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Buckner JD, Vargo LA, Thomas KL. The relations of difficulties in emotion regulation and distress intolerance with cannabis problems: The role of protective behavioral strategies underutilization. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024:209462. [PMID: 39059769 DOI: 10.1016/j.josat.2024.209462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/28/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024]
Abstract
INTRODUCTION Difficulties with emotion regulation and distress tolerance are related to more cannabis problems, yet little research has identified why this is the case. Cannabis-related protective behavioral strategies (PBS; behaviors used to mitigate cannabis related problems) are related to less cannabis consumption and related problems. Potentially, these individuals may use cannabis to alleviate the distress and/or in an attempt to regulate their emotions. Thus, the present study aimed to examine the mediational role of PBS on the relations of emotion dysregulation and distress intolerance with cannabis problems. METHODS Undergraduate students who endorsed past-month cannabis use (N = 339, Mage = 19.33, SDage = 1.37; 77.9 % female) at a southern United States university completed a survey online via Qualtrics. RESULTS More emotion dysregulation and less distress tolerance predicted less PBS use and more cannabis problems, but not cannabis use frequency. After statistically controlling for sex, the relation of each transdiagnostic factor with cannabis problems occurred indirectly via the relations of less PBS use and greater cannabis use frequency CONCLUSIONS: The present study supports previous claims that emotion dysregulation and distress intolerance are related to more cannabis problems. Additionally, results suggest that individuals with high levels of these problems underutilize PBS which, in turn, is associated with more frequent cannabis use and use-related problems. Clinical implications are discussed.
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Affiliation(s)
- Julia D Buckner
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, USA.
| | - Luke A Vargo
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Katharine L Thomas
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, USA
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Kunchay S, Linden-Carmichael AN, Abdullah S. Using a Smartwatch App to Understand Young Adult Substance Use: Mixed Methods Feasibility Study. JMIR Hum Factors 2024; 11:e50795. [PMID: 38901024 PMCID: PMC11224702 DOI: 10.2196/50795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 03/14/2024] [Accepted: 04/08/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Young adults in the United States exhibit some of the highest rates of substance use compared to other age groups. Heavy and frequent substance use can be associated with a host of acute and chronic health and mental health concerns. Recent advances in ubiquitous technologies have prompted interest and innovation in using technology-based data collection instruments to understand substance use and associated harms. Existing methods for collecting granular, real-world data primarily rely on the use of smartphones to study and understand substance use in young adults. Wearable devices, such as smartwatches, show significant potential as platforms for data collection in this domain but remain underused. OBJECTIVE This study aims to describe the design and user evaluation of a smartwatch-based data collection app, which uses ecological momentary assessments to examine young adult substance use in daily life. METHODS This study used a 2-phase iterative design and acceptability evaluation process with young adults (aged 18-25 y) reporting recent alcohol or cannabis use. In phase 1, participants (8/15, 53%) used the data collection app for 14 days on their Apple Watches to report their substance use patterns, social contexts of substance use, and psychosocial risk factors (eg, affect). After this 14-day deployment, the participants completed a user experience survey and a semistructured interview to record their perspectives and experiences of using the app. Formative feedback from this phase informed feature modification and refinement of the app. In phase 2, an additional cohort (7/15, 47%) used the modified app for 14 days and provided feedback through surveys and interviews conducted after the app use period. RESULTS Analyses of overall app use patterns indicated high, consistent use of the app, with participants using the app for an average of 11.73 (SD 2.60) days out of 14 days of data collection. Participants reported 67 instances of substance use throughout the study, and our analysis indicates that participants were able to respond to ecological momentary assessment prompts in diverse temporal and situational contexts. Our findings from the user experience survey indicate that participants found the app usable and functional. Comparisons of app use metrics and user evaluation scores indicate that the iterative app design had a measurable and positive impact on users' experience. Qualitative data from the participant interviews highlighted the value of recording substance use patterns, low disruption to daily life, minimal overall burden, preference of platforms (smartphones vs smartwatches), and perspectives relating to privacy and app use in social contexts. CONCLUSIONS This study demonstrated the acceptability of using a smartwatch-based app to collect intensive, longitudinal substance use data among young adults. The findings document the utility of smartwatches as a novel platform to understand sensitive and often-stigmatized behaviors such as substance use with minimal burden.
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Affiliation(s)
- Sahiti Kunchay
- College of Information Sciences and Technology, The Pennsylvania State University, University Park, PA, United States
| | - Ashley N Linden-Carmichael
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, United States
| | - Saeed Abdullah
- College of Information Sciences and Technology, The Pennsylvania State University, University Park, PA, United States
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Gex KS, Leone RM, Aungst J, Branson K, Gray KM, Tomko RL. Identifying brief intervention factors to improve cannabis related outcomes in adolescents and young adults: A systematic review of sample characteristics and intervention components. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 161:209335. [PMID: 38490335 PMCID: PMC11090745 DOI: 10.1016/j.josat.2024.209335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/19/2023] [Accepted: 03/12/2024] [Indexed: 03/17/2024]
Abstract
INTRODUCTION Prior systematic and meta-analytic reviews observed mixed evidence for the efficacy of cannabis brief interventions (BIs). Inconsistent support for cannabis BIs may be the result of intersecting methodological factors, including intervention structure and content, participant eligibility criteria, and outcome assessment measures. The current systematic review of cannabis BI studies narratively synthesizes these data to guide intervention development decision-making in future cannabis BI studies (PROSPERO CRD42022285990). METHODS We searched PubMed/MEDLINE, PsycINFO, and CINAHL databases in January 2022 and again in June 2023 to capture newly published studies. Studies were included if they were a randomized trial, enrolled adolescents (13-17) and/or young adults (18-30), specified cannabis use and/or problems inclusion criteria, and evaluated a cannabis BI (defined as ≤4 sessions). We extracted and synthesized data on intervention characteristics (e.g., components, length/duration, modality), cannabis inclusion criteria and recruitment setting, baseline cannabis use descriptives and treatment-seeking status, and outcome assessment measures to discern if/how they may intersect to determine intervention efficacy. The Cochrane Risk of Bias Tool 2 assessed study quality. RESULTS Our search resulted in a final sample of 25 study records including 4094 participants. Recruitment setting seemed to provide an influential backdrop for how well inclusion criteria determined baseline cannabis use level, as well as for the type/length of the BI evaluated. Motivational interviewing (MI) and personalized feedback (PF) were the most frequently used BI components overall; however, some differences were observed in the proportion of BIs with reported intervention effects using MI vs. PF. Frequency of use days was the most commonly used outcome measure, although this may not be the most sensitive measure for assessing cannabis BI efficacy. CONCLUSIONS Our systematic review indicates that cannabis BI studies require greater precision in their design, giving special attention to matching the content and structure of the BI to the needs of the target population and selecting outcomes commensurate to the goals of the BI and the target population to more accurately reflect the efficacy of the BI. However, consistent with prior reviews, all included studies demonstrated at least some concerns for risk of bias, and most were at high risk.
