Evidence map›Paper›PMID 40346641›Full record

ArticleBMC health services research2025

Advancing access to substance use prevention for foster youth through digital innovation: an open trial of fostrspace with court appointed special advocate programs.

Marina Tolou-Shams, Johanna B Folk, Margareth V Del Cid, Jannet Lara Salas, Alison Czopp, Juan Carlos Gonzalez, Tylia Lundberg, Erin Michelle Turner Kerrison, Martha Shumway, Ann Wrixon and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Marina Tolou-ShamsDepartment of Psychiatry and Behavioral Sciences|Weill Institute for Neurosciences, University of California, San Francisco, Zuckerberg San Francisco General Hospital, Pride Hall 2540 23rd street, San Francisco, CA, 94110, USA. Marina.tolou-shams@ucsf.edu.
Johanna B FolkDepartment of Psychiatry and Behavioral Sciences|Weill Institute for Neurosciences, University of California, San Francisco, Zuckerberg San Francisco General Hospital, Pride Hall 2540 23rd street, San Francisco, CA, 94110, USA.
Margareth V Del CidDepartment of Psychiatry and Behavioral Sciences|Weill Institute for Neurosciences, University of California, San Francisco, Zuckerberg San Francisco General Hospital, Pride Hall 2540 23rd street, San Francisco, CA, 94110, USA.
Jannet Lara SalasDepartment of Psychiatry and Behavioral Sciences|Weill Institute for Neurosciences, University of California, San Francisco, Zuckerberg San Francisco General Hospital, Pride Hall 2540 23rd street, San Francisco, CA, 94110, USA.
Alison CzoppDepartment of Psychiatry and Behavioral Sciences|Weill Institute for Neurosciences, University of California, San Francisco, Zuckerberg San Francisco General Hospital, Pride Hall 2540 23rd street, San Francisco, CA, 94110, USA.
Juan Carlos GonzalezDepartment of Psychiatry and Behavioral Sciences|Weill Institute for Neurosciences, University of California, San Francisco, Zuckerberg San Francisco General Hospital, Pride Hall 2540 23rd street, San Francisco, CA, 94110, USA.
Tylia LundbergDepartment of Psychiatry and Behavioral Sciences|Weill Institute for Neurosciences, University of California, San Francisco, Zuckerberg San Francisco General Hospital, Pride Hall 2540 23rd street, San Francisco, CA, 94110, USA.
Erin Michelle Turner KerrisonSchool of Social Welfare, University of California, Berkeley, 120 Haviland Hall, Berkeley, CA, 94720, USA.
Martha ShumwayDepartment of Psychiatry and Behavioral Sciences|Weill Institute for Neurosciences, University of California, San Francisco, Zuckerberg San Francisco General Hospital, Pride Hall 2540 23rd street, San Francisco, CA, 94110, USA.
Ann WrixonCASA of Contra Costa County, 2151 Salvio Street, Ste. 295, Concord, CA, 94520, USA.
Robert SalgadoCASA of Contra Costa County, 2151 Salvio Street, Ste. 295, Concord, CA, 94520, USA.
Jill Duerr BerrickSchool of Social Welfare, University of California, Berkeley, 120 Haviland Hall, Berkeley, CA, 94720, USA.

Funding

Substance Use Disorders Treatment/Services Research Training ProgramT32DA007250 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Derek D Satre, Janice Y Tsoh · 1991 to 2026
$7.4M
Mentoring to reduce substance use for youth in the juvenile justice system.K24DA046569 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MARINA TOLOU-SHAMS · 2019 to 2026
$1.5M
Reducing Parenting Stress to Facilitate Justice-Involved Youth’s Treatment EngagementK23DA050798 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI FOLK, JOHANNA BAILEY · 2021 to 2025
$1.1M
CASA and FostrSpace: Systems delivery of digital substance use prevention tools to foster youthR61DA059860 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI TOLOU-SHAMS, MARINA · 2024 to 2024
$582k
NIDA NIH HHS K23 DA050798NIDA NIH HHS K23DA050798NIDA NIH HHS K24 DA046569NIDA NIH HHS R61059860NIDA NIH HHS R61 DA059860NIDA NIH HHS T32 DA007250NIDA NIH HHS T32DA007250
6 · The paper itself

Abstract

backgroundAdolescents in foster care report high rates of mental health needs, yet intervention access remains limited. Substance use commonly co-occurs with mental health symptoms, but availability of substance use services for foster youth is even more scant than mental health services. Technology has advanced access to behavioral health care across the lifespan, but only for certain sectors of the population. Little research focuses on leveraging technology to advance access for foster youth. We report open trial findings, as a precursor to launching a large-scale implementation science trial, on how a U.S. nationwide serving support system for foster youth, Court Appointed Special Advocates (CASA), might be leveraged to expand access to substance use prevention resources via the FostrSpace app. FostrSpace provides asynchronous resources and synchronous navigator, peer support, and direct clinical intervention. A concurrent 6-session ECHO® substance use prevention telementoring curriculum was co-developed as a FostrSpace implementation strategy with a 6-member CASA Advisory Board.

methodsSeven youth-CASA dyads enrolled in the open trial. We used a mixed-methods design (quantitative assessment and qualitative exit interviews) to assess feasibility and acceptability of ECHO® sessions (CASA-only) and the usability of the FostrSpace app (youth-only).

resultsSix of seven of the youth accessed the app at least once, but a majority reported the app log-in process was burdensome and unappealing, thereby limiting them from frequently using the app. All youth rated the app features, design and content as appealing, helpful and relevant. ECHO® -FostrSpace session attendance was high (most attended 5 or more sessions) and CASAs found the content highly engaging and useful, especially regarding CASA-youth substance use communication skills.

conclusionsTechnological barriers, such as log-in burden, can prevent youth in need from accessing relevant services and must be regularly assessed and resolved. Substance use education and skills-building for CASAs is novel and a viable implementation strategy to increase foster youth access to digital behavioral health services innovations. Substance use prevention content should be integrated within discussions on youth mental health and trauma to be most engaging and relevant. Findings are informing the subsequent hybrid implementation-effectiveness trial design of FostrSpace with 400 youth-CASA dyads across 10 CASA programs in California.

trial registrationRetrospectively registered.

Indexed as

Child, FosterFoster Home CareHealth Services AccessibilityMobile ApplicationsSubstance-Related DisordersAdolescentFemaleHumansMaleTelemedicineUnited StatesDigital behavioral health interventionFoster youthMental healthSubstance use

Identifiers

PMID40346641
PMCPMC12065223

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.