SBIR-STTR Award

Each year over 2 million adolescents are arrested in the U.S.[4], and many more (9-18 percent of all youth) engage in serious delinquent behavior, such as heavy drinking, illicit drug use, and school drop-out[5]. The most effective interventions to address these problems are family-based, with a strong clinical emphasis on helping parents regain control of youth behavior through better monitoring of activities and consistent use of contingencies (rewards and punishments) for appropriate and deviant behavior[6]. The fact that 21st century youth are technologically "wired" (75 percent now own a cell phone[1], spending an average of 33 minutes talking and 1.5 hours texting each day;[2] in addition, 93 percent of households with children now have Internet access[45]) offers an opportunity for parents to monitor youth more accurately and to provide more frequent, contingent rewards for good behavior than previously possible. The primary aim of this application is to develop and evaluate a sophisticated multi-component technology suite designed to enhance parents' ability to manage youth behavior. At the core of this VillageWhere suite is a mobile phone app for youth cell phones that uses contextual intelligence (notifies parents of youth activities and prompts youth to change behavior) and gamification (rewards youth and maintains youth engagement). The app will integrate with an Internet-based dashboard for parents (www.villagewhere.com) that will show youth whereabouts and consolidate information critical for parental management. This suite will be developed within the context of Multisystemic Therapy (MST), an empirically-supported and widely-disseminated intervention for youth antisocial behavior designed for the most serious subset of the target population. When incorporated into interventions such as MST, VillageWhere could enhance clinical outcomes while reducing treatment length and cost and expanding treatment access. We will use an iterative development process involving feedback from end-users during all stages of prototype development. Given the novelty of VillageWhere, in Phase I we will conduct an extensive formative evaluation to confirm and ensure proof of concept, and a summative evaluation to examine the product's usability, acceptability, and feasibility. Throughout Phase I we will gather in-depth qualitative and quantitative data from parents, youth, and clinicians drawn from an extensive network of MST providers. In the event of a successful Phase I formative evaluation, we will propose a Phase II plan to conduct a between subjects RCT comparing the fully completed VillageWhere system delivered within MST to MST as usual and examine a range of youth-, parent-, and therapist-level outcomes.

Public Health Relevance Statement:


Public Health Relevance:
To alter the deviant behavior of antisocial youth (those engaged in delinquency, juvenile offending, and substance abuse), research suggests that improving parental monitoring of youth activities and having parents provide contingent responses (rewards and punishments) to appropriate and deviant behaviors is essential. The fact that 21st century youth are technologically "wired" (75 percent now own a cell phone, and they spend an average of 33 minutes talking and 1.5 hours texting each day;[2] in addition, 93 percent of households with children now have Internet access[45]) offers an opportunity for parents to monitor youth more accurately and to provide more frequent, contingent rewards for good behavior than previously possible. This application seeks to develop and evaluate a sophisticated multi-component technology suite, involving a youth smart phone application integrated with a parent internet-based dashboard system, designed to enhance parents' ability to manage the behavior of youth engaged in antisocial behavior.

NIH Spending Category:
Behavioral and Social Science; Clinical Research; Mental Health; Pediatric; Substance Abuse; Violence Research; Youth Violence

Project Terms:
Address; Administrator; Adolescent; adolescent drug abuse; anti social; base; Behavior; behavior change; Car Phone; Cellular Phone; Child; Clinic; Clinical; Communication; Communications Media; Communities; cost; cost effectiveness; Data; design; Development; deviant; digital; Doctor of Philosophy; Drops; Drug abuse; Drug usage; Educational workshop; effective intervention; Effectiveness; Ensure; Evaluation; Event; evidence base; experience; Family; Feedback; Glosso-Sterandryl; Goals; Health Services Accessibility; Heavy Drinking; Hour; Household; Illicit Drugs; improved; information gathering; innovation; innovative technologies; Institutes; Intelligence; Internet; Intervention; Interview; Juvenile Delinquency; Length; Marketing; meetings; Mental Health; Modeling; Monitor; multidisciplinary; National Institute of Drug Abuse; Outcome; parental monitoring; Parents; Penetration; Phase; Practice Management; prevent; probation; Process; prototype; Provider; Psychological reinforcement; public health relevance; Punishment; quality assurance; Randomized Controlled Trials; Research; Resources; response; Rewards; Sales; Schools; Services; skills; social networking website; Social support; Staging; Substance abuse problem; success; System; Target Populations; Technology; Teenagers; Telephone; Testing; Text; therapy outcome; Time; usability; Work; Youth