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Affiliation(s)
- Kathryn S Gex
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, United States.
| | - Ruschelle M Leone
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Jenna Aungst
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN, United States
| | - Kevin Branson
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Rachel L Tomko
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, United States
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Murphy JG, Dennhardt AA, Utzelmann B, Borsari B, Ladd BO, Martens MP, White HR, Yurasek AM, Campbell KW, Witkiewitz K. A pilot trial of a brief intervention for cannabis use supplemented with a substance-free activity session or relaxation training. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2024; 38:255-268. [PMID: 38271079 PMCID: PMC11065625 DOI: 10.1037/adb0000988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVE Cannabis use is increasing among college students and commonly co-occurs with anxiety symptoms in this age group. Interventions that reduce anxiety may also reduce cannabis use. Behavioral economic theory suggests that substance use reductions are most likely when there is an increase in substance-free reinforcement. This randomized pilot trial evaluated the efficacy of a brief motivational intervention (BMI) for cannabis supplemented by either a substance-free activity session (SFAS) or a relaxation training (RT) session for reducing cannabis use, problems, craving, and anxiety symptoms. METHOD One hundred thirty-two college students (Mage = 19.9; 54% female; 67% White, 31% Black) who reported five or more past-month cannabis use days were randomized to: (a) assessment-only (AO); (b) BMI plus SFAS; or (c) BMI plus RT. Participants in the BMI conditions received two individual counselor-administered sessions plus a brief phone booster session. Outcomes were evaluated 1- and 6-months postintervention. RESULTS Relative to assessment, both BMI + SFAS and BMI + RT were associated with significant reductions in cannabis problems and craving at 1-month follow-up, and significant reductions in anxiety at 6-month follow-up. Relative to AO, BMI + RT was associated with significant reductions in cannabis use at 1-month follow-up. There were no differences between BMI conditions. CONCLUSIONS This pilot trial was not adequately powered to conclusively evaluate relative efficacy but provides preliminary support for the short-term efficacy of both two-session interventions for reducing anxiety and cannabis-related risk among nontreatment seeking emerging adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- James G. Murphy
- Department of Psychology, University of Memphis, 400 Innovation Dr., Memphis, TN, 38152 United States
| | - Ashley A. Dennhardt
- Department of Psychology, University of Memphis, 400 Innovation Dr., Memphis, TN, 38152 United States
| | - Bettina Utzelmann
- Department of Psychology, University of Memphis, 400 Innovation Dr., Memphis, TN, 38152 United States
| | - Brian Borsari
- Mental Health Service (116B) San Francisco VA Health Care System, 4150 Clement Street, San Francisco, CA 94121, United States
- Department of Psychiatry and Behavioral Sciences, University of California – San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, United States
| | - Benjamin O. Ladd
- Department of Psychology, Washington State University Vancouver, 14204 NE Salmon Creek Ave, Vancouver, WA 98686-9600, United States
| | - Matthew P. Martens
- College of Education, University of Missouri, 118D Hill Hall, Columbia, MO 65211, United States
| | - Helene R. White
- Center of Alcohol and Substance Studies, Rutgers, the State University of New Jersey, 607 Allison Road, Piscataway, NJ 08854, United States
| | - Ali M. Yurasek
- Department of Health Education and Behavior, University of Florida, FLG16, Gainesville, FL 32611, United States
| | - Kevin W. Campbell
- Department of Psychology, University of Memphis, 400 Innovation Dr., Memphis, TN, 38152 United States
| | - Katie Witkiewitz
- Department of Psychology, Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, 2650 Yale SE, Albuquerque, NM 87131, United States
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Klamert L, Craike M, Bedi G, Kidd S, Pascoe MC, Parker AG. Underreporting of implementation strategies and barriers in physical activity interventions for young people at risk of problematic substance use: a brief report. Implement Sci Commun 2024; 5:45. [PMID: 38649968 PMCID: PMC11036629 DOI: 10.1186/s43058-024-00578-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 04/05/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Several studies have assessed whether physical activity interventions can reduce substance use in young people at risk of problematic substance use. This report identifies and describes the reporting of implementation characteristics within published studies of physical activity interventions for young people at risk of problematic substance use and provides recommendations for future reporting. METHODS Reported implementation strategies (including intervention manualization), barriers, implementation fidelity, and personnel acceptance were extracted from studies of physical activity interventions for young people aged 12-25 years at risk of problematic substance use that were included in a previous systematic review of intervention efficacy. RESULTS Implementation strategies were reported in less than half of the included studies (42.9%), implementation barriers in only 10.7% of studies, intervention fidelity in 21.4%, and personnel acceptance in a single study (3.6%). CONCLUSIONS Results indicate insufficient reporting of implementation strategies, barriers, fidelity, and personnel acceptance. Consideration of implementation characteristics is essential for implementing physical activity interventions in practice. Inadequate or limited reporting of these characteristics may contribute to delayed uptake and adoption of evidence-based interventions in clinical practice. Recommendations to improve the reporting of implementation information include integrating standards for reporting implementation characteristics into existing reporting guidelines, developing an international taxonomy of implementation strategies, and upskilling intervention researchers in the fundamentals of implementation science.
