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Staton CA, Agnihotri D, Phillips AJ, Ngowi K, Huo L, Boshe J, Sakita F, Tupetz A, Suffoletto B, Mmbaga BT, Vissoci JRN. Development of culturally-appropriate text message booster content to follow a brief intervention focused on reducing alcohol related harms for injury patients in Moshi, Tanzania. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002717. [PMID: 39052647 PMCID: PMC11271911 DOI: 10.1371/journal.pgph.0002717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 06/24/2024] [Indexed: 07/27/2024]
Abstract
Alcohol use is a risk factor for death and disability and is attributed to almost one-third of injury deaths globally. This highlights the need for interventions aimed at alcohol reduction, especially in areas with high rates of injury with concurrent alcohol use, such as Tanzania. The aim of this study is to create a culturally appropriate text messages as a booster to a brief negotiational intervention (BNI), to in the Emergency Department of the Kilimanjaro Christian Medical Centre, Moshi, Tanzania. Creation of text message boosters for an ED-based intervention expands the window of opportunity for alcohol use reduction in this high-risk population. The study followed a two-step approach to create the text message content in English and then translate and culturally adapt to Tanzanian Swahili. The culturalization process followed the World Health Organization's process of translation and adaptation of instruments. Translation, back translation, and qualitative focus groups were used for quality control to ensure text message content accuracy and cultural appropriateness. In total, nearly 50 text messages were initially developed in English, yet only 29 text messages were successfully translated and adapted; they were focused on the themes of Self-awareness, Goal setting and Motivation. We developed culturally appropriate text message boosters in Swahili for injury patients in Tanzania coupled with a BNI for alcohol use reduction. We found it important to evaluate content validation for interventions and measurement tools because the intended text message can often be lost in translation. The process of culturalization is critical in order to create interventions that are applicable and beneficial to the target population. Trial registration: Clinical Trials Registration Number: NCT02828267, NCT04535011.
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Affiliation(s)
- Catherine A. Staton
- Duke Global Health Institute, Global Emergency Medicine Innovation and Implementation Research Center, Duke University, Durham, North Carolina, United States of America
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Deepti Agnihotri
- Duke Global Health Institute, Global Emergency Medicine Innovation and Implementation Research Center, Duke University, Durham, North Carolina, United States of America
| | - Ashley J. Phillips
- Duke Global Health Institute, Global Emergency Medicine Innovation and Implementation Research Center, Duke University, Durham, North Carolina, United States of America
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Kennedy Ngowi
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Lily Huo
- Duke Global Health Institute, Global Emergency Medicine Innovation and Implementation Research Center, Duke University, Durham, North Carolina, United States of America
| | - Judith Boshe
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Francis Sakita
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Clinical Medical University College, Moshi, Tanzania
| | - Anna Tupetz
- Duke Global Health Institute, Global Emergency Medicine Innovation and Implementation Research Center, Duke University, Durham, North Carolina, United States of America
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Brian Suffoletto
- Department of Emergency Medicine, Stanford University, Palo Alto, California, United States of America
| | - Blandina T. Mmbaga
- Duke Global Health Institute, Global Emergency Medicine Innovation and Implementation Research Center, Duke University, Durham, North Carolina, United States of America
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Clinical Medical University College, Moshi, Tanzania
| | - Joao Ricardo Nickenig Vissoci
- Duke Global Health Institute, Global Emergency Medicine Innovation and Implementation Research Center, Duke University, Durham, North Carolina, United States of America
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
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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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Jackson K, Meisel M, Sokolovsky A, Chen K, Barnett N. Detecting and Understanding Social Influence During Drinking Situations: Protocol for a Bluetooth-Based Sensor Feasibility and Acceptability Study. JMIR Res Protoc 2024; 13:e50650. [PMID: 38842927 PMCID: PMC11190624 DOI: 10.2196/50650] [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: 07/07/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND High-risk alcohol consumption among young adults frequently occurs in the presence of peers who are also drinking. A high-risk drinking situation may consist of particular social network members who have a primary association with drinking. Fine-grained approaches such as ecological momentary assessment (EMA) are growing in popularity for studying real-time social influence, but studies using these approaches exclusively rely on participant self-report. Passive indicators of peer presence using Bluetooth-based technology to detect real-time interactions have the potential to assist in the development of just-in-time interventions. OBJECTIVE This study seeks to examine the feasibility and acceptability of using a Bluetooth-based sensor and smartphone app to measure social contact in real-world drinking situations. METHODS Young adults (N=20) who drink heavily and report social drinking will be recruited from the community to participate in a 3-week EMA study. Using a social network interview, index participants will identify and recruit 3 of their friends to carry a Bluetooth beacon. Participants will complete a series of EMA reports on their own personal Android devices including random reports; morning reports; first-drink reports; and signal-contingent reports, which are triggered following the detection of a beacon carried by a peer participant. EMA will assess alcohol use and characteristics of the social environment, including who is nearby and who is drinking. For items about peer proximity and peer drinking, a customized peer list will be presented to participants. Feedback about the study protocol will be ascertained through weekly contact with both index and peer participants, followed by a qualitative interview at the end of the study. We will examine the feasibility and acceptability of recruitment, enrollment of participants and peers, and retention. Feasibility will be determined using indexes of eligibility, enrollment, and recruitment. Acceptability will be determined through participant enrollment and retention, protocol compliance, and participant-reported measures of acceptability. Feasibility and acceptability for peer participants will be informed by enrollment rates, latency to enrollment, compliance with carrying the beacon, and self-reported reasons for compliance or noncompliance with beacon procedures. Finally, EMA data about peer proximity and peer drinking will support the validity of the peer selection process. RESULTS Participant recruitment began in February 2023, and enrollment was completed in December 2023. Results will be reported in 2025. CONCLUSIONS The protocol allows us to examine the feasibility and acceptability of a Bluetooth-based sensor for the detection of social contact between index participants and their friends, including social interactions during real-world drinking situations. Data from this study will inform just-in-time adaptive interventions seeking to address drinking in the natural environment by providing personalized feedback about a high-risk social context and alerting an individual that they are in a potentially unsafe situation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50650.
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Affiliation(s)
- Kristina Jackson
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
| | - Matthew Meisel
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
| | - Alexander Sokolovsky
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
| | - Katie Chen
- Brown University, Providence, RI, United States
| | - Nancy Barnett
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
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Yin H, Zhu H, Gu J, Qin H, Ding W, Guo N, Fu J, Yang Y. Mobile-based ecological momentary assessment and intervention: bibliometric analysis. Front Psychiatry 2024; 15:1300739. [PMID: 38469030 PMCID: PMC10925651 DOI: 10.3389/fpsyt.2024.1300739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 02/07/2024] [Indexed: 03/13/2024] Open
Abstract
Objective The aim of this article was to review existing documents in the field of mobile-based EMA and EMI, provide an overview of current hot topics, and predict future development trends. Methods We conducted a bibliometric study on mobile-based EMA and EMI publications that were collected from the Web of Science Core Collection database. Biblioshiny and CiteSpace were utilized to analyze scientific productions, leading sources, authors, affiliations, documents, research hot topics, keywords, and trend topics. Results A total of 2222 documents related to EMA and EMI published between 1992 and 2023 were retrieved. In recent years, scholarly publications have generally increased in mobile-based EMA and EMI research, particularly in the last decade. JMIR mHealth and uHealth (n=86), as well as JMIR (n=73), showed the highest number of publications. The United States (n=1038), Germany (n=218) and Netherlands (n=175) were leading countries. Regarding keyword co-occurrence and trend topics analysis, mental health, health behaviors, and feasibility were hot topics in mobile-based EMA and EMI research. Future research trends included using EMA for tailoring EMI, just-in-time adaptive interventions (JITAI), and digital phenotyping. Conclusion This bibliometric study on mobile-based EMA and EMI is a valuable resource for understanding the field's evolution and future trends. Our analysis indicates that EMA and EMI have great potential in health behaviors and mental health, but implementation should consider feasibility and reactivity issues carefully. Emerging trends include EMA-tailored EMI, JITAI, and digital phenotyping. In the future, strengthening multidisciplinary cooperation will be necessary to promote the continued development of the field.
