Developing a tailored mHealth app for legal guardians/caregivers of youth in aftercare for substance use : a theory-driven and user-centered approach.

Adolescent substance use occurs at alarming rates. Despite these high rates of use, few teenagers obtain treatment. Those who do, return to use at significant rates posttreatment, suggesting that there are gaps in current treatments for adolescents who use substances. Behavioral parent training has positive effects on substance use treatment outcomes for adolescents. However, parents have difficulty participating in treatment because of barriers to access, initiation, and engagement. The use of mHealth apps to disseminate behavioral parent training for adolescent substance use is a possible solution to overcome barriers. However, there are no current behavioral-focused mHealth apps for parents of adolescents who use substances. mHealth apps are best developed through a participant-centered design that incorporates the lived experiences and perceptions of the end-user. Therefore, the present study sought to provide formative work for the development of an mHealth app for parents of adolescents engaged in substance use. This study used a participant-centered, mixed-methods design to recruit parents into a two-part study. Part One included a sample of 36 parents who were surveyed on their use of specific monitoring and supervision practices. Analyses were conducted to determine the frequency of use, and whether the use of specific practices is associated with adolescent age, gender, and substance use treatment history. Part Two included a follow-up interview (N=12) to examine parental lived experiences of using monitoring and supervision methods. Interviews were coded for perceived effectiveness, experience (positive or negative), and barriers to engaging in monitoring and supervision practices. Results indicated minimal differences in monitoring and supervision practices across adolescent age, gender, and substance use histories. Parents provided eleven different methods of monitoring and supervising their teenagers and provided effectiveness, lived experiences, and barriers associated with each method. Active methods of parental monitoring and supervision were determined as being the most effective methods of monitoring and supervising adolescents with substance use histories. Monitoring and supervision practices as well as methods to develop content for an mHealth app for parents of youth with substance use histories are discussed.