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Affiliation(s)
- Lisa Klamert
- Institute for Health and Sport, Victoria University, 70/104 Ballarat Rd, Footscray, VIC, 3011, Australia.
- , Orygen, Parkville, VIC, 3052, Australia.
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, 3052, Australia.
| | - Melinda Craike
- Institute for Health and Sport, Victoria University, 70/104 Ballarat Rd, Footscray, VIC, 3011, Australia
- Mitchell Institute for Education and Health Policy, Victoria University, Footscray, VIC, 3011, Australia
| | - Gillinder Bedi
- , Orygen, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, 3052, Australia
| | - Susan Kidd
- Institute for Health and Sport, Victoria University, 70/104 Ballarat Rd, Footscray, VIC, 3011, Australia
- Acute Care Service, Tweed Byron Mental Health, Northern NSW Health District, Lismore, Australia
| | - Michaela C Pascoe
- Institute for Health and Sport, Victoria University, 70/104 Ballarat Rd, Footscray, VIC, 3011, Australia
| | - Alexandra G Parker
- Institute for Health and Sport, Victoria University, 70/104 Ballarat Rd, Footscray, VIC, 3011, Australia
- , Orygen, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, 3052, Australia
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Gray BA, Bolts OL, Fitzke RE, Douglass MA, Pedersen ER, Prince MA. Using Latent Profile Analysis to Examine Cannabis Use Contexts: Associations with Use, Consequences, and Protective Behaviors. Subst Use Misuse 2023; 59:208-217. [PMID: 37846065 DOI: 10.1080/10826084.2023.2267112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
OBJECTIVE College students represent a large portion of the population, and report high rates of cannabis use and related negative outcomes, including interpersonal problems, risky behaviors, or physical dependency. The contexts in which students use cannabis (e.g., at a party, when feeling down or depressed, after a fight with a loved one) likely affect their risk of experiencing consequences. We aimed to discern profiles of cannabis use contexts and compare profiles on use frequency, consequences, and the use of cannabis protective behavioral strategies (PBS). METHOD College students were surveyed regarding their cannabis use contexts, frequency, consequences, and PBS use (n = 265; female = 72.8%). We used Latent Profile Analysis to identify patterns of cannabis use contexts and auxiliary testing to compare profiles on use frequency, consequences, and PBS use. RESULTS Our examination revealed three latent profiles of cannabis use. The Social Use Profile was associated with use in predominantly social/uplifting contexts. The Physical & Emotional Pain Profile was also associated with use in these contexts but was defined by additional use in response to pain. The All Contexts Profile was associated with frequent use in all contexts, including those that were least endorsed by the other profiles. Profiles differed in cannabis use frequency, PBS use, and the number of consequences experienced, such that profiles were more likely to be associated with more frequent cannabis use, higher risk of experiencing use-consequences, and using fewer PBS as the number of use contexts increased across the profiles. CONCLUSIONS The contexts in which people use cannabis are associated with cannabis risk and protection. Prevention and intervention efforts may benefit from considering contexts of cannabis use.
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Affiliation(s)
- Bethany A Gray
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Olivia L Bolts
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Reagan E Fitzke
- Department of Psychiatry and Behavioral Sciences, University of Southern California; Keck School of Medicine, Los Angeles, California, USA
| | - Morgan A Douglass
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Eric R Pedersen
- Department of Psychiatry and Behavioral Sciences, University of Southern California; Keck School of Medicine, Los Angeles, California, USA
| | - Mark A Prince
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
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Bonar EE, Goldstick JE, Tan CY, Bourque C, Carter PM, Duval ER, McAfee J, Walton MA. A remote brief intervention plus social media messaging for cannabis use among emerging adults: A pilot randomized controlled trial in emergency department patients. Addict Behav 2023; 147:107829. [PMID: 37598642 DOI: 10.1016/j.addbeh.2023.107829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/22/2023]
Abstract
INTRODUCTION Interventions addressing cannabis use among emerging adults (ages 18-25) are currently needed to prevent negative outcomes. Emergency Department (ED) visits provide an opportunity to initiate interventions. In this pilot study, we created a brief intervention (BI), extended with private social media messaging for emerging adult ED patients who use cannabis regularly. Study aims were to examine intervention feasibility, acceptability, and descriptive outcomes. METHODS We recruited and randomized N = 58 emerging adults (M age 21.5 years, 65.5% female) who used cannabis from an ED in-person and remotely after their ED visit (given COVID-19 restrictions). Participants randomized to the intervention (N = 30) received a Motivational Interviewing-based BI and 4 weeks of health coaching via private social media; control participants received a resource brochure and entertaining social media messaging. Follow-ups occurred at 1-month and 3-months. RESULTS Most intervention participants liked the BI (95.8%), found it helpful to discuss cannabis use in the BI (91.7%), and liked interacting with coaches on social media (86.3%). Social media content (e.g., video clips, images/still pictures/memes) were highly rated. Descriptively, the intervention group showed theory-consistent changes in importance of and intentions to change cannabis (increases vs. decrease/stability in control group), whereas findings for cannabis consumption/consequences were mixed. CONCLUSIONS This BI paired with social media messaging was acceptable in a sample of emerging adults from an ED who used cannabis regularly. Despite feasibility challenges due to COVID-19, this intervention warrants future investigation with a larger sample and longer follow-up period, with attention to the changing cannabis landscape when measuring outcomes.