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Affiliation(s)
- Hongfan Yin
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Hanjing Zhu
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jia Gu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Hengwei Qin
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenjing Ding
- Reference Department, Library of Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ningyuan Guo
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Jingjing Fu
- Department of Nursing, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Yang
- Department of Nursing, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
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Pedersen ER, Hummer JF, Davis JP, Fitzke RE, Tran DD, Witkiewitz K, Clapp JD. A mobile-based pregaming drinking prevention intervention for college students: A pilot randomized controlled trial. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:841-852. [PMID: 37053413 PMCID: PMC10570401 DOI: 10.1037/adb0000925] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
OBJECTIVE Pregaming is among the riskiest drinking behaviors in which college students engage, often leading to elevated blood alcohol levels and negative alcohol-related consequences. Yet, tailored interventions to reduce risk associated with pregaming are lacking. The present study was designed to develop and evaluate the efficacy of a brief, mobile-based intervention targeting heavy drinking during pregaming among college students, called Pregaming Awareness in College Environments (PACE). METHOD PACE was developed using two innovations to facilitate behavior change: (a) a mobile-based application to increase intervention accessibility and (b) personalized pregaming-specific intervention content delivered using a harm reduction approach with cognitive behavioral skills training. After development and β-testing, we employed a randomized clinical trial with 485 college students who reported pregaming at least once per week in the past month (Mage = 19.98; 52.2% from minoritized racial and/or ethnic groups; 65.6% female). Participants were randomly assigned to PACE (n = 242) or a control condition website (n = 243), which consisted of general information about the effects of alcohol. Analysis assessed intervention effects on pregaming drinking, global drinking, and alcohol-related consequences at 6 and 14 weeks postintervention. RESULTS Although participants in both conditions reduced drinking, small and significant intervention effects favoring PACE were found at 6-week follow-up for overall drinking days, pregaming days, and alcohol-related consequences. CONCLUSIONS Findings suggest the brief mobile PACE intervention has potential to address risky drinking, but more intensive pregaming-focused efforts may be necessary to achieve stronger and lasting effects among college students. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Eric R. Pedersen
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences
- USC Institute for Addiction Science
| | | | - Jordan P. Davis
- USC Institute for Addiction Science
- University of Southern California, Suzanne Dworak-Peck School of Social Work
| | - Reagan E. Fitzke
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences
| | - Denise D. Tran
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences
| | | | - John D. Clapp
- USC Institute for Addiction Science
- University of Southern California, Suzanne Dworak-Peck School of Social Work
- University of Southern California, Keck School of Medicine, Department of Population and Public Health Sciences
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Jovanova M, Cosme D, Doré B, Kang Y, Stanoi O, Cooper N, Helion C, Lomax S, McGowan AL, Boyd ZM, Bassett DS, Mucha PJ, Ochsner KN, Lydon-Staley DM, Falk EB. Psychological distance intervention reminders reduce alcohol consumption frequency in daily life. Sci Rep 2023; 13:12045. [PMID: 37491371 PMCID: PMC10368637 DOI: 10.1038/s41598-023-38478-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 07/09/2023] [Indexed: 07/27/2023] Open
Abstract
Modifying behaviors, such as alcohol consumption, is difficult. Creating psychological distance between unhealthy triggers and one's present experience can encourage change. Using two multisite, randomized experiments, we examine whether theory-driven strategies to create psychological distance-mindfulness and perspective-taking-can change drinking behaviors among young adults without alcohol dependence via a 28-day smartphone intervention (Study 1, N = 108 participants, 5492 observations; Study 2, N = 218 participants, 9994 observations). Study 2 presents a close replication with a fully remote delivery during the COVID-19 pandemic. During weeks when they received twice-a-day intervention reminders, individuals in the distancing interventions reported drinking less frequently than on control weeks-directionally in Study 1, and significantly in Study 2. Intervention reminders reduced drinking frequency but did not impact amount. We find that smartphone-based mindfulness and perspective-taking interventions, aimed to create psychological distance, can change behavior. This approach requires repeated reminders, which can be delivered via smartphones.
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Affiliation(s)
- Mia Jovanova
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA.
| | - Danielle Cosme
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Bruce Doré
- Desautels Faculty of Management, McGill University, Montreal, Canada
| | - Yoona Kang
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Ovidia Stanoi
- Department of Psychology, Columbia University, New York, USA
| | - Nicole Cooper
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Chelsea Helion
- Department of Psychology, Temple University, Philadelphia, USA
| | - Silicia Lomax
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Amanda L McGowan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Zachary M Boyd
- Mathematics Department, Brigham Young University, Provo, USA
| | - Dani S Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, USA
- Department of Electrical & Systems Engineering, University of Pennsylvania, Philadelphia, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, USA
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, USA
- The Santa Fe Institute, Santa Fe, USA
| | - Peter J Mucha
- Department of Mathematics, Dartmouth College, Hanover, USA
| | - Kevin N Ochsner
- Department of Psychology, Columbia University, New York, USA
| | - David M Lydon-Staley
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA
| | - Emily B Falk
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA.
- Department of Psychology, University of Pennsylvania, Philadelphia, USA.
- Wharton Marketing Department, University of Pennsylvania, Philadelphia, USA.
- Wharton Operations, Information and Decisions Department, University of Pennsylvania, Philadelphia, USA.
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Sharma AK, Shadakshari D, Chand P, Murthy P. Design, development and pilot testing of 'Quest', a smartphone-based relapse prevention app for patients with alcohol dependence. Asian J Psychiatr 2023; 83:103572. [PMID: 37019043 DOI: 10.1016/j.ajp.2023.103572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/15/2023] [Accepted: 03/25/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVE To design, develop and pilot the 'Quest' app for smartphone-based relapse prevention for patients diagnosed with alcohol dependence syndrome (ADS). METHODS Principles of relapse prevention and motivation enhancement were used to develop the Quest App. Four addiction psychiatrists reviewed the app using the "app evaluation framework". Thirty patients (> 18 yrs age) diagnosed with ADS, who had an Android smartphone, were fluent in writing and reading English and agreed to use the app regularly for the next three months were enrolled in this study. After initial treatment for intoxication/withdrawal and with written consent, patients in the study group (TAUQ) were requested to download the Quest application from a downloadable installation file. The usability and acceptability of Quest App amongst TAUQ patients was evaluated using the usability section of the mHealth App Usability Questionnaire (MAUQ). The short-term effectiveness at the end of three months was compared between TAUQ and comparison group who received Treatment as Usual (TAU). RESULTS Both acceptability (65 %) and usability (5.8 out of 7) of the app were high. The patient groups (with or without Quest app) showed a significant reduction in drinking at 30, 60, and 90 days follow-up compared with their baseline number of drinking days. There was no significant difference between the two groups (with or without Quest App) in the median number of lapses and the median number of days of heavy drinking. CONCLUSIONS This is the first attempt to develop a smartphone app and test its feasibility in preventing relapse among patients with ADS in the Indian population. Further validation of the app after incorporating feedback and testing on a larger sample size and multiple languages is required.
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Affiliation(s)
- Abhishek Kumar Sharma
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Darshan Shadakshari
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Prabhat Chand
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India.
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
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Mavragani A, Peels DA, Bolman CAW, de Bruijn GJ, Lechner L. Adding Mobile Elements to Online Physical Activity Interventions for Adults Aged Over 50 Years: Prototype Development Study. JMIR Form Res 2023; 7:e42394. [PMID: 36696157 PMCID: PMC9909523 DOI: 10.2196/42394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/14/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Only a minority of adults aged over 50 years meet physical activity (PA) guidelines of the World Health Organization (WHO). eHealth interventions are proven effective tools to help this population increase its PA levels in the short term, among which the Active Plus and I Move interventions have been developed by our own research group. To achieve long-term effects, increase intervention use, and decrease dropout rates, 3 emergent but different mobile elements (an activity tracker, an ecological momentary intervention [EMI] program, and a chatbot) were added separately to Active Plus and I Move. In this study, the prototype development and pilot-testing of these interventions is described. OBJECTIVE This study aims to enhance 2 existing PA-stimulating computer-based interventions with 3 mobile elements (an activity tracker, an EMI program, or a chatbot) and test the prototypes on usability and appreciation within a target population of adults aged over 50 years. METHODS A systematic design protocol consisting of development, evaluation, and adaptation procedures was followed with involvement of the target population. Literature searches separated per mobile element and interviews with the target population (N=11) led to 6 prototypes: Active Plus or I Move including (1) an activity tracker, (2) EMI, or (3) a chatbot. These prototypes were tested on usability and appreciation during pilot tests (N=47) and subsequently fine-tuned based on the results. RESULTS The literature searches and interviews provided important recommendations on the preferences of the target population, which enabled us to develop prototypes. The subsequent pilot tests showed that the mobile elements scored moderate to good on usability, with average System Usability Scale (SUS) scores of 52.2-82.2, and moderate to good on enjoyment and satisfaction, with average scores ranging from 5.1 to 8.1 on a scale of 1-10. The activity tracker received the best scores, followed by EMI, followed by the chatbot. Based on the findings, the activity tracker interventions were fine-tuned and technical difficulties regarding EMI and the chatbot were solved, which is expected to further improve usability and appreciation. CONCLUSIONS During this study, 6 prototypes of online PA interventions with added mobile elements were developed and tested for usability and appreciation. Although all prototypes scored moderate to high on usability, enjoyment, and satisfaction, it can be concluded that the integration of an activity tracker with a computer-based PA intervention is the most promising option among the 3 mobile elements tested during this study. The prototype development steps of the systematic design protocol followed can be considered useful and successful for the purposes of this study. The interventions can now be evaluated on a larger scale through a randomized controlled trial. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/31677.
