SecondACT: Developing and Adapting a Technology-Enhanced Intervention to Reduce Recidivism and Relapse to Partner Violence and Substance Use Among Young Black Men

Rush Research Team

Chuka Nestor Emezue, Principal Investigator, Rush University College of Nursing

Wrenetha Julion, Co-Investigator and Mentor, Rush University College of Nursing

Award Period

March 1, 2022  - June 30, 2023

Funding Source 

Rush BMO Institute for Health Equity


Intimate partner violence (IPV) and problematic substance use are co-occurring and complex public health problems contributing to substance use–related aggression and violence among young males. Substance use is implicated in 40-80% of all partner violence incidents, and drug court programs report higher program completion rates for non-Hispanic White clients (65%), compared to Hispanic (52%) and Black/African American clients (45%). Despite the threat of incarceration for failing to complete court-mandated programs, Black men are 2.5 times more likely than White men to drop out of these programs. Reasons for program non-completion include racism, systemic distrust, logistical issues (e.g., long drives to treatment, program cost), treatment stigma, competing life demands (e.g., keeping a job, childcare), and substance misuse. Despite this significant co-occurring burden, minority youths report unique difficulties in obtaining services across the prevention, treatment, and recovery continuum.

In general, service options for Black men with substance dependencies who are also domestically violent are subpar. In most cases, the only resources available to them are escalating alternatives such as police and court involvement. As a result, minority men seek out informal avenues for recovery, including online resources with conflicting or error-prone information. Additionally, the pandemic has disrupted rehabilitation and ongoing treatment venues, revealing a critical need for scalable, interactive, and stable interventions accessible at home. Furthermore, there is a crucial need for provider-mediating services for treatment-curious males as well as ongoing care models for men who have previously completed programs (i.e., booster interventions), given the high rate of recidivism to IPV (50% re-abuse within three months and 75% within six months of program intake).

Young Black men (YBM) from disinvested communities are particularly underserved. Evidence suggests they are “digital natives” (they have higher per time use of technology and daily internet use) and prefer digital health interventions to face-to-face modalities to target behavioral and functional outcomes. After completing a treatment program, this period is a crucial window of opportunity to deliver a booster intervention to reduce the risk of relapse to problematic substance use and recidivism to partner abuse. Specifically, digital interventions delivered online or through smartphone apps can assist program completers in maintaining learned behaviors and skills and may also be beneficial to treatment-curious individuals who want to change.

Building on my prior research in male-specific violence prevention and digital health intervention design, the proposed study will utilize user-centered design principles and the ADAPT-ITT framework to develop and adapt the ‘SecondACT’ intervention for YBM in Chicago and surrounding areas. This intervention will be based on the evidence-based Acceptance and Commitment Therapy (or ACT) and builds on the Achieving Change Through Values-Based Behavior, shown in effectiveness trials to reduce domestic violence and general criminality among incarcerated men and women. In addition, SecondACT will co-locate resources for 1) psychoeducation and safety planning, 2) life skills and mindfulness coaching, 3) risk assessment/screening, and 4) a location-based service referral directory. This co-location of services moves current prevention approaches from “why” change to “how” to change and will not only divert YBM from risky behaviors but teach them how to learn and master positive coping strategies and mindfully plan for a safe and values-based lifestyle.

We will address the following specific aims: Aim 1) Identify culturally salient and positive masculinity needs, existing resources, trauma-informed drivers of behavior, technology use patterns, and barriers to technology use for provider mediation. Using focus groups, 1:1 in-depth interviews, and needs elicitation wishlisting activities with service providers and young Black males, 18-24 years. Aim 2) Develop a low-fidelity wireframe (or clickable mockup) of the SecondACT intervention with multiple stakeholder input and co-design sessions with an advisory panel that will 1) recommend psychoeducation and life skills content needed to prevent relapse and recidivism to substance use and partner violence, respectively (or IPV+SUD), 2) preferred delivery modalities for this intervention (text, quizzes, chatbot, and video) targeting IPV+SUD prevention and treatment disparities; 3) recommend content tone, phrasing, and aesthetics, and 4) identify barriers and facilitators impacting this mode of intervention. The long-term goal of this research is to develop and implement a digital intervention to mitigate social and structural barriers to help-seeking and prevent recidivism to violence and relapse to substance use among Young Black males (ages 18-24).