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Affiliation(s)
- Erin E Bonar
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA; Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA.
| | - Jason E Goldstick
- Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA; Department of Emergency Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA; Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Chiu Yi Tan
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA.
| | - Carrie Bourque
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA.
| | - Patrick M Carter
- Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA; Department of Emergency Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA; Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA; Emergency Medicine, Hurley Medical Center, 1 Hurley Plaza, Flint, MI 48503, USA.
| | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
| | - Jenna McAfee
- Department of Anesthesiology, University of Michigan, Burlington Building, 325 E. Eisenhower Parkway, Ann Arbor, MI 48108, USA.
| | - Maureen A Walton
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA; Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA.
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Klamert L, Craike M, Bedi G, Kidd S, Pascoe MC, Parker AG. Behaviour change techniques in physical activity-focused interventions for young people at risk of problematic substance use: A systematic review and meta-analysis. Early Interv Psychiatry 2023; 17:1139-1153. [PMID: 37749782 DOI: 10.1111/eip.13467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/06/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023]
Abstract
AIM This systematic review investigates behaviour change techniques in interventions promoting physical activity for young people aged 12-25 years at heightened risk of problematic substance use, and the effect of these techniques on physical activity participation and substance use outcomes. METHODS Four databases (PsycINFO, CINAHL, SPORTDiscus and Medline) were searched between November 2020 and November 2022 for randomized and non-randomized controlled studies according to inclusion criteria. Meta-analyses were calculated using weighted, standardized averages of effect sizes (Hedges' g). RESULTS Twenty-eight studies were included, 14 studies in the meta-analysis (intervention n = 1328; control n = 845). Reported BCTs included behavioural instructions, social comparison and goal setting. There was a significant effect of behaviour change techniques on combined substance use outcomes, such as cravings and consumption, for interventions reporting multiple behaviour change techniques (g = -0.33, p < .001, 95% CI [-0.50,-0.16]) or one single behaviour change technique (g = -1.84, p < .001, 95% CI [-2.89,-0.8]). Limitations include unexplained variance and limited reporting of relevant behaviour change technique data in the included studies. CONCLUSION The results indicate that using behaviour change techniques in interventions that promote physical activity for young people has an effect on substance use. Further research needs to be completed comparing the impact of the number and type of behaviour change technique, and improved reporting of intervention content is required.
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Affiliation(s)
- Lisa Klamert
- Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Melinda Craike
- Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
- Mitchell Institute for Education and Health Policy, Victoria University, Footscray, Victoria, Australia
| | - Gillinder Bedi
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | - Susan Kidd
- Acute Care Service, Tweed Byron Mental Health, Northern NSW Health District, Tweed Heads, Australia
| | - Michaela C Pascoe
- Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
| | - Alexandra G Parker
- Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
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Zhu Y, Zhu J, Song G. The impact of aerobic exercise training on cognitive function and gut microbiota in methamphetamine-dependent individuals in the community. Physiol Behav 2023; 270:114302. [PMID: 37474085 DOI: 10.1016/j.physbeh.2023.114302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/27/2023] [Accepted: 07/17/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE This study aimed to investigate the impact and mechanism of gut microbiota on the enhancement of cognitive function in methamphetamine (MA)-dependent individuals during aerobic exercise training. METHODS A total of sixty-four MA-dependent individuals were randomly assigned to either an aerobic exercise training group (DK, n = 32) or a conventional rehabilitation group (CK, n = 32). After an eight-week intervention, the participants' working memory and inhibition ability were assessed using the Stroop paradigm and Go/NoGo paradigm, respectively. Gut microbiota composition was analyzed using high-throughput sequencing. RESULTS 1) Eight weeks of aerobic exercise training significantly improved the working memory and inhibition ability of MA-dependent individuals (P < 0.05). 2) Following the intervention, the DK group exhibited significantly higher levels of Lactobacillus, Lactococcus lactis, Prevotellaceae, and Ruminococcaceae compared to the CK group. Conversely, the DK group demonstrated significantly lower levels of Desulfovibrio and Akkermansia compared to the CK group. Furthermore, the DK group showed significantly increased metabolic pathways associated with d-Glutaralate and d-Galactate Degradation, as well as the Alanine, aspartate, and glutamate metabolism pathway, compared to the control group. 3) Cognitive function related to MA addiction positively correlated with Bifidobacterium, Dialister, and Adlercreutzia, while negatively correlated with Enterobacteria, Bacillus cereus, Catabacter, and Akkermansia. CONCLUSION Aerobic exercise training enhances working memory and inhibition ability in MA-dependent individuals, thereby mitigating the detrimental effects of MA addiction on cognitive function. Additionally, analysis of gut microbiota suggests that the modulation of gut microbiota and associated metabolic pathways play a role in regulating the improvement of cognitive function in MA-dependent individuals through exercise.
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Affiliation(s)
- Yuping Zhu
- Key Lab of Physical Fitness Evaluation and Motor Function Monitoring, College of Physical Education, Southwest University, Chongqing, 400715, China
| | - Jiang Zhu
- Key Lab of Physical Fitness Evaluation and Motor Function Monitoring, College of Physical Education, Southwest University, Chongqing, 400715, China
| | - Gang Song
- Key Lab of Physical Fitness Evaluation and Motor Function Monitoring, College of Physical Education, Southwest University, Chongqing, 400715, China.
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Manthey J, Pons‐Cabrera MT, Rosenkranz M, Lopez‐Pelayo H. Measuring cannabis quantities in online surveys: A rapid review and proposals for ways forward. Int J Methods Psychiatr Res 2023; 32:e1971. [PMID: 37089041 PMCID: PMC10485338 DOI: 10.1002/mpr.1971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/04/2023] [Accepted: 04/15/2023] [Indexed: 04/25/2023] Open
Abstract
OBJECTIVES Cannabis use quantities are relevant for determining cannabis-related harms. This research aims to provide an overview of the available methods to assess quantities through self-report. METHODS A rapid review of various strategies to collect information on cannabis use quantities through self-report. Two independent literature searches resulted in n = 38 studies included for review. RESULTS A total of n = 14 studies employed methods for collecting cannabis use quantities that are not suitable for online surveys (e.g., rolling a fake joint). Of the remaining n = 24 studies with items that are suitable for online surveys, the quantity assessment was performed in three different ways. The data collection was either carried out by asking (a) for the total number of joints (i.e., crude joint method), (b) for the total weight (i.e., crude weight method), or (c) for specific products separately, for example, for the amount of flower and resin (i.e., product-specific method). In only n = 8 studies, cannabis use quantities were ascertained by providing visual aids (e.g., illustration of various amounts of flower). CONCLUSIONS The crude joint method and the product-specific method are the two most promising methods to collect information on cannabis use quantities. Using visual aids may potentially improve the accuracy of those methods.