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Affiliation(s)
| | - Denise A Peels
- Faculty of Psychology, Open Universiteit, Heerlen, Netherlands
| | | | - Gert-Jan de Bruijn
- Department of Communication Science, University of Antwerp, Antwerp, Belgium
| | - Lilian Lechner
- Faculty of Psychology, Open Universiteit, Heerlen, Netherlands
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Riordan BC, Winter T, Carey KB, Conner TS, Moradi S, Jang K, Reid KE, Mason A, Scarf D. A combined web based intervention and ecological momentary intervention for reducing alcohol use among incoming first-year university students: Results from a three-arm randomised controlled trial. Addict Behav 2023; 136:107471. [PMID: 36081248 DOI: 10.1016/j.addbeh.2022.107471] [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: 01/13/2022] [Revised: 08/16/2022] [Accepted: 08/23/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND The transition from high school to university is associated with increased alcohol use and harm. Web-based interventions (WBIs) and ecological momentary interventions (EMIs) are two methods that have had some success in reducing alcohol use among university students and may be particularly effective if implemented during the transition to university. The aim of the current study was to investigate the effectiveness of a combined WBI and EMI to reduce alcohol use among incoming university students. METHODS Incoming first-year students (n = 783, in 2018 and 2019) were randomized into either a WBI + EMI, WBI-only, or an assessment-only condition. All participants completed online questionnaires before university, after their first and second semester, and reported their alcohol use fortnightly throughout their first year. Those in the WBI + EMI and WBI conditions received online feedback about their drinking (i.e., the WBI) immediately following the pre-university survey. Those in the WBI + EMI were also sent eight EMI messages to their mobile phones during Orientation Week and six EMI messages across the academic year aimed at reducing alcohol harm. RESULTS There were no significant differences between the conditions in Orientation Week drinking, academic year drinking (both "typical" semester or fortnightly drinking), or alcohol-related harms. CONCLUSION A WBI + EMI intervention aimed at the transition to university did not reduce university students' alcohol use. The transition, however, continues to be a period of serious harm where students drink more than any other period.
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Affiliation(s)
- Benjamin C Riordan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.
| | - Taylor Winter
- Department of Psychology, Victoria University of Wellington, Wellington, New Zealand.
| | - Kate B Carey
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912, United States.
| | - Tamlin S Conner
- Department of Psychology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Saleh Moradi
- Department of Psychology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Kyungho Jang
- Department of Psychology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Kelly E Reid
- Department of Psychology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Andre Mason
- Department of Psychology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Damian Scarf
- Department of Psychology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
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Malloy J, Partridge SR, Kemper JA, Braakhuis A, Roy R. Co-design of digital health interventions with young people: A scoping review. Digit Health 2023; 9:20552076231219117. [PMID: 38107986 PMCID: PMC10722957 DOI: 10.1177/20552076231219117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Innovative health promotion strategies are crucial for enhancing global quality of life and curbing premature deaths. Digital health promotion is particularly impactful for young individuals often using internet-connected devices. Collaborative methodologies in digital intervention research offer insights into supporting youth during key life stages, such as adolescence. This review sought to examine the literature on digital health interventions for youth co-designed via participatory frameworks. Methods Following the Joanna Briggs Institute Manual and an adapted Arksey & O'Malley's 6-stage framework, this review utilised the PRISMA-ScR checklist for structured reporting. Peer-reviewed research where young individuals (15-35 years) contributed to digital health intervention design was analysed. Systematic synthesis adhered to Braun & Clarke's Thematic Analysis Guidelines, mapping data to research queries and thematic framework. Results Eighteen articles were systematically synthesised, revealing seven main themes: digital tool, inquiry field, report aim, participatory activities, intervention attributes and behavioural change support. Seventeen distinctive digital health interventions were assessed, mostly within risk mitigation and mental health domains. Predominantly, interventions were web-based, with mental wellness websites emerging as the prevalent tool. User experience testing stood out as the primary reported outcome. Conclusion Several innovative digital health interventions targeting youth have been identified. Platforms including social media, specialised apps, websites and video games are instrumental for health advice and clinical support dissemination, overcoming access and cost barriers. Participatory techniques are integral for the efficacy of digital health resources, encompassing youth aspirations and anticipations. Continued efforts will enrich comprehension of optimal practices in digital health promotion and intervention formulation.
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Affiliation(s)
- Jessica Malloy
- Discipline of Nutrition & Dietetics, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - Stephanie R Partridge
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Joya A Kemper
- Department of Management, Marketing, and Entrepreneurship, University of Canterbury Business School, University of Canterbury, Christchurch, New Zealand
| | - Andrea Braakhuis
- Discipline of Nutrition & Dietetics, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - Rajshri Roy
- Discipline of Nutrition & Dietetics, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
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Howlett N, García-Iglesias J, Bontoft C, Breslin G, Bartington S, Freethy I, Huerga-Malillos M, Jones J, Lloyd N, Marshall T, Williams S, Wills W, Brown K. A systematic review and behaviour change technique analysis of remotely delivered alcohol and/or substance misuse interventions for adults. Drug Alcohol Depend 2022; 239:109597. [PMID: 35963209 DOI: 10.1016/j.drugalcdep.2022.109597] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/22/2022] [Accepted: 08/02/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND There has been a lack of systematic exploration of remotely delivered intervention content and their effectiveness for behaviour change outcomes. This review provides a synthesis of the behaviour change techniques (BCT) contained in remotely delivered alcohol and/or substance misuse approaches and their association with intervention promise. METHODS Searches in MEDLINE, Scopus, PsycINFO (ProQuest), and the Cochrane Library, included studies reporting remote interventions focusing on alcohol and/or substance misuse among adults, with a primary behaviour change outcome (e.g., alcohol levels consumed). Assessment of risk of bias, study promise, and BCT coding was conducted. Synthesis focussed on the association of BCTs with intervention effectiveness using promise ratios. RESULTS Studies targeted alcohol misuse (52 studies) or substance misuse (10 studies), with predominantly randomised controlled trial designs and asynchronous digital approaches. For alcohol misuse studies, 16 were very promising, 17 were quite promising, and 13 were not promising. Of the 36 eligible BCTs, 28 showed potential promise, with seven of these only appearing in very or quite promising studies. Particularly promising BCTs were 'Avoidance/reducing exposure to cues for behaviour', 'Pros and cons' and 'Self-monitoring of behaviour'. For substance misuse studies, three were very promising and six were quite promising, with all 12 BCTs showing potential promise. CONCLUSIONS This review showed remotely delivered alcohol and substance misuse interventions can be effective and highlighted a range of BCTs that showed promise for improving services. However, concerns with risk of bias and the potential of promise ratios to inflate effectiveness warrant caution in interpreting the evidence.
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Affiliation(s)
- Neil Howlett
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK.
| | - Jaime García-Iglesias
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK
| | - Charis Bontoft
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK
| | - Gavin Breslin
- Bamford Centre for Mental Health and Wellbeing, School of Psychology, Ulster University, Cromore Road, Coleraine Co, Antrim BT52 1SA, UK
| | - Suzanne Bartington
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Imogen Freethy
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK
| | - Monica Huerga-Malillos
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK
| | - Julia Jones
- Centre for Research in Public Health and Community Care, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK
| | - Nigel Lloyd
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK
| | - Tony Marshall
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK
| | - Stefanie Williams
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK
| | - Wendy Wills
- Centre for Research in Public Health and Community Care, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK
| | - Katherine Brown
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK
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12
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Walters ST, Mun EY, Tan Z, Luningham JM, Hébert ET, Oliver JA, Businelle MS. Development and preliminary effectiveness of a smartphone-based, just-in-time adaptive intervention for adults with alcohol misuse who are experiencing homelessness. Alcohol Clin Exp Res 2022; 46:1732-1741. [PMID: 35869820 PMCID: PMC9509425 DOI: 10.1111/acer.14908] [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: 03/28/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Adults experiencing homelessness have much higher rates of alcohol misuse than housed individuals. This study describes the development and preliminary effectiveness of a smartphone-based, just-in-time adaptive intervention (JITAI) to reduce alcohol use among adults experiencing homelessness. METHODS We conducted a pilot trial (N = 41; mean age [SD] = 45.2 [11.5]; 19.5% women) of the Smart-T Alcohol JITAI where participants completed brief ecological momentary assessments (EMAs) each day, received personalized treatment messages following each EMA, and accessed on-demand intervention content for 4 weeks. The prediction algorithm and treatment messages were developed based on an independent but similar sample as part of the trial. We examined three drinking outcomes: daily drinking (yes/no), drinks per day, and heavy episodic drinking, controlling for scores on the Alcohol Use Disorders Identification Test (AUDIT) at baseline, age, and sex using quadratic growth curve models. RESULTS Over the 4-week period, participants showed a decline in all alcohol use outcomes. Participants also reported high levels of satisfaction with the JITAI. CONCLUSIONS Use of the Smart-T Alcohol JITAI was well received and provided encouraging evidence that it may reduce any drinking, drinks per day, and heavy episodic drinking among adults experiencing homelessness.
