Adolescents in rural communities face limited access to effective substance use services, increasing their risk for opioid and other substance use disorders. This project will use an adaptive, iterative implementation approach to improve the integration of external substance use service providers into rural school settings. Findings will inform strategies to integrate and scale adolescent substance use services in schools. Support for this trial is provided by the HEAL Initiative (https://heal.nih.gov/).
Are enrolled in one of the participating schools
Are referred or independently access YSU services;
Are above age of 13
Demonstrating active, unstable or untreated psychiatric symptoms, including mania and/or psychosis that would interfere with study participation
Inability to understand the study and provide informed consent in English
Single group
Youth Substance Use Unit
BehavioralThe YSU provides adolescents access to several evidence-based interventions, including access to an on-site substance use counselor trained in evidence-based practices for adolescent SUD, peer recovery specialists, and, if indicated, virtual access to an OUD treatment provider and/or clinical psychologist for more acute and co-occurring disorder treatment.
Reach and Engagement
Reach and Engagement will be tracked through service logs, including the number of students referred, completed referrals, and retention in care.
90-day Substance Use Self Report
The timeline followback will be used to assess self-reported substance use frequency
90-Day Substance Use Urinalysis
Substance use will be assessed using urinalysis.
Opioid-related knowledge and likelihood to engage in misuse behaviors
Opioid-related knowledge and likelihood to engage in misuse behaviors will be assessed with the Adolescent Opioid Safety and Learning scale. The Adolescent Opioid Safety and Learning Scale is a 16-item instrument comprising four separately scored subscales: Opioid Learning Interest (5 items; summed score range 5-25, with higher scores indicating greater interest in learning about opioid safety), Opioid Misuse Behavior Recognition (4 yes/no items; summed score range 0-4, with higher scores indicating better recognition of opioid misuse), Likelihood to Misuse Opioids (4 items; summed score range 4-20, with higher scores indicating a greater likelihood of opioid misuse and therefore a worse outcome), and Opioid Harm (3 items; summed score range 3-15, with higher scores indicating greater perceived harm from opioid misuse). The four subscales will be analyzed separately.
Motivation for substance use and problems associated
Motivation for substance use and problems associated will be measured with the Short Inventory of Problems
Depressive Symptoms
Depressive symptoms will be assessed with the Patient Health Questionnaire-9. The Patient Health Questionnaire-9 is a 9-item self-report measure of depressive symptom severity during the preceding two weeks. Each item is scored from 0 ("not at all") to 3 ("nearly every day"). Item scores are summed to produce a total score ranging from 0 to 27. Higher scores indicate greater depressive symptom severity and therefore a worse outcome.
Anxiety Symptoms
Anxiety symptoms will be measured with the Generalized Anxiety Disorder 7-item scale (GAD-7). The Generalized Anxiety Disorder is a 7-item self-report measure of anxiety symptom severity during the preceding two weeks. Each item is scored from 0 ("not at all") to 3 ("nearly every day"). Item scores are summed to produce a total score ranging from 0 to 21. Higher scores indicate greater anxiety symptom severity and therefore a worse outcome.
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University of Maryland, College Park
Lead sponsor
National Institute on Drug Abuse (NIDA)
Collaborator
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