Culturally Adapted Treatment for Substance Abuse

(CAST Trial)

Overseen By Brittany E Bryant, DSW

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Medical University of South Carolina

Disqualifiers: Parole violation, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

55 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a specialized treatment for Black youth in the justice system who struggle with substance abuse. The goal is to understand how racial discrimination affects their drug and alcohol use. The trial includes interviews and group discussions with both the youth and their supporters. Black individuals aged 12 to 17, on community probation, and dealing with regular substance use problems may find this trial suitable. As an unphased trial, it offers a unique opportunity to contribute to important research that could improve support for Black youth facing similar challenges.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this culturally adapted treatment is safe for adolescents?

Research shows that treatments tailored to cultural needs can be effective for substance use. One study found that these customized treatments may lead to better results for Black individuals dealing with substance abuse. This suggests that the treatment is likely both effective and well-received by those it aims to help.

Other studies also suggest that culturally adapted treatments can help reduce substance use and its negative effects. Although more research is needed to confirm these findings, early results are promising.

The researchers are testing this treatment to determine its effectiveness and acceptability for Black Justice-Involved Youth. So far, no reports of negative side effects or safety issues have emerged for this group. Based on current evidence, the treatment appears safe and well-tolerated. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the culturally adapted adolescent substance use treatment because it tailors interventions specifically to the cultural backgrounds of Black justice-involved youth (JIY). Unlike standard treatments that might not consider cultural nuances, this approach is designed to be more relatable and effective by integrating cultural elements into therapy. This could potentially increase engagement and improve outcomes for these adolescents, addressing a critical gap in current treatment options.

What evidence suggests that this culturally adapted treatment is effective for adolescent substance use?

Research shows that culturally sensitive programs can help prevent or reduce substance use among Black teenagers. This trial will test a culturally adapted adolescent substance use treatment. Studies have found that therapies with multiple components, including cultural adjustments, effectively treat substance use disorders (SUDs) in adolescents. These therapies succeed by considering cultural factors that influence behavior and treatment outcomes. Reviews suggest that cultural adjustments enhance treatment effectiveness by making it more relevant to the individual's background and experiences. This is particularly important for Black youth involved in the justice system, as they often encounter unique challenges related to ethnic and racial discrimination. ^{1 3 6 7 8}

Who Is on the Research Team?

Brittany Bryant, DSW

Principal Investigator

University of California, San Francisco

Are You a Good Fit for This Trial?

This trial is for Black or African American youth aged 12-17 who are currently on community probation. It aims to address substance use disorders by considering the impact of racial discrimination in treatment.

Inclusion Criteria

I am a Black or African American aged 12-17 and currently on community probation.

Adult Participants who are a guardian of JIY and an advocate for Black JIY in the justice community

I am a Black or African American youth, 12-17, on probation, misusing substances with at least one related problem and weekly use over 3 months.

Exclusion Criteria

Adult Participants will be excluded if they do not provide consent to participate

Black JIY Participants will be excluded if they do not have parental consent to participate or have a parole violation

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention Adaptation

Data from interviews and focus groups are used to culturally adapt an adolescent substance use intervention

4-6 weeks

Pilot Treatment

Piloting the culturally adapted CYT intervention with 30 Black JIY to examine feasibility and acceptability

8 weeks

Weekly visits (in-person)

Follow-up

Participants are monitored for changes in substance use, mental health symptoms, and discrimination distress

3 months

Monthly visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Culturally Adapted Adolescent Substance Use Treatment

Trial Overview

The study is testing a culturally adapted treatment program for adolescent substance abuse, focusing on the unique experiences of Black Justice-Involved Youth and how ethnic and racial discrimination affects recovery.

How Is the Trial Designed?

Group I: ADAP-ITT Phase 8 Experimental Treatment 1 Intervention

Phase 8 consists of piloting the culturally adapted CYT intervention with 30 Black JIY to examine feasibility and acceptability.

Who Is Running the Clinical Trial?

Medical University of South Carolina

Lead Sponsor

Trials

994

Recruited

7,408,000+

University of California, San Francisco

Lead Sponsor

Trials

2,636

Recruited

19,080,000+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials

2,658

Recruited

3,409,000+

Published Research Related to This Trial

A randomized trial involving 70 Latina/o adolescents with substance use disorders showed that a culturally accommodated cognitive-behavioral treatment (A-CBT) was significantly more effective than a standard version (S-CBT) at the 12-month follow-up, with a large effect size (d = .92).