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Affiliation(s)
- Jakob Manthey
- Department of Psychiatry and PsychotherapyCenter for Interdisciplinary Addiction Research (ZIS)University Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany
- Department of PsychiatryMedical FacultyUniversity of LeipzigLeipzigGermany
| | - Maria Teresa Pons‐Cabrera
- Grup de Recerca en Addicions ClínicInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)Unitat de Conductes AddictivesServei de Psiquiatria Psicologia (ICN)Hospital Clínic de BarcelonaBarcelonaSpain
| | - Moritz Rosenkranz
- Department of Psychiatry and PsychotherapyCenter for Interdisciplinary Addiction Research (ZIS)University Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany
| | - Hugo Lopez‐Pelayo
- Grup de Recerca en Addicions ClínicInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)Unitat de Conductes AddictivesServei de Psiquiatria Psicologia (ICN)Hospital Clínic de BarcelonaBarcelonaSpain
- Red de Investigación en Atención Primaria de Adicciones (RIAPAd)BarcelonaSpain
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11
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Bou Nassif Y, Rahioui H, Varescon I. Psychological Interventions for Cannabis Use among Adolescents and Young Adults: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6346. [PMID: 37510578 PMCID: PMC10380066 DOI: 10.3390/ijerph20146346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/22/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
Regular cannabis use during adolescence can lead to cognitive, psychological, and social consequences, causing significant distress. Although psychological interventions are the mainstay type of treatment for cannabis use disorder, the results remain mixed among youths. The objective of this review is twofold: to identify the existing psychological interventions for cannabis use among youths, and to assess the evidence regarding the effectiveness of those interventions. Randomized controlled trials focused exclusively on cannabis use among adolescents and young adults were included. Three databases-Embase, PsycInfo, and PubMed-were searched to identify relevant peer-reviewed manuscripts published before February 2022 in English and French. The risk of bias was assessed using the Cochrane Collaboration's tool. Twenty-five randomized controlled trials were included. Fourteen studies reported a significant outcome related to cannabis use. These were mainly non-intensive, online interventions that aimed to improve the patients' relationships and emotion regulation. This review highlights the need to conduct additional randomized control trials that target cannabis use disorder specifically among adolescents. These randomized control trials should also aim to reduce the risk of bias related to psychiatric comorbidities as well as detection and attrition problems.
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Affiliation(s)
- Yara Bou Nassif
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, 92100 Boulogne Billancourt, France
- Consultations en Addictologie pour Adolescent, Centre des Troubles de Neuro-Développement chez l'Adulte, Groupe Hospitalier Universitaire, Site Sainte-Anne, 75014 Paris, France
| | - Hassan Rahioui
- Consultations en Addictologie pour Adolescent, Centre des Troubles de Neuro-Développement chez l'Adulte, Groupe Hospitalier Universitaire, Site Sainte-Anne, 75014 Paris, France
| | - Isabelle Varescon
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, 92100 Boulogne Billancourt, France
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12
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Fontana TJK, Schulz JA, Budney AJ, Villanti AC. Feasibility and utility of a structured guide for cannabis tolerance breaks in young adults. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-5. [PMID: 36595624 PMCID: PMC10315416 DOI: 10.1080/07448481.2022.2155061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/02/2022] [Accepted: 10/07/2022] [Indexed: 06/17/2023]
Abstract
Objective: To explore the feasibility and utility of a tolerance break (T-Break) guide on young adults' cannabis use. Participants: Young adults aged 18-29 (n = 125) who were current cannabis users. Methods: Participants recruited through posters and listservs at various universities were offered the T-Break Guide-daily activities, advice, and encouragement-to help complete a 21-day cannabis break. Bivariate analyses examined associations between Guide use and follow-up measures. Results: Compared to non-Guide users, participants who used the Guide "a lot" were more likely to complete the 21-day abstinence break (84% vs. 57%), revise their personal definition of balance to mean less cannabis (84% vs. 62%), and plan a future break (32% vs. 11%). Conclusion: Use of this self-directed T-Break Guide may help young adults take a break from cannabis use and reduce future use. Further research using more rigorous designs to test the Guide's efficacy and assess longer-term maintenance of effects is needed.
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Affiliation(s)
- Thomas J K Fontana
- Center for Health & Wellbeing, University of Vermont, Burlington, VT, USA
| | - Jonathan A Schulz
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Alan J Budney
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Dartmouth College, Lebanon, NH, USA
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health and Rutgers Center for Tobacco Studies, New Brunswick, NJ, USA
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13
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Bonar EE, Chapman L, Pagoto S, Tan CY, Duval ER, McAfee J, Collins RL, Walton MA. Social media interventions addressing physical activity among emerging adults who use cannabis: A pilot trial of feasibility and acceptability. Drug Alcohol Depend 2023; 242:109693. [PMID: 36442441 DOI: 10.1016/j.drugalcdep.2022.109693] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/31/2022] [Accepted: 11/05/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE Cannabis use is common among emerging adults (ages 18-25), yet few prevention interventions have targeted this unique developmental period. Physical activity (PA) is an under-utilized intervention target for cannabis use, despite research showing its potential utility. Based on prior promising social media-delivered interventions targeting cannabis and PA separately, we developed and piloted, in a randomized controlled feasibility trial (NCT04901910), interventions for emerging adults who use cannabis that focused on PA. PROCEDURES Using social media, we recruited 60 emerging adults (Mean age=21.7 years; 63.3% female sex) who used cannabis (>=3 times/week for the past month) and could engage in PA. We randomized participants into one of 3 conditions (PA-Only; PA+Cannabis, Attention-Control) that each lasted 8 weeks and were delivered in secret Facebook groups by health coaches. We collected follow-up data at 3- and 6-months post-group start. Outcomes are presented descriptively given the pilot nature and limited sample size. RESULTS The interventions were rated favorably, with ratings of the content in each condition averaging around 3 on a 5-point scale. Both intervention groups demonstrated larger reductions in cannabis consequences and cannabis-impaired driving over time than the control condition. Findings were mixed regarding patterns of change in cannabis use in the intervention conditions. Proportions of group members reporting increased PA ranged from 38.9% to 80.0% across time. CONCLUSIONS Interventions targeting PA and delivered via social media to emerging adults who regularly use cannabis offer a novel intervention target. These interventions warrant future investigation in larger trials over a longer follow-up period.
