Adolescents who are truant from school are more likely to use substances, engage in delinquent behavior, and engage in earlier and unprotected sexual activity. Truant youth also have high rates of emotional/behavioral disorders which in turn may also increase their susceptibility for substance abuse. When substance use co- occurs with emotional/behavioral problems, there is an increased likelihood of suicidal behavior, sexual risk taking behavior, and involvement with the juvenile justice system. Findings such as these deem truant youth as an at-risk population and argue for the need to include screening and intervention for substance use as part of any comprehensive truancy program. This application will provide a test of one potential model for adding substance use assessment and brief intervention into a truancy court program. The primary goal of this study is to determine whether a motivational intervention will reduce substance use among adolescents referred to truancy court for school attendance problems. In this treatment development application, an open trial with 20 families referred by truancy court will first be conducted. This trial will be used to adapt an existing motivational intervention to include material relevant to school attendance and performance. Then 100 families participating in the RI Truancy Court Program with adolescents between the ages of 13-16 years who report using substances will be randomly assigned to receive the experimental intervention plus standard truancy court procedures or psycho education plus standard truancy court procedures. The 2-session intervention protocol consists of an individual motivational interview plus the Family Check-Up (Dishion &Kavanagh, 2003), a family based motivational interview. The experimental protocol provides a thorough assessment of both individual and family strengths and weaknesses with respect to substance use prevention and school attendance/performance. Follow-up interviews will be conducted at 3 and 6 months. The proposed research will fill a gap in the existing literature by testing preventive interventions with a population known to be at risk for the eventual development of substance use disorders (SUD's). This application addresses Healthy People 2010 indicators 26-10a to """"""""increase the proportion of adolescents not using alcohol or any illicit drugs during the past 30 days"""""""" and 25-11 to """"""""increase the proportion of adolescents who abstain from sexual intercourse or use condoms if currently sexually active."""""""" This application also addresses indicator 7-1 to """"""""increase high school completion"""""""" because """"""""low academic achievement and low attachment to school, adverse peer influence, inadequate family management and parental supervision"""""""" have been identified as antecedents to high school dropout and substance use.

Public Health Relevance

Adolescents who are truant from school are more likely to engage in substance use, delinquent behavior, and risk-taking including risky sexual behavior. The earlier a child initiates alcohol and other drug use, the greater the risk of long-range problems. This brief family prevention program is geared to truant young adolescents who have already begun experimenting with marijuana, alcohol, and other drugs. Separate brief motivational interventions for both adolescents and parents will be conducted to determine their effects on substance use, school attendance/performance, and risky sexual behavior.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Planning Grant (R34)
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Special Emphasis Panel (ZRG1-RPIA-K (09))
Program Officer
Lloyd, Jacqueline
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Brown University
Public Health & Prev Medicine
Schools of Public Health
United States
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Spirito, Anthony; Hernandez, Lynn; Cancilliere, Mary Kathryn et al. (2017) Parent and Adolescent Motivational Enhancement Intervention for Substance-Using, Truant Adolescents: A Pilot Randomized Trial. J Clin Child Adolesc Psychol :1-13
Hernandez, Lynn; Rodriguez, Ana Maria; Spirito, Anthony (2015) Brief Family-Based Intervention for Substance Abusing Adolescents. Child Adolesc Psychiatr Clin N Am 24:585-99
Abar, Caitlin C; Hernandez, Lynn; Rodriguez, Ana Maria et al. (2015) Trajectories of Adolescent Alcohol Use in the Year Following a Brief Alcohol Intervention. J Stud Alcohol Drugs 76:710-20