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Affiliation(s)
- Scott T. Walters
- School of Public Health, University of North Texas Health Science Center, Ft. Worth, Texas, USA
| | - Eun-Young Mun
- School of Public Health, University of North Texas Health Science Center, Ft. Worth, Texas, USA
| | - Zhengqi Tan
- School of Public Health, University of North Texas Health Science Center, Ft. Worth, Texas, USA
| | - Justin M. Luningham
- School of Public Health, University of North Texas Health Science Center, Ft. Worth, Texas, USA
| | - Emily T. Hébert
- University of Texas Health Science Center School of Public Health, Austin, Texas, USA
| | - Jason A. Oliver
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Michael S. Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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13
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Perski O, Hébert ET, Naughton F, Hekler EB, Brown J, Businelle MS. Technology-mediated just-in-time adaptive interventions (JITAIs) to reduce harmful substance use: a systematic review. Addiction 2022; 117:1220-1241. [PMID: 34514668 PMCID: PMC8918048 DOI: 10.1111/add.15687] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 09/01/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS Lapse risk when trying to stop or reduce harmful substance use is idiosyncratic, dynamic and multi-factorial. Just-in-time adaptive interventions (JITAIs) aim to deliver tailored support at moments of need or opportunity. We aimed to synthesize evidence on decision points, tailoring variables, intervention options, decision rules, study designs, user engagement and effectiveness of technology-mediated JITAIs for reducing harmful substance use. METHODS Systematic review of empirical studies of any design with a narrative synthesis. We searched Ovid MEDLINE, Embase, PsycINFO, Web of Science, the ACM Digital Library, the IEEE Digital Library, ClinicalTrials.gov, the ISRCTN register and dblp using terms related to substance use/mHealth/JITAIs. Outcomes were user engagement and intervention effectiveness. Study quality was assessed with the mHealth Evidence Reporting and Assessment checklist. FINDINGS We included 17 reports of 14 unique studies, including two randomized controlled trials. JITAIs targeted alcohol (S = 7, n = 120 520), tobacco (S = 4, n = 187), cannabis (S = 2, n = 97) and a combination of alcohol and illicit substance use (S = 1, n = 63), and primarily relied on active measurement and static (i.e. time-invariant) decision rules to deliver support tailored to micro-scale changes in mood or urges. Two studies used data from prior participants and four drew upon theory to devise decision rules. Engagement with available JITAIs was moderate-to-high and evidence of effectiveness was mixed. Due to substantial heterogeneity in study designs and outcome variables assessed, no meta-analysis was performed. Many studies reported insufficient detail on JITAI infrastructure, content, development costs and data security. CONCLUSIONS Current implementations of just-in-time adaptive interventions (JITAIs) for reducing harmful substance use rely on active measurement and static decision rules to deliver support tailored to micro-scale changes in mood or urges. Studies on JITAI effectiveness are lacking.
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Affiliation(s)
- Olga Perski
- Department of Behavioural Science and Health, University
College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Emily T. Hébert
- University of Texas Health Science Center (UTHealth) School
of Public Health, Austin, Texas, USA
| | - Felix Naughton
- Behavioural and Implementation Science Group, School of
Health Sciences, University of East Anglia, Norwich NR4 7UL, UK
| | - Eric B. Hekler
- Herbert Wertheim School of Public Health and Human
Longevity (HWSPH), University of California at San Diego, La Jolla, CA 92093,
USA
- Center for Wireless and Population Health Systems (CWPHS),
Qualcomm Institute and HWSPH, University of California at San Diego, La Jolla, CA
92093, USA
| | - Jamie Brown
- Department of Behavioural Science and Health, University
College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Michael S. Businelle
- TSET Health Promotion Research Center, Stephenson Cancer
Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
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Rodda SN, Bagot KL, Merkouris SS, Youssef G, Lubman DI, Thomas AC, Dowling NA. Gambling Habit Hacker: Protocol for a micro-randomised trial of planning interventions delivered via a Just-In-Time Adaptive Intervention for adult gamblers (Preprint). JMIR Res Protoc 2022; 11:e38919. [PMID: 35881441 PMCID: PMC9364163 DOI: 10.2196/38919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 11/21/2022] Open
Abstract
Background People with gambling problems frequently report repeated unsuccessful attempts to change their behavior. Although many behavior change techniques are available to individuals to reduce gambling harm, they can be challenging to implement or maintain. The provision of implementation support tailored for immediate, real-time, individualized circumstances may improve attempts at behavior change. Objective We aimed to develop and evaluate a Just-In-Time Adaptive Intervention (JITAI) for individuals who require support to adhere to their gambling limits. JITAI development is based on the principles of the Health Action Process Approach with delivery, in alignment with the principles of self-determination theory. The primary objective was to determine the effect of action- and coping planning compared with no intervention on the goal of subsequently adhering to gambling expenditure limits. Methods Gambling Habit Hacker is delivered as a JITAI providing in-the-moment support for adhering to gambling expenditure limits (primary proximal outcome). Delivered via a smartphone app, this JITAI delivers tailored behavior change techniques related to goal setting, action planning, coping planning, and self-monitoring. The Gambling Habit Hacker app will be evaluated using a 28-day microrandomized trial. Up to 200 individuals seeking support for their own gambling from Australia and New Zealand will set a gambling expenditure limit (ie, goal). They will then be asked to complete 3 time-based ecological momentary assessments (EMAs) per day over a 28-day period. EMAs will assess real-time adherence to gambling limits, strength of intention to adhere to goals, goal self-efficacy, urge self-efficacy, and being in high-risk situations. On the basis of the responses to each EMA, participants will be randomized to the control (a set of 25 self-enactable strategies containing names only and no implementation information) or intervention (self-enactable strategy implementation information with facilitated action- and coping planning) conditions. This microrandomized trial will be supplemented with a 6-month within-group follow-up that explores the long-term impact of the app on gambling expenditure (primary distal outcome) and a range of secondary outcomes, as well as an evaluation of the acceptability of the JITAI via postintervention surveys, app use and engagement indices, and semistructured interviews. This trial has been approved by the Deakin University Human Research Ethics Committee (2020-304). Results The intervention has been subject to expert user testing, with high acceptability scores. The results will inform a more nuanced version of the Gambling Habit Hacker app for wider use. Conclusions Gambling Habit Hacker is part of a suite of interventions for addictive behaviors that deliver implementation support grounded in lived experience. This study may inform the usefulness of delivering implementation intentions in real time and in real-world settings. It potentially offers people with gambling problems new support to set their gambling intentions and adhere to their limits. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12622000497707; www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=383568 International Registered Report Identifier (IRRID) DERR1-10.2196/38919
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Affiliation(s)
- Simone N Rodda
- Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
- School of Psychology, Deakin University, Geelong, Australia
- School of Population Health, University of Auckland, Grafton, New Zealand
| | | | | | - George Youssef
- School of Psychology, Deakin University, Geelong, Australia
| | - Dan I Lubman
- Turning Point and Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Anna C Thomas
- School of Psychology, Deakin University, Geelong, Australia
| | - Nicki A Dowling
- School of Psychology, Deakin University, Geelong, Australia
- Melbourne Graduate School of Education, University of Melbourne, Parkville, Australia
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15
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Colonna R, Alvarez L. Characteristics of mobile-based brief interventions targeting substance use among youth: a rapid review. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2051622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Robert Colonna
- Health and Rehabilitation Sciences Graduate Program, Western University, London, Ontario, Canada
| | - Liliana Alvarez
- School of Occupational Therapy, Western University, London, Ontario, Canada
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16
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Lipperman-Kreda S, Mair C, Gruenewald PJ. Ecological momentary assessments of night-time drinking among California adolescents: bases for informing night-time preventive interventions. Addiction 2021; 116:3408-3421. [PMID: 34159671 PMCID: PMC8578195 DOI: 10.1111/add.15623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/30/2020] [Accepted: 06/09/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIM To inform the development of effective night-time preventive interventions, our goal was to assess adolescents' residence (i.e. being at) and transitions across contexts during evening hours and risks for drinking and drinking-related problems in relation to contexts and to these transitions. DESIGN Ecological momentary assessment and survey methods. SETTING Twelve mid-sized cities (50 000-500 000 population) in California, USA from December 2014 to September 2015. ANALYTICAL SAMPLE A total of 153 adolescents (mean age = 16.4, 46.2% female). MEASUREMENT Initial conditions (e.g. past-year heavy drinking, gender, best friend's approval of drinking); adolescents' residence (i.e. being at) and transitions between (a) their own homes, (b) others' homes and (c) public spaces (e.g. restaurants, parks, concert venues) at early, middle and late evening hours; drinking in these contexts at early, middle and late evening hours; and drinking-related problems across evening hours. FINDINGS Risks for drinking were 23.5 times greater in others' homes (P < 0.01) and somewhat less in public spaces [odds ratio (OR) = 6.01, P < 0.01], compared with own home. Risks for problems in any evening time were elevated in relation to being in others' homes (OR = 2.37, P < 0.05) and public spaces (OR = 2.71, P < 0.01) versus at own home. Drinking in others' homes was related to 5.9 times increase in odds of transitioning back to own home (OR = 5.93, P < 0.05), 11.9 times increase in odds of remaining in others' homes (OR = 11.86, P < 0.01) or 7.3 times increase in odds of transitioning from others' homes to public spaces (OR = 7.3, P < 0.05). Initial conditions were associated with being in states, drinking and problems during evening hours and transitions across states. CONCLUSIONS In California, adolescents who are older, female, Hispanic or have greater spending money may be more likely to be outside their own home during evening hours than adolescents who do not match those criteria. In turn, being outside one's home during evening hours appears to be related to greater risks for drinking and drinking-related problems. Finally, transitions between contexts increased differential risks for drinking such that, for example, drinking in others' homes was highly related to transitioning to public spaces and less to returning to own home.