Parental familism, which emphasizes family loyalty and support, was found to moderate treatment outcomes, suggesting that cultural factors play an important role in the effectiveness of substance use treatments for Latina/o adolescents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized trial of culturally accommodated versus standard group treatment for Latina/o adolescents with substance use disorders: Posttreatment through 12-month outcomes. Burrow-Sánchez, JJ., Hops, H.[2021]

Culturally adapting evidence-based treatments (EBTs) for substance abuse is essential due to the changing ethnic composition of the population, and effective adaptations often involve community input, existing research, and expert consultation.

Key challenges in developing these culturally adapted interventions include identifying which EBTs need adaptation, balancing fidelity to the original treatment with necessary modifications, and addressing the diversity within cultural groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does cultural adaptation have a role in substance abuse treatment? Burlew, AK., Copeland, VC., Ahuama-Jonas, C., et al.[2021]

The Shadow Project, a 3-year pilot study involving 60 American Indian families, tested a culturally adapted family-enhanced intervention for youth entering substance use treatment, showing promising links between cultural storytelling and improved youth prosocial behavior and abstinence rates.

The study highlighted the importance of integrating cultural elements into treatment, with preliminary findings suggesting that culturally responsive interventions can positively influence family dynamics and support youth in achieving and maintaining abstinence from drugs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A culturally responsive, family-enhanced intervention model. Boyd-Ball, AJ.[2015]

A new culturally tailored substance abuse treatment program on Molokai, Hawaii, targets root causes of substance abuse such as low self-esteem and lack of identity, using activities like cultural events and counseling.

The evaluation plan developed aims to measure changes in behaviors and attitudes, laying the groundwork for assessing the program's effectiveness in addressing substance abuse in the community.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A practical framework for evaluating a culturally tailored adolescent substance abuse treatment programme in Molokai, Hawaii. Withy, KM., Lee, W., Renger, RF.[2021]

Incorporating cultural content into treatment for substance-abusing African American adolescent males can significantly enhance their engagement in therapy, as supported by previous research.

The article provides clinical guidelines for developing culturally specific interventions, suggesting that integrating these methods within a multisystemic treatment approach can lead to improved clinical outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An empirically supported and culturally specific engagement and intervention strategy for African American adolescent males. Liddle, HA., Jackson-Gilfort, A., Marvel, FA.[2022]

The cultural adaptation of the keepin' it REAL (kiR) program for Mexican adolescents involved extensive data collection, including focus groups and feedback from teachers, ensuring the program addresses local substance use issues and cultural norms.

The adapted kiR program incorporates both surface and deep structure changes, making it relevant to Mexican youth by addressing specific experiences with substance use, such as family influences and shifting gender norms, which enhances its potential effectiveness as a prevention intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Binational Cultural Adaptation of the keepin' it REAL Substance Use Prevention Program for Adolescents in Mexico. Marsiglia, FF., Medina-Mora, ME., Gonzalvez, A., et al.[2020]

A culturally-sensitive intervention called RAD-PAL was developed through focus groups with 30 adolescents and 21 caregivers, highlighting the need for support to reduce substance use and associated risk behaviors.

The intervention was found to be acceptable to both adolescents and caregivers, but further testing is necessary to evaluate its feasibility and effectiveness in a trial setting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The adaptation of an evidence-based brief intervention for substance-using adolescents and their caregivers. Carney, T., Chimbambo, V., Johnson, K., et al.[2021]

A pilot study involving 35 Latino adolescents compared standard cognitive-behavioral treatment (S-CBT) and a culturally accommodated version (A-CBT) over 12 weeks, finding both treatments equally effective in reducing substance use.

Participants in both treatment groups showed significant decreases in substance use, but outcomes were influenced by cultural factors like ethnic identity and familism, highlighting the importance of cultural considerations in substance abuse treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparing culturally accommodated versus standard group CBT for Latino adolescents with substance use disorders: a pilot study. Burrow-Sanchez, JJ., Wrona, M.[2021]

In a study analyzing the implementation of MET/CBT-5 treatment for adolescents, it was found that those who received the standard five sessions had better discharge outcomes compared to those who received either more or fewer sessions.

The length of treatment varied by agency rather than by the severity of substance use issues, and extending treatment beyond five sessions did not lead to significant improvements in substance abuse outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treatment length and outcomes among adolescents: a secondary data analysis. Riley, KJ., Srikanth, P., Choi, D., et al.[2021]

Citations

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pmc.ncbi.nlm.nih.gov

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Multicomponent therapies have strong evidence for treating adolescent SUDs and some combinations of multicomponent therapy may have stronger evidence than ...

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The aim of this paper is to provide a scoping review of the literature on cultural adaptations of SUD treatment for Latinx communities.

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pmc.ncbi.nlm.nih.gov

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Our study found CAIs to be a promising approach for reducing substance use and related consequences. We call for more efficacy/effectiveness and implementation ...

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Abstract. Purpose: To examine the characteristics and effects of culturally adapted substance use interventions with Latino adolescents on.