Using Re-inforcement Learning to Automatically Adapt a Remote Therapy Intervention (RTI) for Reducing Adolescent Violence Involvement
2 other identifiers
interventional
584
1 country
4
Brief Summary
This study will use a randomized control trial (RCT) design to administer two versions of a multisession remote behavioral intervention for youth seeking Emergency Department care for a violent injury with the goal to reduce their violence involvement and associated negative behaviors and consequences. The study examines two versions of the remote therapy intervention - a standard RTI (S-RTI) and an Artificial Intelligence RTI (AI-RTI). The application of a just-in-time adaptive strategy to address youth violence is an important and novel direction for this research, particularly given the need to understand best practices for delivering behavioral interventions among lower-income populations.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started May 2021
Longer than P75 for not_applicable
4 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
March 24, 2021
CompletedFirst Posted
Study publicly available on registry
April 20, 2021
CompletedStudy Start
First participant enrolled
May 19, 2021
CompletedPrimary Completion
Last participant's last visit for primary outcome
February 13, 2026
CompletedStudy Completion
Last participant's last visit for all outcomes
February 13, 2026
CompletedMay 6, 2026
May 1, 2026
4.7 years
March 24, 2021
May 1, 2026
Conditions
Outcome Measures
Primary Outcomes (2)
Change in Aggression
Aggression will be measured at baseline, 6-month follow-up, 12-month follow-up. Conflict Tactic Scale measures have been used in prior work and is scored using a summary score (0=Never; 6=20+ Times).
Baseline, 6-months, 12-months
Change in Victimization
Aggression will be measured at baseline, 6-month follow-up, 12-month follow-up. Conflict Tactic Scale measures have been used in prior work and is scored using a summary score (0=Never; 6=20+ Times).
Baseline, 6-months, 12-months
Study Arms (3)
Remote Therapy Intervention
EXPERIMENTALYouth will receive the maximal dose of six S-RTI therapy sessions delivered by a remote therapist with no alteration in intensity
Artificial Intelligence Remote Therapy Intervention
EXPERIMENTALYouth will first receive a remote therapy session in the Emergency Department (ED). The RL system will then make decisions about the intensity of each subsequent therapy session (the initial decision is seven days post ED visit and bi-weekly \[i.e., every other two weeks\] thereafter) for the next 11 weeks. Potential treatment decisions include a 30-minute remote therapy session delivered via phone or video chat (mirroring the S-RTI), a less intensive tailored Motivational Interviewing (MI)-adherent electronic remote therapy (delivered by an electronic robot), or an assessment only without intervention.
Enhanced Usual Care
NO INTERVENTIONThe youth's retaliatory risk will be assessed and a pamphlet with referrals for violence, substance use, and mental health services will be provided.
Interventions
A single ED session followed by 5 remote therapy sessions
Optimized by reinforcement learning to step up or down the intensity of treatment between three levels based on patient response to daily assessments.
Eligibility Criteria
You may qualify if:
- Youth will be eligible if they screen is positive for seeking treatment in the ED for a violent injury, age 14-24, and report ownership of a smartphone with texting capability and internet access.
You may not qualify if:
- Youth will be excluded if they do not understand English, cannot provide informed consent due to mental incompetence, incarceration or medical instability (unstable patients will be recruited if they stabilize within 72 hours), are 14-17 years old and presenting without an accessible parent/guardian, are presenting for suicide attempt/intent, sexual assault, and/or child abuse (due to high intensity of social services needed for such patients during their ED visit).
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (4)
Grady Health System
Atlanta, Georgia, 30303, United States
Ascension St. John Hospital
Detroit, Michigan, 48236, United States
Hurley Medical Center
Flint, Michigan, 48503, United States
HUP and PPMC
Philadelphia, Pennsylvania, 19104, United States
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- OUTCOMES ASSESSOR
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Associate Professor of Emergency Medicine
Study Record Dates
First Submitted
March 24, 2021
First Posted
April 20, 2021
Study Start
May 19, 2021
Primary Completion
February 13, 2026
Study Completion
February 13, 2026
Last Updated
May 6, 2026
Record last verified: 2026-05
Data Sharing
- IPD Sharing
- Will not share