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Affiliation(s)
- Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704 USA
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, 130 De Soto Street Pittsburgh, PA 15261 USA
| | - Paul J. Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704 USA
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Stevens AK, Blanchard BE, Sokolovsky AW, Gunn RL, White HR, Jackson KM. Forgoing plans for alcohol and cannabis use in daily life: Examining reasons for nonuse when use was planned in a predominantly white college student sample. Alcohol Clin Exp Res 2021; 45:2167-2178. [PMID: 34762304 DOI: 10.1111/acer.14693] [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: 04/20/2021] [Revised: 07/18/2021] [Accepted: 08/07/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The reasons for college students to abstain from alcohol and cannabis use on a given day can inform efforts to prevent or intervene in those behaviors. Research on reasons for alcohol nonuse remains in its nascent stages and no study to date has examined reasons for cannabis nonuse on a given day. Here we examine reasons for nonuse among college students after they planned to use alcohol and/or cannabis. METHODS College students (N = 341; Mage = 19.79; 53% women; 74% White) from 3 universities completed 54 days of data collection across which approximately 50% were nonuse days. Each morning, participants indicated whether they planned to use that day; nonuse reasons were assessed the next morning, if applicable. Generalized linear mixed-effects models were used to disentangle within- and between-person effects. RESULTS On a given nonuse day (at the within-person level), "work" and "school" were reasons associated with having no plan to use alcohol and "to feel in control" was linked to having no plan to use cannabis. "Did not want to get high" was related to forgoing plans (did not use when originally planned) for alcohol use at the within-person level. At the between-person level, "no desire" was associated with no plans for alcohol or cannabis use and "did not want to get high" was related to no plans for cannabis use. "School" and "could not get" were related to forgoing plans for alcohol and cannabis use, respectively, at the between-person level. CONCLUSION An examination of earlier intentions for alcohol and/or cannabis use on nonuse days yielded novel findings on the intention-behavior gap. Reasons for nonuse can inform intervention and prevention strategies (e.g., those involving social norms or just-in-time adaptive efforts) for alcohol and cannabis use on college campuses.
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Affiliation(s)
- Angela K Stevens
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Brittany E Blanchard
- Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, Washington, USA
| | - Alexander W Sokolovsky
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Rachel L Gunn
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Helene R White
- Center of Alcohol and Substance Use Studies, Rutgers, the State University of New Jersey, Piscataway, New Jersey, USA
| | - Kristina M Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
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18
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Gibbons C, Porter I, Gonçalves-Bradley DC, Stoilov S, Ricci-Cabello I, Tsangaris E, Gangannagaripalli J, Davey A, Gibbons EJ, Kotzeva A, Evans J, van der Wees PJ, Kontopantelis E, Greenhalgh J, Bower P, Alonso J, Valderas JM. Routine provision of feedback from patient-reported outcome measurements to healthcare providers and patients in clinical practice. Cochrane Database Syst Rev 2021; 10:CD011589. [PMID: 34637526 PMCID: PMC8509115 DOI: 10.1002/14651858.cd011589.pub2] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Patient-reported outcomes measures (PROMs) assess a patient's subjective appraisal of health outcomes from their own perspective. Despite hypothesised benefits that feedback on PROMs can support decision-making in clinical practice and improve outcomes, there is uncertainty surrounding the effectiveness of PROMs feedback. OBJECTIVES To assess the effects of PROMs feedback to patients, or healthcare workers, or both on patient-reported health outcomes and processes of care. SEARCH METHODS We searched MEDLINE, Embase, CENTRAL, two other databases and two clinical trial registries on 5 October 2020. We searched grey literature and consulted experts in the field. SELECTION CRITERIA Two review authors independently screened and selected studies for inclusion. We included randomised trials directly comparing the effects on outcomes and processes of care of PROMs feedback to healthcare professionals and patients, or both with the impact of not providing such information. DATA COLLECTION AND ANALYSIS Two groups of two authors independently extracted data from the included studies and evaluated study quality. We followed standard methodological procedures expected by Cochrane and EPOC. We used the GRADE approach to assess the certainty of the evidence. We conducted meta-analyses of the results where possible. MAIN RESULTS We identified 116 randomised trials which assessed the effectiveness of PROMs feedback in improving processes or outcomes of care, or both in a broad range of disciplines including psychiatry, primary care, and oncology. Studies were conducted across diverse ambulatory primary and secondary care settings in North America, Europe and Australasia. A total of 49,785 patients were included across all the studies. The certainty of the evidence varied between very low and moderate. Many of the studies included in the review were at risk of performance and detection bias. The evidence suggests moderate certainty that PROMs feedback probably improves quality of life (standardised mean difference (SMD) 0.15, 95% confidence interval (CI) 0.05 to 0.26; 11 studies; 2687 participants), and leads to an increase in patient-physician communication (SMD 0.36, 95% CI 0.21 to 0.52; 5 studies; 658 participants), diagnosis and notation (risk ratio (RR) 1.73, 95% CI 1.44 to 2.08; 21 studies; 7223 participants), and disease control (RR 1.25, 95% CI 1.10 to 1.41; 14 studies; 2806 participants). The intervention probably makes little or no difference for general health perceptions (SMD 0.04, 95% CI -0.17 to 0.24; 2 studies, 552 participants; low-certainty evidence), social functioning (SMD 0.02, 95% CI -0.06 to 0.09; 15 studies; 2632 participants; moderate-certainty evidence), and pain (SMD 0.00, 95% CI -0.09 to 0.08; 9 studies; 2386 participants; moderate-certainty evidence). We are uncertain about the effect of PROMs feedback on physical functioning (14 studies; 2788 participants) and mental functioning (34 studies; 7782 participants), as well as fatigue (4 studies; 741 participants), as the certainty of the evidence was very low. We did not find studies reporting on adverse effects defined as distress following or related to PROM completion. AUTHORS' CONCLUSIONS PROM feedback probably produces moderate improvements in communication between healthcare professionals and patients as well as in diagnosis and notation, and disease control, and small improvements to quality of life. Our confidence in the effects is limited by the risk of bias, heterogeneity and small number of trials conducted to assess outcomes of interest. It is unclear whether many of these improvements are clinically meaningful or sustainable in the long term. There is a need for more high-quality studies in this area, particularly studies which employ cluster designs and utilise techniques to maintain allocation concealment.
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Affiliation(s)
| | - Ian Porter
- Health Services & Policy Research, University of Exeter Medical School, Exeter, UK
| | - Daniela C Gonçalves-Bradley
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Stanimir Stoilov
- College of Medicine and Health, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Ignacio Ricci-Cabello
- Primary Care Research Unit, Instituto de Investigación Sanitaria Illes Balears, Palma de Mallorca, Spain
| | | | | | - Antoinette Davey
- Health Services and Policy Research Group, University of Exeter Medical School, Exeter, UK
| | - Elizabeth J Gibbons
- PROM Group, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Anna Kotzeva
- Health Technology Assessment Department, Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain
| | - Jonathan Evans
- Health Services and Policy Research Group, University of Exeter Medical School, Exeter, UK
| | - Philip J van der Wees
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, Netherlands
| | - Evangelos Kontopantelis
- Centre for Health Informatics, Institute of Population Health, The University of Manchester, Manchester, UK
| | - Joanne Greenhalgh
- School of Sociology and Social Policy, University of Leeds, Leeds, UK
| | - Peter Bower
- NIHR School for Primary Care Research, Manchester Academic Health Science Centre, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Jordi Alonso
- CIBER Epidemiologia y Salud Publica (CIBERESP), IMIM-Hospital del mar, Barcelona, Spain
| | - Jose M Valderas
- Health Services & Policy Research, Exeter Collaboration for Academic Primary Care (APEx), NIHR School for Primary Care Research, NIHR ARC South West Peninsula (PenARC), University of Exeter, Exeter, UK
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Jackson KM, Stevens AK, Sokolovsky AW, Hayes KL, White HR. Real-world simultaneous alcohol and cannabis use: An ecological study of situational motives and social and physical contexts. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:698-711. [PMID: 34472880 DOI: 10.1037/adb0000765] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Given the adverse outcomes associated with simultaneous alcohol and marijuana (SAM) use, understanding factors that give rise to occasions of simultaneous use is critical. This study examines the relationships between situational motives and contexts and three situational outcomes: simultaneous alcohol and marijuana use (SAM) use versus cannabis-only use, number of cannabis uses, and subjective effects. METHOD Past-month SAM users (n = 341; 52% female; 75% White; 10% Latinx/Hispanic; age 18-24) from three U.S. college campuses completed 8 weeks of surveys up to five times a day. Three-level generalized linear mixed-effects models tested the effects of situational motives and social and physical contexts on occasion type (SAM vs. cannabis-only), cannabis use, and subjective effects. RESULTS Situational social and enhancement motives were related to greater odds of SAM relative to cannabis-only use; expansion motives were reported more often on cannabis-only occasions. Using with others and at friends' places, being with others consuming cannabis, and being with others who are intoxicated were more likely when combining alcohol with cannabis. Increased number of cannabis uses and subjective effects in a social context were evident only on cannabis-only occasions. Using alone and using at home were greater on cannabis-only occasions and were associated with lower cannabis use and subjective effects. CONCLUSIONS The combination of alcohol and cannabis use occurs during social situations and when motivated by positive reinforcement but number of cannabis uses is not increased when consuming cannabis with alcohol in social situations. Characterizing the complex interplay of situational factors that contribute to risky use will inform interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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20
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van Egmond K, Wright CJC, Livingston M, Kuntsche E. A parallel test of the SCRAM-CAM transdermal monitors ensuring reliability. Drug Alcohol Rev 2021; 40:1122-1130. [PMID: 34235793 DOI: 10.1111/dar.13353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 06/06/2021] [Accepted: 06/11/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Previous studies validating the transdermal alcohol concentration (TAC) as measured by the Secure Continuous Remote Alcohol Monitors Continuous Alcohol Monitoring (SCRAM-CAM) have tested the monitor against self-reports or breath alcohol concentration (BrAC). This study aims to provide further evidence of the reliability of the SCRAM-CAM testing two monitors in parallel. METHODS Participants (N = 21) received four standard drinks in a laboratory session while wearing SCRAM-CAMs simultaneously on their left and right ankles. The SCRAM-CAMs sampled TAC every 30 min and participants were monitored for at least 2-3 h after their BrAC levels reached zero. Weight and height measures were taken to calculate body mass index (BMI). RESULTS There was a positive correlation between the TAC measurements from the left and right SCRAM-CAM (r = 0.718), a cross-correlation model revealed that this correlation was not significantly different for sex or BMI. Area under the TAC curve (AUC) and peak TAC values as measured by the left and right SCRAM-CAM also show positive correlations (r = 0.554 and r = 0.579, respectively). Cross-correlation models show a significant effect of BMI on the relationship between left and right peak TAC values, which may be due to outlier effects. No further effects were significant for on both peak and AUC values. DISCUSSION AND CONCLUSIONS Results show that TAC measured by SCRAM-CAMs worn on the left and right showed a good correlation, with correlations between AUC and peak TAC values considered to be fair. TAC monitors show promise for use in research settings; however, work is needed testing the reliability of TAC as measured by two TAC monitors.
