Methods: One hundred and thirty self-identified substance using girls and young women (ages 12-24) who are either at-risk for justice involvement (referred from the schools) or already justice-involved (referred from juvenile probation, diversion and court) will be enrolled. To date, the study has enrolled 92 female participants (46 school-based, 46 justice-involved). Participants are randomized to receive the VOICES or GirlHealth (psychoeducational attention control condition), each of which consists of 12, 1 hour group-based sessions, delivered weekly. Groups are delivered in the schools or in the community (for justice-involved, e.g., at probation offices) by trained study staff facilitators. Participants are assessed (using tablet-based questionnaires) at baseline, 1, 3, 6 and 9 months post-baseline.
Findings: Baseline data suggest that the trial is reaching the intended sample of justice-involved (or at risk for) substance using girls with co-occurring mental health symptoms and sexual risk behavior (e.g., 68% are sexually active, 41% used a condom at last sex and 34% with above clinical cut-off scores on the Brief Symptom Inventory). Examples of organizational and system-level challenges that have impacted the ongoing trial include: system referral gatekeeping (that limits access to girls in need), no single available time and/or community location for girls on probation to attend an outpatient group, multiple family moves, inaccessibility of caregivers for minor girls’ consent, differing youth and school/class schedules, long existing curriculum (originally 18, 90 minute sessions) and reliable reporting of substance use (for eligibility) in the context of justice involvement.
Conclusions: Preliminary efficacy trial outcomes will be discussed in light of these real-world efficacy trial challenges; in particular, how they impact interpretation of trial findings and how they inform next steps in translating findings to the community. Results will inform next steps for implementation science studies of gender-responsive substance use treatment programs for justice-involved girls.