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Affiliation(s)
- Erin E Bonar
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA; Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA; Center for Sexuality and Health Disparities, University of Michigan, 400 North Ingalls Street, Ann Arbor, MI 48109, USA.
| | - Lyndsay Chapman
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - Sherry Pagoto
- Department of Allied Health Sciences, University of Connecticut, 2006 Hillside Road, Unit 1248, Storrs, CT 06268, USA
| | - Chiu Yi Tan
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA
| | - Jenna McAfee
- Department of Anesthesiology, University of Michigan, Back and Pain Center, 325. E. Eisenhower Parkway, Building 1, Ann Arbor, MI 48108, USA
| | - R Lorraine Collins
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, 3435 Main Street, Buffalo, NY 14214, USA
| | - Maureen A Walton
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA; Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA
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14
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Dlima SD, Shevade S, Menezes SR, Ganju A. Digital Phenotyping in Health Using Machine Learning Approaches: Scoping Review. JMIR BIOINFORMATICS AND BIOTECHNOLOGY 2022; 3:e39618. [PMID: 38935947 PMCID: PMC11135220 DOI: 10.2196/39618] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 06/29/2024]
Abstract
BACKGROUND Digital phenotyping is the real-time collection of individual-level active and passive data from users in naturalistic and free-living settings via personal digital devices, such as mobile phones and wearable devices. Given the novelty of research in this field, there is heterogeneity in the clinical use cases, types of data collected, modes of data collection, data analysis methods, and outcomes measured. OBJECTIVE The primary aim of this scoping review was to map the published research on digital phenotyping and to outline study characteristics, data collection and analysis methods, machine learning approaches, and future implications. METHODS We utilized an a priori approach for the literature search and data extraction and charting process, guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews). We identified relevant studies published in 2020, 2021, and 2022 on PubMed and Google Scholar using search terms related to digital phenotyping. The titles, abstracts, and keywords were screened during the first stage of the screening process, and the second stage involved screening the full texts of the shortlisted articles. We extracted and charted the descriptive characteristics of the final studies, which were countries of origin, study design, clinical areas, active and/or passive data collected, modes of data collection, data analysis approaches, and limitations. RESULTS A total of 454 articles on PubMed and Google Scholar were identified through search terms associated with digital phenotyping, and 46 articles were deemed eligible for inclusion in this scoping review. Most studies evaluated wearable data and originated from North America. The most dominant study design was observational, followed by randomized trials, and most studies focused on psychiatric disorders, mental health disorders, and neurological diseases. A total of 7 studies used machine learning approaches for data analysis, with random forest, logistic regression, and support vector machines being the most common. CONCLUSIONS Our review provides foundational as well as application-oriented approaches toward digital phenotyping in health. Future work should focus on more prospective, longitudinal studies that include larger data sets from diverse populations, address privacy and ethical concerns around data collection from consumer technologies, and build "digital phenotypes" to personalize digital health interventions and treatment plans.
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15
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Côté J, Cossette S, Auger P, Page G, Coronado-Montoya S, Fontaine G, Chicoine G, Rouleau G, Genest C, Lapierre J, Pedersen ER, Jutras-Aswad D. Psychometric properties of the French and English short form of the Protective Behavioural Strategies for Marijuana Scale in Canadian university students. BMJ Open 2022; 12:e053715. [PMID: 35387810 PMCID: PMC8987794 DOI: 10.1136/bmjopen-2021-053715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The Protective Behavioural Strategies for Marijuana (PBSM-17) scale serves to identify and measure strategies employed by young adults before, during or after cannabis use. After the adaptation and translation of the PBSM-17 into French, a methodological study was conducted to evaluate the psychometric properties of this French version (FV) and of the original English version (EV) in a sample of bilingual Canadian university students. METHODS A total of 211 cannabis users (mean age=22.1 years) completed a sociodemographic questionnaire, a question on frequency of cannabis use (four categories: 1-3 times a month, once a week, more than once a week, everyday) and both versions (FV and EV) of the PBSM-17. RESULTS Both versions had similar internal reliability (α=0.91; α=0.88). The one-factor solution explained 36.46% of the variance for the FV and 42.26% for the EV. As hypothesised, greater use of protective behavioural strategies was related to lower frequency of cannabis use. One-way ANOVA test results revealed a statistically significant difference in use of strategies by frequency of cannabis use for both the FV (F(3, 207)=27.38, p<0.001) and EV (F(3, 207)=29.32, p<0.001). Post hoc comparisons showed that everyday users employed fewer strategies on average than lower-frequency users. CONCLUSION The FV and EV of the PBSM-17 demonstrated satisfactory psychometric properties. The proposed FV of the PBSM-17 is a reliable instrument that could be used for research and clinical purposes. Protective behavioural strategies can serve as indicator of lower-risk cannabis use and could be targeted in prevention interventions.
