for developing the workforce for the project, recruiting families, and avoiding interference by research in the critical mission of Department of Children, Youth, and Families programs.

Phase 2 – Randomized Trial (R33) Specific Aims

Aim 4: To conduct a randomized controlled trial examining the impact of the iTRAC-SU intervention on substance use relative to a waitlist control among 200 adolescents ages 12 to 15.

Aim 5: To examine iTRAC-SU relative to a waitlist control in enhancing theoretically important emotional competencies (such as emotion regulation, emotion recognition, distress tolerance) that mediate risk as measured by self-report, performance measures, caregiver report, and respiratory sinus arrhythmia.

Aim 6: To examine the feasibility, acceptability, uptake, and costs of iTRAC-SU when implemented with child welfare involved youth.

This research project was awarded to the Rhode Island Hospital by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (DA059785; Dr. Chris Houck and Dr. Stephanie Parade, Multiple Principal Investigators). Collaborators include Ms. Julia Berteletti and Dr. W. Gill Woodall from Klein Buendel, and the Rhode Island Department of Children, Youth, and Families. The enhanced iTRAC modules will be designed and programmed by the Creative Team at Klein Buendel.

Use of Media and Social Media in the Prevention of Substance Use

Use of Media and Social Media in the Prevention of Substance Use

Three Klein Buendel Senior Scientists have authored a chapter in a new 2019 book, Prevention of Substance Use, published by Springer. The chapter titled, “Use of Media and Social Media in the Prevention of Substance Use,” was written by Dr. David Buller, Dr. Barbara Walkosz, and Dr. W. Gill Woodall.

Mass media have changed dramatically over the past 25 years, yet still remain an important channel for substance abuse prevention messages (e.g., alcohol, tobacco, marijuana). Exposure to messaging is an important issue for campaigns. This book chapter describes how online and social media have added new media platforms for substance abuse campaigns. Overall, evaluations of web-based interventions show some promise for substance abuse prevention, although the effects appear modest. Less is known about the effectiveness of social media in substance abuse campaigns, especially the influence of user-generated content and commercial advertising.

The chapter describes several recent changes that have revolutionized the media. These include the birth of the Internet, the emergence of new media (including web-based intervention and social media) that has made content available on-demand, and the introduction of mobile computing that has vastly changed connectivity, reach, and engagement. Each of these developments raises questions (which the authors explore) about the influence of new media on substance abuse campaigns and challenges for conducting research on the effects of prevention intervention delivery. The book chapter delves into the role of audience activity, starting with audience exposure determined by selective attention, exposure, and retention, and moving on to examine user-generated content in the new media environment.

The emergence of new media holds promise for future substance abuse prevention campaigns but comes with a number of challenges that are explored in the chapter. These include (1) the fact that theories of social media impact are not well developed; (2) the development of effective methodologies to measure and assess the effects of emerging media; (3) the determination of how commercial online marketing strategies influence substance use and how social marketing approaches can use similar strategies for prevention; (4) the need to understand the use of multiple platforms for promotion (e.g., broadcast, print, online media); (5) the determination of how best to leverage and encourage user-generated media for substance abuse interventions; and (6) the need to explore the interactive nature of emerging media more fully. The authors suggest that these challenges represent tremendous opportunites to better understand and more effectively impact many different populations for the improvement of their health.

Book Citation

Z. Sloboda, R. Hingson, and H. Petras (Eds.), Prevention of substance use. New York: Springer, 2019.