A Pilot Investigation of a Mobile Application-Enhanced Mindfulness-Based Preventive Intervention Targeting Adolescent Conduct Problems

Project Summary/Abstract Adolescent conduct problems, such as aggression, defiance, violence, and criminality, represent a major public health concern with substantial costs to individuals, their families, and larger society. Current evidence-based programming addressing adolescent conduct problems is resource intensive and has limited effectiveness. The proposed R34 study will investigate the feasibility of using a mindfulness-based intervention (MBI) as a new approach to preventing escalations in conduct problems among at-risk youth in a school setting. MBIs have been demonstrated to support the development of effective self-control, a key risk factor underlying adolescent conduct problems. However, MBIs have not previously been evaluated for their effectiveness in preventing the development of serious conduct problems. Notably, previous implementations of MBIs with adolescents have been limited by a lack of generalization of mindfulness skills in daily life, particularly during times of stress. The proposed study will enhance an existing evidence-based MBI, Learning to BREATHE (L2B), with a recently-developed mobile app designed to support greater generalization of skills in daily life and times of stress. The proposed study will be completed in two primary phases, including Phase 1, a small pilot feasibility- focused 3-arm RCT will assign youth (n=120) to either the standard L2B intervention, L2B+App, or Skills for Success, an active control life skills intervention. We will address four primary aims. Aim 1 will focus on refining the implementation (n=10) of L2B enhanced by the mobile app (i.e., L2B+App), and Phase 2, in which a L2B+App intervention, including app usability, app functioning and features, integration with face-to-face programming, and cultural responsiveness of the integrated app. Focus groups and facilitator feedback from the Phase 1 pilot implementation will support refinement prior to the Phase 2 feasibility RCT. Further refinement will be supported by additional participant focus groups and facilitator interviews in Phase 2. Aim 2 will evaluate the feasibility of research procedures in the Phase 2 3-arm RCT, including our ability to reach recruitment, enrollment, and retention of participants, randomization procedures, and data collection procedures acceptability, appropriateness, engagement, feasibility, and fidelity of delivery i.e., L2B, L2B+App, and Skills for Success) with a focus on achieving benchmarks in each area. Finally, Aim 4 involves using a mixed-methods approach to refine all protocols, including facilitator training, intervention implementation, and research procedures, in preparation for a subsequent fully-powered efficacy trial. Successful completion of these aims will provide critical preliminary data required for the efficacy trial. benchmarks in . Aim 3 will evaluate the of the three interventions ( Moreover, the proposed research will demonstrate the potential of app- based strategies for enhancing delivery of mindfulness skills in at-risk youth. This program of research has the potential to innovate our approach to preventing adolescent conduct problems through the incorporation of mindfulness techniques as well as reduce the high costs and burden associated with these behaviors.