NCT04850274

Using Re-inforcement Learning to Automatically Adapt a Remote Therapy Intervention (RTI) for Reducing Adolescent Violence Involvement

• Status: Active Not Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 584 (actual)
• Sponsor: University of Michigan · Academic / Other
• Sex: All
• Age: 14 Years – 24 Years
• Healthy volunteers: Accepted

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.

Detailed description

The Specific Aims for the proposed study are to refine the Remote Therapy Intervention (RTI) for delivery using a standardized remote therapy package (S-RTI; 1 ED + 5 remote sessions) based on a piloted RTI and an adaptive RTI that optimizes bi-weekly dose and intervention intensity between four levels of therapy (remote therapy+, remote therapy; automated electronic tailored therapy; none) based on a reinforcement learning (RL) algorithm \[AI-RTI\]. A total of 750 youth (age=14-24) seeking ED care for a violent injury will be enrolled and randomly assigned (stratified by age/gender) to the S-RTI (n=250), AI-RTI (n=300), and a control (EUC; n=200) condition. In addition to the randomized assignment, all youth will take a daily assessment over the course of the intervention timeline. Outcomes will be assessed at 6 and 12 months.

Conditions

• Violence
• Substance Use
• Criminal Behavior
• Violence in Adolescence

Interventions

Type	Name	Description
BEHAVIORAL	Remote Therapy Intervention (RTI)	A single ED session followed by 5 remote therapy sessions
BEHAVIORAL	Artificial Intelligence Remote Therapy Intervention	Optimized by reinforcement learning to step up or down the intensity of treatment between three levels based on patient response to daily assessments.

Timeline

• Start date: 2021-05-19
• Primary completion: 2026-03-31
• Completion: 2026-03-31
• First posted: 2021-04-20
• Last updated: 2025-10-29

Locations

4 sites across 1 country: United States