Mechanisms of Change at the Client and Organizational Level for Selective Prevention Programs Embedded within Juvenile Courts: Results from a Female-Specific Study

Introduction: Knowledge about the mechanisms that drive outcomes for prevention programs can be leveraged for improved program development and implementation in multiple ways. This paper reports findings from a study on the association between hypothesized mechanisms of change and adolescent female substance use, aggression and risk behaviors from a 6-month study in six juvenile courts. We also report results from a qualitative analysis of organizational factors affecting program feasibility from the perspective of court staff involved in implementing services.

Methods: Youth in the study sample were female adolescents, aged 12-17, placed on probation in one of six juvenile courts in Washington State between January through December 2016 (n = 87). Youth were surveyed at baseline and 6 months and were referred to court or community services as usual by probation officers. A significant proportion of youth (n = 50) were referred to a female-specific, cognitive-behavioral based program designed to build emotional, cognitive and relationship skills. Other programs participants received included Aggression Replacement Training, substance use prevention, mental health counseling and youth development programs. Facilitators of services in the participating juvenile courts (n = 12) were interviewed about the fit of programs in court operations, particularly programs facilitated by court staff. Qualitative analysis used a content analysis approach with iterative coding and discussion with the research team (5 coders).

Findings: The results provide preliminary evidence for different mechanisms of effect in drivers of substance use, aggression and risk taking for at risk adolescent girls. Regression analyses indicated that increases in family conflict were associated with increased substance use but not increased fighting or risk taking. Increased use of emotional coping strategies was associated with lower substance use and risk taking but not fighting. Lower fighting was associated with increased impulsivity control. Qualitative analyses highlighted the importance of designing programs that limit complexity and are aligned with court operational goals to reduce recidivism. The findings also highlighted the challenges associated with bringing digital and ehealth technologies into court-based programs.

Conclusions: The findings will be discussed in light of female-specific theories of substance use and risk taking etiology, highlighting the role of family conflict in precipitating harmful behaviors among adolescent girls. The results suggest that programs aiming to address both substance use and delinquency prevention for girls may need to pay particular attention to family climate. Implications for tailoring programs to court contexts will be discussed.