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Affiliation(s)
- Kelly van Egmond
- Centre for Alcohol Policy and Research, Department of Public Health and Psychology, La Trobe University, Melbourne, Australia
| | - Cassandra J C Wright
- Centre for Alcohol Policy and Research, Department of Public Health and Psychology, La Trobe University, Melbourne, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, Australia.,Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Michael Livingston
- Centre for Alcohol Policy and Research, Department of Public Health and Psychology, La Trobe University, Melbourne, Australia.,National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Emmanuel Kuntsche
- Centre for Alcohol Policy and Research, Department of Public Health and Psychology, La Trobe University, Melbourne, Australia.,Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
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21
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Crouse JJ, Morley KC, Buckley N, Dawson A, Seth D, Monds LA, Tickell A, Kay-Lambkin F, Chitty KM. Online interventions for people hospitalized for deliberate self-harm and problematic alcohol use: Lessons learned from the iiAIM trial. Bull Menninger Clin 2021; 85:123-142. [PMID: 34032460 DOI: 10.1521/bumc.2021.85.2.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Deliberate self-harm and suicide affect all age groups, sexes, and regions, and their prevention is a global health priority. Acute alcohol misuse and chronic alcohol misuse are strong, modifiable risk factors, and Internet interventions aiming to reduce alcohol misuse and comorbid mental health problems (e.g., depression) are a promising and effective treatment modality. The research team aimed to evaluate the feasibility and effectiveness of an Internet-based comorbidity intervention primarily aiming to reduce alcohol consumption, and secondarily to reduce readmission for deliberate self-harm and improve psychological outcomes among people hospitalized for deliberate self-harm who also engage in problematic alcohol use. However, due to several barriers to recruitment, the trial could not be completed and was discontinued. The authors present a "Lessons Learned" discussion and describe the Internet Intervention for Alcohol Improvement (iiAIM) trial, discuss the key barriers experienced by the research team, and recommend potential solutions that may help future trials in this area.
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Affiliation(s)
- Jacob J Crouse
- University of Sydney, Youth Mental Health and Technology Team, Brain & Mind Centre, Central Clinical School, Sydney, NSW, Australia
| | - Kirsten C Morley
- University of Sydney, Discipline of Addiction Medicine, Central Clinical School, Sydney, NSW, Australia
| | - Nicholas Buckley
- University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Sydney, NSW, Australia
| | - Andrew Dawson
- University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Sydney, NSW, Australia.,Royal Prince Alfred Hospital, Drug Health Services, Sydney, NSW, Australia
| | - Devanshi Seth
- Royal Prince Alfred Hospital, Drug Health Services, Sydney, NSW, Australia.,University of Sydney, Centenary Institute of Cancer Medicine and Cell Biology, Sydney, NSW, Australia, and the University of Sydney, Faculty of Medicine and Health, Sydney, NSW, Australia
| | - Lauren A Monds
- University of Sydney, Discipline of Addiction Medicine, Central Clinical School, Sydney, NSW, Australia
| | - Ashleigh Tickell
- University of Sydney, Youth Mental Health and Technology Team, Brain & Mind Centre, Central Clinical School, Sydney, NSW, Australia
| | - Frances Kay-Lambkin
- University of Newcastle, Centre for Brain and Mental Health Priority Research Centre, Newcastle, Australia
| | - Kate M Chitty
- University of Sydney Faculty of Medicine and Health, Discipline of Pharmacology, Translational Australian Clinical Toxicology Program, Sydney, NSW, Australia
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22
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Murphy KM, Burns J, Victorson D. Consider the Source: Examining Attrition Rates, Response Rates, and Preliminary Effects of eHealth Mindfulness Messages and Delivery Framing in a Randomized Trial with Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2021; 10:272-281. [PMID: 33347390 PMCID: PMC8220541 DOI: 10.1089/jayao.2020.0102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Young adults with cancer often experience stress, depression, and anxiety. Mindfulness meditation is an effective intervention for these outcomes, and maintenance support may be needed for long-term improvements. eHealth technologies provide a promising delivery strategy for maintenance interventions. Methods: Following an 8-week mindfulness-based stress reduction (MBSR) course, 62 young adult cancer survivors were randomized to 8 weeks of instructor-framed messages, peer-framed messages, or no messages. On average, participants were 33.6 years old. The majority of participants were college-educated Caucasian females. We examined attrition rates between participants who received messages and those who did not, and compared response rates from different perceived sources. In addition, we evaluated the preliminary effects of eHealth support on mindfulness and associated outcomes. Results: No significant differences in attrition or message response rates across groups were observed. Repeated measures models revealed significant group by time interactions on perceived stress, anxiety, and depression. There were no differences between the groups that received eHealth messages and the group that did not. There was a significant difference in anxiety symptoms from post-MBSR to post-messaging between messaging groups. Individuals who received instructor-framed messages reported increased symptoms of anxiety over time. Conclusion: Attrition and response rates did not differ across groups, suggesting that eHealth may be a feasible strategy for providing maintenance support. However, further evaluation of feasibility, acceptability, and optimal content and dose of such an intervention is needed. Additionally, young adult cancer survivors may be more likely to benefit from eHealth interventions that are not delivered by authority figures.
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Affiliation(s)
- Karly M. Murphy
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Social Sciences and Health Policy, Wake Forest Baptist Comprehensive Cancer Center, Winston Salem, North Carolina, USA
| | - James Burns
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Robert H. Lurie Comprehensive Cancer Center, Northwestern Memorial Hospital, Chicago, Illinois, USA
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23
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Hultgren BA, Scaglione NM, Buben A, Turrisi R. Examining protocol compliance and self-report congruence between daily diaries and event-contingent ecological momentary assessments of college student drinking. Addict Behav 2020; 110:106471. [PMID: 32526551 PMCID: PMC7919385 DOI: 10.1016/j.addbeh.2020.106471] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Daily diaries and ecological momentary assessments (EMA) are frequently used to assess event-level college student drinking. While both methods have advantages, they also raise questions about data validity, particularly in regard to alcohol's impact on protocol compliance. The current study examined congruence in drinking behaviors reported via retrospective daily diaries and event-contingent drinking logs, protocol compliance with each method, and the extent to which alcohol consumption impacted compliance. METHODS Participants were first-semester college women (n = 69) who reported 4+ drinks during an occasion at least once in the past month. Participants reported the number of drinks consumed and subjective intoxication using a 14-day EMA protocol. Event-contingent drinking logs (via self-initiated EMA) assessed behavior immediately after each drinking event; daily diaries assessed behaviors from the previous day. Pairwise correlations examined congruence between drinking logs and corresponding daily dairies; protocol compliance was examined through descriptive analysis of data missingness; and multilevel regression models assessed the associations between protocol compliance, alcohol consumption, and subjective intoxication. RESULTS Drinking log and daily diary reports were highly correlated (r's = 0.70 to 0.93). On drinking days, diary reports had higher protocol compliance (96.0%) compared to momentary drinking logs (41.4%). Drinking log missingness was associated with greater alcohol use and subjective intoxication reported in the corresponding daily diary (p's < 0.05). CONCLUSIONS Similarities in reports of alcohol consumption and subjective intoxication, coupled with higher missingness of momentary assessments suggest daily diaries may have methodological advantages and unique utility in supplementing momentary assessments.
