Keywords: Adaptive interventions, Dynamic treatment regimes, Substance use, Adolescents
In 2014, over 78,018 admissions to substance use treatment facilities in the United States were for adolescents between 12 and 17. These adolescents are highly heterogeneous: in their characteristics at entry and how they respond to treatment. Adaptive interventions provide one way to operationalize sequential, individualized treatment decision-making by recommending how and when to alter treatment at critical points in the continuum of care. However, we know little about how best to individualize treatment setting for adolescents with or at risk for substance use disorders (SUD). In this talk, we describe the design and results of a multi-methods study which seeks to develop an adaptive treatment-setting intervention for adolescents with SUD. Aim 1 explores the views of various stakeholders on important considerations when deciding the setting of care for adolescents. Aims 2 and 3 use a large (n>15,000), observational cohort of youth in substance abuse treatment to develop and evaluate an adaptive intervention for improving substance use and related outcomes. Notably, Aim 1 stakeholder input is novelly incorporated in the development of adaptive interventions in Aim 2.