Adolescent Behavior clinical trials at University of California Health
3 in progress, 1 open to eligible people
open to eligible people ages 11-14
Adolescence is a time of biological and behavioral changes that can lead to risky and dangerous behaviors, and African-American youth are highly vulnerable to the consequences of risky behavior, including HIV/AIDS and violence, leading to premature death. The investigators previously showed that an intervention program reduces HIV-risk vulnerability behaviors in many African-American youth. The investigators aim to measure how the program affects different regions of the brain in order to better prevent or reduce such risky behaviors among African-American youth.
at UC Irvine
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As most adolescents visit a healthcare provider once a year, health behavior change interventions linked to clinic-based health information technologies hold significant promise for improving healthcare quality and subsequent behavioral health outcomes for adolescents (Baird, 2014, Harris, 2017). Recognizing the potential to leverage recent advances in machine learning and interactive narrative environments, the investigators are now well positioned to design health behavior change systems that extend the reach of clinicians to realize significant impacts on behavior change for adolescent preventive health. The proposed project centers on the design, development, and evaluation of a clinically-integrated health behavior change system for adolescents. CHANGEGRADIENTS will introduce an innovative reinforcement learning-based feedback loop in which adolescent patients interact with personalized behavior change interactive narratives that are dynamically personalized and realized in a rich narrative-centered virtual environment. CHANGEGRADIENTS will iteratively improve its behavior change models using policy gradient methods for Reinforcement Learning (RL) designed to optimize adolescents' achieved behavior change outcomes. This in turn will enable CHANGEGRADIENTS to generate more effective behavior change narratives, which will then lead to further improved behavior change outcomes. With a focus on risky behaviors and an emphasis on alcohol use, adolescents will interact with CHANGEGRADIENTS to develop an experiential understanding of the dynamics and consequences of their alcohol use decisions. The proposed project holds significant transformative potential for (1) producing theoretical and practical advances in how to realize significant impacts on adolescent health behavior change through novel interactive narrative technologies integrated with policy-based reinforcement learning, (2) devising sample-efficient policy gradient methods for RL that produce personalized behavior change experiences by integrating theoretically based models of health behavior change with data-driven models of interactive narrative generation, and (3) promoting new models for integrating personalized health behavior change technologies into clinical care that extend the effective reach of clinicians.
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Advancement via Individual Determination (AVID) is a college preparatory program that provides a unique opportunity to determine whether schools can reduce substance use by re-grouping at-risk students with high-performing students, while providing additional academic and emotional support. Operating in 4,837 K-12th grade schools worldwide and across 45 US states, this widely-disseminated program targets students from groups traditionally underrepresented in higher education who are currently performing in the academic middle (i.e., a 2.0-3.5 grade point average). AVID removes these students from typical classrooms and exposes them to a peer network in which academic performance and positive social norms are valued. In addition, by strengthening the student/teacher relationship, AVID expands students' networks of supportive adults. For low-income minority students in the academic middle, relatively small investments in prevention might significantly impact their academic and health trajectories. AVID capitalizes on a moment when social networks are in flux-the transition to high school-to shift these students' trajectories. This study is a longitudinal, randomized pilot evaluation of AVID among low-income minority adolescents entering high school, comparing academic performance and drug use, as well as other risky behaviors, over 3 years. Although social networks are hypothesized to have a strong influence on behavior, few studies have tried to re-wire networks to change behaviors. This study will provide a clearer understanding of whether schools can intentionally shape networks and whether these changes can reduce substance use. This study will also explore important mechanistic questions about whether and how AVID changes peer networks and relationships with teachers, whether those changes lead to improvements in academic and behavioral outcomes and, if so, what the relative importance of peer versus adult network changes are.