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Affiliation(s)
- Brittney A Hultgren
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.
| | - Nichole M Scaglione
- Center on Social Determinants, Risk Behaviors, and Prevention Science RTI International, Research Triangle Park, NC, United States
| | - Alex Buben
- Center on Social Determinants, Risk Behaviors, and Prevention Science RTI International, Research Triangle Park, NC, United States
| | - Rob Turrisi
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, University Park, PA, United States; Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, United States
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24
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Carreiro S, Newcomb M, Leach R, Ostrowski S, Boudreaux ED, Amante D. Current reporting of usability and impact of mHealth interventions for substance use disorder: A systematic review. Drug Alcohol Depend 2020; 215:108201. [PMID: 32777691 PMCID: PMC7502517 DOI: 10.1016/j.drugalcdep.2020.108201] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/10/2020] [Accepted: 07/19/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Connected interventions use data collected through mobile/wearable devices to trigger real-time interventions and have great potential to improve treatment for substance use disorder (SUD). This review aims to describe the current landscape, effectiveness and usability of connected interventions for SUD. METHODS A systematic review was conducted to identify articles evaluating connected health interventions for SUD in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three databases (PubMed, IEEE, and Scopus) were searched over a five-year period. Included articles described a connected health intervention targeting SUD and provided outcomes data. Data were extracted using a standardized reporting tool. RESULTS A total of 1676 unique articles were identified during the initial search, with 32 articles included in the final analysis. Seven articles of the 32 were derived from two large studies. The most commonly studied SUD was alcohol use disorder. Sixteen articles reported at least one statistically significant result with respect to reduced craving and/or substance use. The majority of articles used ecological momentary assessment to trigger interventions, while four used biologic/physiologic data. Two articles used a wearable device. Common intervention types included craving management, coping assistance, and tailored feedback. Twenty-three articles measured usability factors, and acceptability was generally reported as high. CONCLUSION Identified themes included a focus on AUD, use of smart phones, use of EMA for intervention delivery, positive effects on SUD related outcomes, and overall high acceptability. Wearables that directly monitor biologic data and predictive analytics using integrated data streams represent understudied opportunities for new research.
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Affiliation(s)
- Stephanie Carreiro
- Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
| | - Mark Newcomb
- Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Rebecca Leach
- Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Simon Ostrowski
- Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Edwin D Boudreaux
- Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Daniel Amante
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
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25
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Bell L, Garnett C, Qian T, Perski O, Potts HWW, Williamson E. Notifications to Improve Engagement With an Alcohol Reduction App: Protocol for a Micro-Randomized Trial. JMIR Res Protoc 2020; 9:e18690. [PMID: 32763878 PMCID: PMC7442945 DOI: 10.2196/18690] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/13/2020] [Accepted: 05/27/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Drink Less is a behavior change app that aims to help users in the general adult population reduce hazardous and harmful alcohol consumption. The app includes a daily push notification, delivered at 11 am, asking users to "Please complete your mood and drinking diaries." Previous analysis of Drink Less engagement data suggests the current notification strongly influences how users engage with the app in the subsequent hour. To exploit a potential increase of vulnerability of excess drinking and opportunity to engage with the app in the evenings, we changed the delivery time from 11 am to 8 pm. We now aim to further optimise the content and sequence of notifications, testing 30 new evidence-informed notifications targeting the user's perceived usefulness of the app. OBJECTIVE The primary objective is to assess whether sending a notification at 8 pm increases behavioral engagement (opening the app) in the subsequent hour. Secondary objectives include comparing the effect of the new bank of messages with the standard message and effect moderation over time. We also aim to more generally understand the role notifications have on the overall duration, depth, and frequency of engagement with Drink Less over the first 30 days after download. METHODS This is a protocol for a micro-randomized trial with two additional parallel arms. Inclusion criteria are Drink Less users who (1) consent to participate in the trial; (2) self-report a baseline Alcohol Use Disorders Identification Test score of 8 or above; (3) reside in the United Kingdom; (4) age ≥18 years and; (5) report interest in drinking less alcohol. In the micro-randomized trial, participants will be randomized daily at 8 pm to receive no notification, a notification with text from the new message bank, or the standard message. The primary outcome is the time-varying, binary outcome of "Did the user open the app in the hour from 8 pm to 9 pm?". The primary analysis will estimate the marginal relative risk for the notifications using an estimator developed for micro-randomized trials with binary outcomes. Participants randomized to the parallel arms will receive no notifications (Secondary Arm A), or the standard notification delivered daily at 11 am (Secondary Arm B) over 30 days, allowing the comparison of overall engagement between different notification delivery strategies. RESULTS Approval was granted by the University College of London's Departmental Research Ethics Committee (CEHP/2016/556) on October 11, 2019, and The London School of Hygiene and Tropical Medicine Interventions Research Ethics Committee (17929) on November 27, 2019. Recruitment began on January 2, 2020, and is ongoing. CONCLUSIONS Understanding how push notifications may impact engagement with a behavior change app can lead to further improvements in engagement, and ultimately help users reduce their alcohol consumption. This understanding may also be generalizable to other apps that target a variety of behavior changes. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/18690.
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Affiliation(s)
- Lauren Bell
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Claire Garnett
- Research Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Tianchen Qian
- Department of Statistics, Harvard University, Cambridge, MA, United States
| | - Olga Perski
- Research Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, United Kingdom
- Health Data Research UK, London, United Kingdom
| | - Elizabeth Williamson
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Health Data Research UK, London, United Kingdom
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26
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Stevens AK, Sokolovsky AW, Padovano HT, White HR, Jackson KM. Heaviness of Alcohol Use, Alcohol Problems, and Subjective Intoxication Predict Discrepant Drinking Reports in Daily Life. Alcohol Clin Exp Res 2020; 44:1468-1478. [PMID: 32530512 PMCID: PMC7572532 DOI: 10.1111/acer.14362] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 05/05/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Self-reported consumption is pervasive in alcohol research, though retrospective recall bias is a concern. Fine-grained methods are designed to limit retrospection; yet, discrepancies can arise when comparing responses on fine-grained surveys with responses to retrospective surveys across weeks or months. Many fine-grained studies use both repeated daily surveys (RDS) and end-of-day (EOD) summaries, but little research has examined whether these survey types are consistent. The purpose of this study was to quantify the magnitude and directionality of discrepancy between EOD summaries and RDS and identify alcohol-related predictors of discrepancy. METHODS As a part of a larger study, college student alcohol and cannabis users (N = 341; 53% women; Mage = 19.79 years) were recruited to complete 56 days of data collection, including 5 daily assessments of their substance use and related constructs, one of which included an EOD summary of the previous day. Generalized linear mixed-effects models were used to examine between- and within-person predictors of a 5-category, discrepancy outcome: no discrepancy, low discrepancy where RDS < EOD, low discrepancy where EOD < RDS, high discrepancy where RDS < EOD, and high discrepancy where EOD < RDS. RESULTS Discrepancies between EOD and RDS were observed in both directions. Alcohol problems predicted more alcohol consumption reported on the EOD survey than across RDS. Within-person alcohol quantity and hourly rate of consumption were most strongly related to less alcohol consumption reported on the EOD survey. Between- and within-person peak subjective intoxication and within-person liquor consumption were associated with discrepancies in both directions. CONCLUSIONS Surveys requiring more retrospection may overestimate alcohol consumption in problematic drinkers and underestimate consumption on days where more alcohol is consumed than typical. Evidence also suggests that greater day-to-day instability in alcohol behavior is linked to less consistent reporting overall. More research is needed to discern factors contributing to inconsistent reporting on fine-grained surveys to maximize the validity of reports.
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Affiliation(s)
- Angela K. Stevens
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Alexander W. Sokolovsky
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Hayley Treloar Padovano
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Helene R. White
- Center of Alcohol and Substance Studies, Rutgers, the State University of New Jersey, Piscataway, New Jersey
| | - Kristina M. Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA
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27
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Lecomte T, Potvin S, Corbière M, Guay S, Samson C, Cloutier B, Francoeur A, Pennou A, Khazaal Y. Mobile Apps for Mental Health Issues: Meta-Review of Meta-Analyses. JMIR Mhealth Uhealth 2020; 8:e17458. [PMID: 32348289 PMCID: PMC7293054 DOI: 10.2196/17458] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/11/2020] [Accepted: 02/26/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Mental health apps have great potential to help people needing support to cope with distress or specific symptoms. In fact, there is an exponential increase in the number of mental health apps available on the internet, with less than 5% being actually studied. OBJECTIVE This study aimed to assess the quality of the available evidence regarding the use of mental health apps and to summarize the results obtained so far. METHODS Systematic reviews and meta-analyses were searched, specifically for mobile apps on mental health issues or symptoms, and rated using the Grading of Recommendations Assessment, Development and Evaluation system. RESULTS A total of 7 meta-analyses were carefully reviewed and rated. Although some meta-analyses looked at any mental health issue and analyzed the data together, these studies were of poorer quality and did not offer strong empirical support for the apps. Studies focusing specifically on anxiety symptoms or depressive symptoms were of moderate to high quality and generally had small to medium effect sizes. Similarly, the effects of apps on stress and quality of life tended to offer small to medium effects and were of moderate to high quality. Studies looking at stand-alone apps had smaller effect sizes but better empirical quality than studies looking at apps with guidance. The studies that included follow-ups mostly found a sustained impact of the app at an 11-week follow-up. CONCLUSIONS This meta-review revealed that apps for anxiety and depression hold great promise with clear clinical advantages, either as stand-alone self-management or as adjunctive treatments. More meta-analyses and more quality studies are needed to recommend apps for other mental health issues or for specific populations.
