Cultural Adaptation of Drug Treatment for DJJ Youth

Official title

The Cultural Adaptation of an Alcohol and Other Drug Use Treatment for Black Justice Involved Youth

Overview

This project aims to improve the understanding of the impact of Ethnic and Racial Discrimination (ERD) on adolescent alcohol and other drug use (AOD) within the Black Justice-Involved Youth (JIY) population. Individual interviews with Black JIY and focus groups with parents and guardians of Black JIY and community members who support change and reform in the justice community for Black JIY will be conducted.

Detailed description

Black JIY are overrepresented in the criminal justice system due to institutional racism and discrimination. The General Strain Theory posits that high levels of ethnic and racial discrimination (ERD), paired with elevated levels of witnessing or experiencing police brutality, places Black JIY at unique risk of increased alcohol and other drug use (AOD) as a means of coping with stressful events. Black JIY report engaging in comorbid alcohol and cannabis use to achieve temporary respite from discrimination-induced stress. While JIY engage in higher rates of comorbid alcohol and cannabis use compared to non-justice-involved youth, overall, Black JIY are less likely to be diverted to substance use treatment programs, less likely to engage in care after being released on probation, less likely to benefit from substance use treatment in terms of reduced risk of recidivism, and are more adversely affected by early onset of AOD activity than White JIY. To date, no known adolescent substance use treatment directly addresses ERD, the increased risk of AOD due to ERD, or explicitly presents tools on how to appropriately respond to AOD and discrimination distress among Black JIY. To address this problem, the investigator's research program aspires to improve the understanding of the impact of ERD on adolescent AOD within the Black JIY population. Individual interviews with Black JIY and focus groups with guardians of Black JIY and community members will be conducted. Data will be used to culturally adapt an adolescent substance use intervention. The culturally adapted intervention will then be piloted with 30 Black JIY.

Interventions

• Behavioral Culturally Adapted Adolescent Substance Use Treatment
  The Cannabis Youth Treatment Series (CYT) (MET/CBT12 model) aims to reduce alcohol and cannabis use.

Primary outcome measures

• Feasibility and Acceptability [Time frame: After study completion, an average of 3 months]

Secondary outcome measures (3)

• Change in substance use [Time frame: Baseline, after each study visit, at study completion, up to 3 months post-intervention, an average of 6 months.]
• Change in mental health symptoms [Time frame: Baseline, after each study visit, at study completion, up to 3 months post-intervention, an average of 6 months.]
• Change in discrimination distress [Time frame: baseline, after study completion, and up to 3 months post-intervention, an average of 6 months.]

Eligibility criteria

For Focus Groups and Interviews:

Black JIY Participants:

Inclusion criteria

• 1) Between the ages of 13-17; 2) identify as Black or African American; and 3) on community probation.

Exclusion criteria

• Will be excluded if they do not have parental consent to participate.

For Focus Groups and Interviews:

Adult Participants

Inclusion criteria

• A guardian of JIY
• An advocate (someone who supports change and reform in the justice community) for Black JIY.

Exclusion criteria

• Will be excluded if they do not provide consent to participate.

For pilot feasibility study:

Black JIY Participants:

Inclusion criteria

• Between the ages of 13 and 17
• Identify as Black or African American
• Be on community probation
• Meet criteria for alcohol, cannabis, or other drug misuse as defined by the DSM 5
• Be experiencing at least 1 problem related to AOD;
• The frequency of AOD must be weekly use over a 3-month period

Exclusion criteria

• Will be excluded if they do not have parental consent to participate
• Parole violation

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

N/A

Model

Sequential

Masking

Open label

Primary purpose

Treatment

Study locations

United States · 2 centers

• University of California, San Francisco — San Francisco
• Medical University of South Carolina — Charleston

Publications

• Bryant BE, Tolou-Shams M, Ezimora I, Zapolski TC, DiClemente R, Jordan A, Becker SJ, Squeglia LM. Adapting substance use treatment for black adolescents in the US legal system: protocol for a mixed-method, exploratory, feasibility and acceptability study using the eight-step ADAPT-ITT framework. BMJ Open. 2026 Mar 2;16(3):e115193. doi: 10.1136/bmjopen-2025-115193. PMID 41771593

Identifiers

NCT: NCT06003725 · 23-40126 · K23DA057412

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