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Affiliation(s)
- José Côté
- Centre de Recherche du CHUM, Montreal, Québec, Canada
- Université de Montréal, Montreal, Québec, Canada
| | | | | | - Gabrielle Page
- Centre de Recherche du CHUM, Montreal, Québec, Canada
- Université de Montréal, Montreal, Québec, Canada
| | | | - Guillaume Fontaine
- Research Center, Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | | | | | - Eric R Pedersen
- University of Southern California, Los Angeles, California, USA
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16
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Lewis MA, Litt DM, Fairlie AM, Kilmer JR, Kannard E, Resendiz R, Walker T. Investigating Why and How Young Adults Utilize Protective Behavioral Strategies for Alcohol and Marijuana Use: Protocol for Developing a Randomized Controlled Trial (Preprint). JMIR Res Protoc 2022; 11:e37106. [PMID: 35438642 PMCID: PMC9066324 DOI: 10.2196/37106] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Melissa A Lewis
- Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Dana M Litt
- Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Anne M Fairlie
- Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Jason R Kilmer
- Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Emma Kannard
- Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Raul Resendiz
- Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Travis Walker
- Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, United States
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17
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Factores que diferencian el consumo frecuente y esporádico de marihuana en estudiantes universitarios. ACTA COLOMBIANA DE PSICOLOGIA 2021. [DOI: 10.14718/acp.2022.25.1.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Aunque el consumo de marihuana es altamente prevalente entre universitarios de Argentina, poco se sabe respecto a los factores que permiten distinguir a los consumidores frecuentes de marihuana de quienes consumen esporádicamente. Por esta razón, en el presente trabajo se indagó sobre las posibles variaciones en los contextos de consumo, motivos de consumo, normas percibidas y estrategias conductuales de protección entre universitarios con consumo frecuente o esporádico de marihuana, y se analizó la utilidad de este conjunto de variables para distinguir entre estos los tipos de consumidores mencionados. Para ello, se contó con una muestra de 1083 estudiantes universitarios argentinos que completó una encuesta en línea sobre el consumo de sustancias. En particular, este trabajo se realizó con la submuestra que reportó consumir marihuana en los últimos 30 días (n = 158; 51.3 % mujeres). Dicha encuesta interrogaba sobre el consumo de marihuana y las consecuencias negativas asociadas, así como por motivos de consumo, normas sociales percibidas y estrategias conductuales de protección. Como resultado, los consumidores frecuentes presentaron mayor cantidad de consecuencias negativas (M = 4.92) que los consumidores esporádicos (M = 1.82; p ≤ .05), y se halló un perfil distintivo en un conjunto de variables. A nivel multivariado, los motivos de animación (or = 1.230; p ≤ .05), las estrategias conductuales de protección (or = .941; p ≤ .05), el consumo en solitario (or = 2.024; p ≤ .05) y el consumo en fiestas universitarias (or = 2.669; p ≤ .05) discriminaron significativamente entre ambas clases de consumidores. En general, los hallazgos revelaron subpoblaciones heterogéneas de consumidores de marihuana que difieren no solo en el consumo y sus consecuencias, sino también en los contextos de consumo y en un conjunto de variables relevantes. Estas subpoblaciones distintivas requieren de intervenciones diferentes y específicas.
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18
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Richards DK, Schwebel FJ, Bravo AJ, Pearson MR. A comparison of cannabis protective behavioral strategies use across cultures and sex. Addict Behav 2021; 120:106966. [PMID: 34020169 DOI: 10.1016/j.addbeh.2021.106966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cannabis protective behavioral strategies (PBS) are behaviors used before, during, after, and/or instead of cannabis use to reduce consumption, intoxication, and related harms. To leverage PBS to address the global health burden of cannabis use, especially in light of the changes in cannabis-related policies around the world, a better understanding of PBS across cultures is needed. In the present study, we conduct a cross-cultural examination of cannabis PBS use among college students. METHOD Participants were 1175 college students (U.S. [n = 697], Argentina [n = 153], Uruguay [n = 46], Spain [n = 169], and the Netherlands [n = 66]) who reported past-month cannabis use (63.3% female; Mage = 20.96, SD = 3.95). RESULTS We found differences in the frequency of cannabis PBS use across countries such that the U.S. and Spain samples reported the most frequent cannabis PBS use and the Netherlands sample reported the least frequent cannabis PBS use. Although not statistically significant, we found that cannabis PBS use was positively correlated with cannabis-related outcomes (i.e., frequency, quantity, and negative consequences of cannabis use) among the Argentina and the Netherlands samples. Finally, across all countries but the Netherlands, females reported more frequent cannabis PBS use than males, but the associations of PBS with cannabis-related outcomes were larger for males than females. CONCLUSIONS Given preliminary evidence for cultural differences in cannabis PBS use, future research is needed to better understand the cultural factors underlying these differences to inform the delivery of interventions aimed at reducing the harms of cannabis among college students.
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Affiliation(s)
- Dylan K Richards
- Center on Alcohol, Substance Use, And Addictions (CASAA), University of New Mexico, United States.
| | - Frank J Schwebel
- Center on Alcohol, Substance Use, And Addictions (CASAA), University of New Mexico, United States
| | - Adrian J Bravo
- Department of Psychological Sciences, William & Mary, United States
| | - Matthew R Pearson
- Center on Alcohol, Substance Use, And Addictions (CASAA), University of New Mexico, United States
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19
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Blanchard BE, Stevens AK, Littlefield AK. Differences in alcohol-related protective behavioral strategies among female and male college students. Addict Behav 2021; 120:106969. [PMID: 34000650 DOI: 10.1016/j.addbeh.2021.106969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 01/14/2023]
Abstract
Alcohol use is prevalent among college students, and some are at risk for developing alcohol use disorders. However, many students report using alcohol without experiencing negative consequences, which may be due, in part, to use of protective behavioral strategies (PBS). Although evidence of PBS effectiveness on reducing alcohol use and negative consequences is mixed, gender/sex differences in PBS use remain a consistent finding. To further explore these associations, we used item response theory models and assessed item-level PBS correlations with alcohol outcomes separately for female and males. Results indicated specific items exhibited significant sex differences in the amount of information and location of information across the latent trait. Some items provided little information across females and males, suggesting these items can be removed. All PBS items significantly associated with alcohol outcomes were negative in direction, but effects ranged from small to large in magnitude. These findings suggest strategies that are effective against alcohol-related harms vary across females and males, and PBS measurement may be improved by establishing sex-specific norms and analyzing females and males separately when studying PBS. Future research priorities include examining PBS among intersex, trans, and nonbinary people.
