DESCRIPTION (provided by applicant): Compared to both non-offending females and male offending counterparts, offending girls are at significantly greater risk for the development of substance use disorders, psychiatric symptoms and negative health outcomes, such as HIV/AIDS or other sexually transmitted infections (STIs). Research suggests that girls may have different developmental pathways to drug use, initial legal involvement and co-occurring negative health outcomes that support the importance of testing gender-specific treatments for juvenile justice girls. Although there is recent increased emphasis on gender-specific programming in juvenile justice, empirically supported gender specific interventions to improve health, mental health and/or legal outcomes among juvenile justice girls are lacking. The objective of this Stage II treatment trial is therefore to test the efficacy of a pre-existing, widly disseminated gender-responsive drug use treatment (VOICES) among 200 court-involved, non- incarcerated (CINI) girls. We seek to test the effect of VOICES on CINI girls' drug and alcohol use, HIV/STI risk, psychiatric symptoms and recidivism as well as explore moderators and mediators of outcomes. CINI girls, ages 12-18 (N= 6 juveniles for Phase I Intervention Run-Through; N=200 for Phase II RCT study) will be recruited from the Rhode Island Family Court and randomized to either the VOICES (active) intervention (n=100) or a Standard of Care (control) condition (n=100). In Phase I (first six months of Year 1), 6 juveniles will be recruitedto complete the Intervention Run-Through and research assessment once to allow testing of RCT intervention and assessment procedures prior to the RCT phase. In Phase II (last half of Year 1 through Year 4), 200 juveniles will be recruited and randomized at baseline and then re-assessed at mid-treatment, end of treatment, and 3, 6, 9 and 12 month post-intervention follow-ups. Biological specimens for juvenile drug use and sexually transmitted infections (STIs) will also be collected at each 3-month assessment. Efficacy trial results can be used to make immediate changes to current widespread program delivery resulting in direct impact on the field of evidence-based gender-responsive substance use interventions for juvenile justice girls.

PUBLIC HEALTH RELEVANCE: Girls in the juvenile justice system have unique developmental pathways to drug use and co-occurring risk (e.g., HIV/STI) behaviors that have typically not been considered or tested in order to identify evidence-based gender-specific substance use treatment approaches for this population. This study will advance scientific knowledge and clinical practice in the drug treatment and public health fields by testing the efficacy of a pre- existing, widely disseminated gender-responsive substance use treatment (VOICES) on drug use and HIV/STI risk behavior outcomes for a broad range of substance-using, court-involved, non-incarcerated girls.