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Affiliation(s)
- Tania Lecomte
- Department of Psychology, University of Montreal, Montreal, QC, Canada
- Centre de recherche, l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Stéphane Potvin
- Centre de recherche, l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| | - Marc Corbière
- Centre de recherche, l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Education, Career Counselling, University du Quebec a Montreal, Montreal, QC, Canada
| | - Stéphane Guay
- Centre de recherche, l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Criminology, University of Montreal, Montreal, QC, Canada
| | - Crystal Samson
- Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Briana Cloutier
- Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Audrey Francoeur
- Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Antoine Pennou
- Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Yasser Khazaal
- Department of Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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28
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Wright C, Dietze PM, Kuntsche E, Livingston M, Agius PA, Room R, Raggatt M, Hellard M, Lim MSC. Effectiveness of an Ecological Momentary Intervention for Reducing Risky Alcohol Consumption Among Young Adults: Protocol for a Three-Arm Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e14190. [PMID: 32229471 PMCID: PMC7157500 DOI: 10.2196/14190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/16/2019] [Accepted: 10/09/2019] [Indexed: 11/29/2022] Open
Abstract
Background Recent research has investigated the utility of mobile phone–delivered interventions for reducing risky single-occasion drinking, also known as binge drinking. In the past five years, focus has been placed on ecological momentary interventions (EMIs), which aim to deliver intervention content in correspondence to real-time assessments of behavior, also known as ecological momentary assessments (EMAs). Objective This study aims to assess the effect of a fully automated, tailored, mobile phone–delivered EMI termed Mobile Intervention for Drinking in Young people (MIDY) on young people's risky single-occasion drinking behavior. Methods We will use a three-armed randomized controlled trial design to determine the impact of MIDY on peak consumption of alcohol among young people. A list of mobile telephone numbers for random digit dialing will be generated, and researchers will telephone potential participants to screen for eligibility. Participants will be randomized into one of three intervention groups. For 6 weeks, EMI, EMA, and attention control groups will complete hourly EMA surveys on their mobile phones on Friday and Saturday nights. EMI participants will receive personalized feedback in the form of text messages corresponding to their EMA survey responses, which focus on alcohol consumption, spending, and mood. EMA participants will not receive feedback. A third group will also complete EMA and receive feedback text messages at the same time intervals, but these will be focused on sedentary behavior and technology use. All groups will also complete a short survey on Saturday and Sunday mornings, with the primary outcome measure taken on Sunday mornings. A more detailed survey will be sent on the final Sunday of the 6-week period, and then again 1 year after recruitment. Results The primary outcome measure will be an observed change (ie, reduction) in the mean peak number of drinks consumed in a single night over the 6-week intervention period between the EMI and attention control groups as measured in the weekly EMA. We expect to see a greater reduction in mean peak drinking in the EMI group compared to that in the attention control group. As a secondary aim, we will assess whether mean peak drinking is reduced in the EMA group compared to the attention control group. We will use a random-effects mixed-modeling approach using maximum-likelihood estimation to provide estimates of differences in peak drinking across time periods between those receiving the intervention (EMI) and attention control participants. An intention-to-treat approach will be taken for the analysis. Individuals and study groups will be modeled as random and fixed factors, respectively. Conclusions This study extends our previous work investigating the efficacy of a mobile EMI (MIDY) for reducing risky drinking among young adults in Australia, and will add to the expanding literature on the use of mobile interventions for reducing risky alcohol consumption. Trial Registration Australian New Zealand Clinical Trials Registration (ANZCTR): ACTRN12617001509358p; http://www.anzctr.org.au/ACTRN12617001509358p.aspx International Registered Report Identifier (IRRID) DERR1-10.2196/14190
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Affiliation(s)
- Cassandra Wright
- Burnet Institute, Melbourne, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Paul M Dietze
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Emmanuel Kuntsche
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Paul A Agius
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Michelle Raggatt
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Margaret Hellard
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Megan S C Lim
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Parkville, Australia
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Patrick ME, Fairlie AM, Cadigan JM, Abdallah DA, Larimer ME, Lee CM. Daily Motives for Alcohol and Marijuana Use as Predictors of Simultaneous Use Among Young Adults. J Stud Alcohol Drugs 2020. [PMID: 31495383 DOI: 10.15288/jsad.2019.80.454] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Research on substance use motives typically examines each substance separately. However, simultaneous alcohol and marijuana (SAM) use-that is, using alcohol and marijuana at the same time so that their effects overlap-is common among young adults. This study examines day-to-day fluctuations in motives for using alcohol and/ or marijuana among young adult substance users as predictors of alcohol, marijuana, and SAM use across days. METHOD Data were from a community sample of young adults who reported SAM use in the past month (analytic sample: N = 399, mean [SD] age = 21.63 [2.17]; 50.9% women). Participants reported alcohol, marijuana, and SAM use, and also motives "for alcohol and/or marijuana use" for 14 consecutive days. RESULTS Multilevel models showed that elevated enhancement motives were associated with heavy episodic drinking, drinking more, and more hours high from marijuana. Elevated social motives were associated with heavy episodic drinking and drinking more, and also with fewer hours high. Elevated conformity motives were associated with drinking more. SAM use was more likely: on alcohol days and on marijuana days with elevated enhancement and conformity motives, on alcohol days with elevated coping motives, and on marijuana days with elevated social motives. CONCLUSIONS SAM use on a given day was primarily associated with enhancement and conformity motives. Social motives were more strongly linked to alcohol use, and to some extent coping motives were linked to marijuana use in this young adult sample. Further examination of situation-specific motives and contexts of use is needed to inform development of real-time interventions for SAM use and consequences.
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Affiliation(s)
- Megan E Patrick
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota.,Institute for Translational Research in Children's Mental Health, University of Minnesota, Minneapolis, Minnesota
| | - Anne M Fairlie
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Jennifer M Cadigan
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Devon A Abdallah
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Mary E Larimer
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Christine M Lee
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
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30
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Patrick ME, Fairlie AM, Cadigan JM, Abdallah DA, Larimer ME, Lee CM. Daily Motives for Alcohol and Marijuana Use as Predictors of Simultaneous Use Among Young Adults. J Stud Alcohol Drugs 2019; 80:454-461. [PMID: 31495383 PMCID: PMC6739644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/22/2019] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE Research on substance use motives typically examines each substance separately. However, simultaneous alcohol and marijuana (SAM) use-that is, using alcohol and marijuana at the same time so that their effects overlap-is common among young adults. This study examines day-to-day fluctuations in motives for using alcohol and/ or marijuana among young adult substance users as predictors of alcohol, marijuana, and SAM use across days. METHOD Data were from a community sample of young adults who reported SAM use in the past month (analytic sample: N = 399, mean [SD] age = 21.63 [2.17]; 50.9% women). Participants reported alcohol, marijuana, and SAM use, and also motives "for alcohol and/or marijuana use" for 14 consecutive days. RESULTS Multilevel models showed that elevated enhancement motives were associated with heavy episodic drinking, drinking more, and more hours high from marijuana. Elevated social motives were associated with heavy episodic drinking and drinking more, and also with fewer hours high. Elevated conformity motives were associated with drinking more. SAM use was more likely: on alcohol days and on marijuana days with elevated enhancement and conformity motives, on alcohol days with elevated coping motives, and on marijuana days with elevated social motives. CONCLUSIONS SAM use on a given day was primarily associated with enhancement and conformity motives. Social motives were more strongly linked to alcohol use, and to some extent coping motives were linked to marijuana use in this young adult sample. Further examination of situation-specific motives and contexts of use is needed to inform development of real-time interventions for SAM use and consequences.
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Affiliation(s)
- Megan E. Patrick
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota
- Institute for Translational Research in Children’s Mental Health, University of Minnesota, Minneapolis, Minnesota
| | - Anne M. Fairlie
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Jennifer M. Cadigan
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Devon A. Abdallah
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Mary E. Larimer
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Christine M. Lee
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
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O’Donnell R, Richardson B, Fuller-Tyszkiewicz M, Staiger PK. Delivering Personalized Protective Behavioral Drinking Strategies via a Smartphone Intervention: a Pilot Study. Int J Behav Med 2019; 26:401-414. [DOI: 10.1007/s12529-019-09789-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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32
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Cardiovascular Disease Prevention in Adolescents: eHealth, Co-Creation, and Advocacy. Med Sci (Basel) 2019; 7:medsci7020034. [PMID: 30813490 PMCID: PMC6410225 DOI: 10.3390/medsci7020034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 12/15/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death globally. Early atherosclerotic changes can begin to occur early in life and though adolescence. The prevalence of modifiable CVD risk factors, namely, smoking, poor diet quality, excessive alcohol intake, physical inactivity, and overweight and obesity can exacerbate the early onset of atherosclerosis. There is a need to improve modifiable risk factors during adolescence to prevent progression to CVD in later life. Electronic health (eHealth) behaviour change interventions are a potential solution for adolescents to improve CVD risk factors, given adolescents are digital frontrunners and digital technology is wide-reaching. The process of co-creating eHealth behaviour change interventions with adolescents is a promising strategy to improve intervention effectiveness and engagement. Additionally, effective youth advocacy is an emerging strategy for CVD prevention in adolescents. This narrative review evaluates published eHealth behaviour change interventions targeting cardiovascular disease risk factors in adolescents, which utilize a co-creation process, describe the emerging role of advocacy in CVD prevention for adolescents and provide recommendations for future interventions.
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