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Affiliation(s)
- Brittany E Blanchard
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA.
| | - Angela K Stevens
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI 02912, USA.
| | - Andrew K Littlefield
- Department of Psychological Sciences, Texas Tech University, Psychology Building, Box 42051, Lubbock, TX 79409, USA.
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20
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Mian MN, Altman BR, Luba R, Ueno LF, Dalal D, Earleywine M. Factor analysis of a short form of the Protective Behavioral Strategies for Marijuana scale. Addict Behav 2021; 117:106852. [PMID: 33581678 DOI: 10.1016/j.addbeh.2021.106852] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/13/2020] [Accepted: 01/27/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The Protective Behavioral Strategies for Marijuana Scale (PBSM), a 17-item scale targeting strategies for mitigating the negative consequences of cannabis use, highlights a range of behaviors that can reduce harm beyond straightforward decreases in quantity or frequency. The 17-item scale's factor structure remains under-examined but could reveal meaningful distinctions among strategies. This study aimed to confirm the factor structure of the short form of the PBSM. METHODS This study recruited cannabis-using undergraduates (N = 454,Mage = 19.6, 68.8% female, 39% White), who reported using cannabis approximately 2.3 days per week with mild cannabis-related consequences (CAPQ; M = 9.74). RESULTS A confirmatory factor analysis demonstrated poor fit for the one-factor model of the PBSM, prompting an exploratory factor analysis. Analyses revealed two internally reliable factors: a "Quantity" factor, strategies specific to mitigating overuse and limiting amounts consumed and an "Context" factor loosely related to troubles with others. This two-factor model accounted for over half of the total variance; invariance testing indicated reduced fit as models became more restrictive. Though each of the factors covaried negatively with both days of use and problems, Context had a stronger relation to both variables compared to Quantity. Only Context predicted fewer cannabis problems and use. CONCLUSIONS The two-factor solution suggests further work on the psychometric properties of the scale could provide heuristic information to allow for more nuanced approaches in clinical and research settings. Theoretically, each factor might have novel links to some constructs but not others in ways that could assist harm-reduction strategies and treatment.
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Affiliation(s)
- Maha N Mian
- Department of Psychology, University at Albany, State University of New York, USA.
| | - Brianna R Altman
- Department of Psychology, University at Albany, State University of New York, USA
| | - Rachel Luba
- Department of Psychology, University at Albany, State University of New York, USA
| | - Luna F Ueno
- Department of Psychology, University at Albany, State University of New York, USA
| | - Dev Dalal
- Department of Psychology, University at Albany, State University of New York, USA
| | - Mitch Earleywine
- Department of Psychology, University at Albany, State University of New York, USA
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21
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Mechanisms of change in an adapted marijuana e-CHECKUP TO GO intervention on decreased college student cannabis use. J Subst Abuse Treat 2021; 124:108308. [PMID: 33771289 DOI: 10.1016/j.jsat.2021.108308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/03/2020] [Accepted: 01/19/2021] [Indexed: 11/22/2022]
Abstract
The objective of this study was to test indirect effects of the Marijuana e-CHECKUP TO GO program on college students' frequent marijuana use through decreased use in specific social and academic activities. This study randomly assigned college students who reported frequent marijuana use (i.e., approximately five times per week) in fall 2016 to receive Marijuana e-CHECKUP TO GO or healthy stress management (HSM) strategies. The final baseline sample included 298 participants. Path analyses tested direct program effects on marijuana use at six-week posttest, as well as the indirect effect via use within four activities frequently participated in by college students: socializing, being physically active, studying, and being in class. Direct Marijuana e-CHECKUP TO GO effects on reductions in frequent use were transmitted by decreased marijuana use while studying and no use while socializing, being physically active, or in class. Marijuana e-CHECKUP TO GO may be most effective at reducing use of marijuana among college students while studying.
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Rowland SP, Fitzgerald JE, Holme T, Powell J, McGregor A. What is the clinical value of mHealth for patients? NPJ Digit Med 2020; 3:4. [PMID: 31970289 PMCID: PMC6957674 DOI: 10.1038/s41746-019-0206-x] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/22/2019] [Indexed: 12/14/2022] Open
Abstract
Despite growing interest from both patients and healthcare providers, there is little clinical guidance on how mobile apps should be utilized to add value to patient care. We categorize apps according to their functionality (e.g. preventative behavior change, digital self-management of a specific condition, diagnostic) and discuss evidence for effectiveness from published systematic reviews and meta-analyses and the relevance to patient care. We discuss the limitations of the current literature describing clinical outcomes from mHealth apps, what FDA clearance means now (510(k)/de novo FDA clearance) and in the future. We discuss data security and privacy as a major concern for patients when using mHealth apps. Patients are often not involved in the development of mobile health guidelines, and professionals' views regarding high-quality health apps may not reflect patients' views. We discuss efforts to develop guidelines for the development of safe and effective mHealth apps in the US and elsewhere and the role of independent app reviews sites in identifying mHealth apps for patient care. There are only a small number of clinical scenarios where published evidence suggests that mHealth apps may improve patient outcomes.
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Affiliation(s)
- Simon P. Rowland
- Department of Surgery and Cancer, Imperial College London, London, UK
| | | | - Thomas Holme
- Department of trauma and orthopaedic surgery, Epsom and St Helier University Hospitals NHS, London, UK
| | - John Powell
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Alison McGregor
- Department of Surgery and Cancer, Imperial College London, London, UK
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