Preventing Substance Use Among Youth in Foster Care Through Collaborative Court Appointed Special Advocates(CASA) Brief Intervention

Research documents that youth in foster care exhibit elevated risk for substance use problems compared tothe general adolescent population. Yet substance use prevention programs often fail to reach youth in fostercare due to a number of factors including high rates of placement instability a critical lack of substance useprogramming tailored for the unique needs of youth in foster care and implementation challenges. Increasingreferrals is not an effective strategy alone and substance use prevention is not part of services as usual foryouth in foster care. The objective of this R01 is to leverage a robust existing service delivery program foryouth in foster care Court Appointed Special Advocates (CASAs) to deliver an evidence-based intervention(EBI) specifically focused on trauma-informed substance use prevention called CASA Brief Intervention (CBI).We will first adapt core components of existing EBIs so that they are tailored for the needs of youth in fostercare and can be delivered by CASAs (Aim 1). We will then conduct a large-scale hybrid type 1 effectiveness-implementation randomized trial to test whether the adapted intervention improves substance use outcomesfor foster youth compared to CASA services-as-usual (Aim 2 and Aim 3). CASAs are ideal interventionists foryouth in foster care because the structure for hiring training and monitoring CASAs to support youth in fostercare already exists nationwide. In this proposal we build on an existing partnership between the University ofOregon CASA of Lane County and the joint CASA program of Josephine and Jackson Counties. The overallgoal of this project is to expand our current partnership with CASA to co-adapt and deliver effective substanceuse programming to youth in foster care. Findings will clarify the implications of using a lay health worker modelto improve the implementation sustainability and scalability of substance use prevention programming for youthin foster care. Given that CASA is currently in 49 U.S. states serving approximately 242000 (60%) youth infoster care the potential for scalability and reach is exceptional if the current project demonstrates that the EBIdelivered by CASAs effectively prevents substance use and improves outcomes for youth foster youth.