# CASA and FostrSpace: Systems delivery of digital substance use prevention tools to foster youth

> **NIH NIH R61** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2024 · $582,040

## Abstract

PROJECT SUMMARY
Youth in foster care have documented higher rates of substance use and unmet behavioral health needs than
youth who are not involved in the child welfare system. Social determinants of health (e.g., child maltreatment,
community violence) have been consistently identified as driving increased likelihood of substance use among
foster youth and may also explain why those who use substances also experience high rates of co-occurring
mental health needs. Access to substance use prevention interventions is sorely limited in part due to
inadequate linkage between child welfare and behavioral health serving systems but also due to other factors
such as stigma, lack of intervention options that include peers with lived experiences and lack of intervention
tailoring to unique needs. Behavioral intervention technologies (BITs) hold great promise to increase access to
youth substance use prevention interventions. Participatory technology co-design approaches allow for foster
youth to tailor technology interventions to their relevant multiple social and contextual drivers of health
vulnerability and inherently reduce stigma and build youth engagement because peers with lived experience
drive BIT design and content. FostrSpace is a BIT co-designed with foster youth that provides tailored
substance use prevention resources, services navigation, direct peer supports and direct in-app access to
evidence-based substance use and mental health (SU/MH) interventions. To promote successful uptake and
utilization of stand-alone technology for underserved populations such as Fostrspace, however, research
indicates additional systems and structural level intervention is required. Court Appointed Special Advocates
(CASA) are community volunteers who support and advocate for the needs of abused and/or neglected children
and who hold promise as facilitators for foster youth SU/MH services referrals. Evidence-based telementoring
and training models such as Extension for Community Health Outcomes (ECHO) have been highlighted as a
crucial strategy for expanding SU/MH services access. This study, in partnership with California CASA
programs, will study ECHO's effectiveness as an implementation strategy to facilitate FostrSpace referrals from
CASA volunteers and assess FostrSpace's reach and effectiveness in preventing SU among foster youth. RE-
AIM (Reach Effectiveness-Adoption Implementation Maintenance) and PRISM (Practical Robust
Implementation and Sustainability Model) frameworks guide aims. The R61 phase (Planning/Exploratory) will
include peer and CASA co-design meetings for implementation strategy (ECHO) and intervention (FostrSpace)
adaptation, open trial and R33 trial planning. The Hybrid II R33 trial mixed-methods design will test
effectiveness of FostrSpace in preventing progression of youth substance use and effectiveness of ECHO as
implementation strategy to increase reach of FostrSpace through CASA programs using a cluster randomized
controlled tr...

## Key facts

- **NIH application ID:** 10810339
- **Project number:** 1R61DA059860-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** MARINA TOLOU-SHAMS
- **Activity code:** R61 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $582,040
- **Award type:** 1
- **Project period:** 2024-03-01 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10810339

## Citation

> US National Institutes of Health, RePORTER application 10810339, CASA and FostrSpace: Systems delivery of digital substance use prevention tools to foster youth (1R61DA059860-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10810339. Licensed CC0.

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