Each year, over one million adolescents are arrested; many more engage in other serious conduct problems, including binge drinking, illicit drug use, and school drop-out. Collectively, these problems result in enormous costs to individuals, families, and society. The most effective interventions to address these problems are family-based, with a strong clinical emphasis on helping parents better manage youth behavior through increased monitoring of activities, consistent use of contingencies to reward appropriate behavior, and enhancing intrinsic motivation toward prosocial behavior. Although empirically-supported treatments (ESTs), like Multisystemic Therapy (MST), exist, they are expensive and time-intensive, thus limiting their public health impact. We seek to develop, evaluate, and commercialize a linked parent-youth mobile app system (VillageWhere; VW) to support the key treatment targets of EBTs for this population: clear parental expectations, parental monitoring, discipline consistency, and parental support, while simultaneously cultivating intrinsic motivation in youth toward prosocial behaviors. When used in conjunction with an EST for delinquent youth, VW could help reduce treatment length and cost. When provided in non-EST clinical settings, VW may increase access to state-of-the-art clinical techniques to those who might not otherwise receive them. In Phase I, we developed and tested the usability, acceptability, and feasibility of VW with serious juvenile offenders and their parents receiving MST. Proof of concept was determined in two phases: a formativeevaluation, to test usability and acceptability with feedback from target end-users and stakeholders; and a summative evaluation, to test feasibility in a four-week within-subjects pilot study where parent-youth dyads used VW. Consistent with initial hypotheses, VW was well-liked by parents and teens, rated as useful, improved parental management practices, and reduced parental stress. In Phase II, we propose to accomplish the following aims: (1) complete the development of VW by expanding its features, including creating an iPhone version of VW to expand its reach and impact; (2) createan advisory board to guide additional features and processes to ensure its usability, acceptability, andreadiness for commercial success in Phase III; (3) conduct usability and acceptability tests of all new features for all target-end users; and (4) conduct a 16-week randomized controlled trial comparing VW to an attention-control mobile app to evaluate its effectiveness across four time points with 100 parent-youth dyads across the spectrum of clinically significant conduct-disorder severity. In comparison to study controls, we expect VW will significantly increase parental structuring of youth behavior, parental monitoring, greater effectiveness and consistency in providing rewards for meeting expectations, parenting efficacy, and warm parent-youth communication; and will decrease parent report of life stress as well as youths’ externalizing behaviors, including reports of delinquent and substance-using behaviors.

Public Health Relevance Statement:
Research suggests that adolescent criminal activity and substance abuse can be changed, and youth can be supported to develop intrinsic motivation for prosocial behavior, with interventions focused on improving key parenting skills: setting clear expectations, providing a good rationale for a rule, monitoring youth activities, and giving consistent rewards for non-problem behavior (e.g., going to school, associating with youth who don’t get in trouble)4. Now that 21st century youth are technologically “wired” (73% of teens in the U.S. have or have regular access to a smartphone6), smartphones can be a tool to help parents and youth address these problems. This proposal seeks to develop and evaluate VillageWhere (VW), a sophisticated parent-youth linked smartphone app that supports parents in using effective parenting skills and encourages youth to engage in prosocial, instead of antisocial, behavior.

Project Terms:
Accelerometer; Address; adjudicate; Administrator; Adolescent; Adolescent Behavior; Adoption; Adult; Alcohol or Other Drugs use; Android; antisocial behavior; attentional control; base; Behavior; binge drinking; Car Phone; Cellular Phone; Child Rearing; Clinic; Clinical; Clinical Treatment; clinically significant; commercialization; Communication; Community Networks; Conduct Disorder; conduct problem; Controlled Study; cost; design; Development; Discipline; effective intervention; Effectiveness; Ensure; Evaluation; Event; expectation; externalizing behavior; Family; Feedback; formative assessment; foster care; Goals; Health Personnel; Human Resources; illicit drug use; improved; Individual; Intervention; intrinsic motivation; Justice; juvenile delinquent; Language; Length; Life Stress; Link; Location; Mechanics; meetings; Mental Health; Mental Health Services; mobile application; mobile computing; Modeling; Monitor; multidisciplinary; Notification; Oregon; Outpatients; parental monitoring; Parents; Penetration; Phase; Pilot Projects; Placebos; Population; Practice Management; probation; Process; programs; Public Health; Randomized Controlled Trials; Reaction; Recruitment Activity; Reporting; Research; Resources; Rewards; Schools; Self Determination; Severities; skills; social; Societies; Specific qualifier value; standard care; Stress; Structure; Student Dropouts; Substance abuse problem; success; System; Techniques; Technology; Teenagers; Testing; theories; therapy outcome; Time; tool; Translating; trial comparing; tv watching; usability; Youth; youth conduct problem