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Rochat L, Rothen S, Edel Y, Penzenstadler L, Lecomte T, Potvin S, Dan Glauser E, Etter JF, Khazaal Y. Measurement invariance of the Marijuana Motives Measure among men and women using Stop Cannabis App. Addict Behav 2024; 148:107866. [PMID: 37748226 DOI: 10.1016/j.addbeh.2023.107866] [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: 04/04/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Motives to use cannabis play a central role in the development and maintenance of problematic cannabis use and previous studies stressed sex-related differences on motives to use cannabis. However, motives cannot be validly compared in men and women without first establishing the measurement invariance across sex. Therefore, the aim of the study is to (1) examine for the first time the measurement and structural invariance of the Marijuana Motives Measure (MMM) across sex, and (2) to investigate the motives for cannabis use that best explain problematic use. METHODS 2951 (41.7% women) users of the "Stop cannabis" smartphone app of which 99.8% reported having used cannabis in the last three months completed an online MMM and ASSIST to assess the severity of their problematic cannabis use. RESULTS Multigroup confirmatory factor analyses supported measurement invariance across sex, whereas structural invariance was not confirmed. Indeed, group comparisons indicated that women reported greater coping motives then men whereas men showed greater social motives than women. A multiple linear regression analysis showed that only coping and conformity motives were significantly associated with greater problematic cannabis use, whereas neither sex nor the sex by motives interactions were significantly related to problematic cannabis use. CONCLUSIONS The MMM appears to function comparably across men and women. Therefore, sex-related comparisons on the questionnaire can be considered valid. Coping and conformity motives may play a central role part in the development of marijuana use problems which may hold implications for intervention development and public policy.
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Affiliation(s)
- Lucien Rochat
- Specialized Facility in Behavioral Addiction ReConnecte, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland; Faculty of Psychology, UniDistance, Brig, Switzerland.
| | - Stéphane Rothen
- Addiction Division, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland; Research Center for Statistics, Geneva School of Management and Economics, University of Geneva, Geneva, Switzerland.
| | - Yves Edel
- ELSA , GHU Pitié-Salpétrière, Sorbonne-Université Paris, Paris, France.
| | - Louise Penzenstadler
- Addiction Division, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland.
| | - Tania Lecomte
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal and Université de Montréal, Montreal, Canada.
| | - Stephane Potvin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal and Université de Montréal, Montreal, Canada.
| | - Elise Dan Glauser
- Institute of Psychology, Lausanne University, Lausanne, Switzerland.
| | | | - Yasser Khazaal
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal and Université de Montréal, Montreal, Canada; Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland; Faculty of Biology and Medicine, Lausanne University, Lausanne, Switzerland.
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Etter JF, Vera Cruz G, Khazaal Y. Predicting smoking cessation, reduction and relapse six months after using the Stop-Tabac app for smartphones: a machine learning analysis. BMC Public Health 2023; 23:1076. [PMID: 37277740 DOI: 10.1186/s12889-023-15859-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 05/10/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND An analysis of predictors of smoking behaviour among users of smoking cessation apps can provide useful information beyond what is already known about predictors in other contexts. Therefore, the aim of the present study was to identify the best predictors of smoking cessation, smoking reduction and relapse six months after starting to use the smartphone app Stop-Tabac. METHOD Secondary analysis of 5293 daily smokers from Switzerland and France who participated in a randomised trial testing the effectiveness of this app in 2020, with follow-up at one and six months. Machine learning algorithms were used to analyse the data. The analyses for smoking cessation included only the 1407 participants who responded after six months; the analysis for smoking reduction included only the 673 smokers at 6-month follow-up; and the analysis for relapse at 6 months included only the 502 individuals who had quit smoking after one month. RESULTS Smoking cessation after 6 months was predicted by the following factors (in this order): tobacco dependence, motivation to quit smoking, frequency of app use and its perceived usefulness, and nicotine medication use. Among those who were still smoking at follow-up, reduction in cigarettes/day was predicted by tobacco dependence, nicotine medication use, frequency of app use and its perceived usefulness, and e-cigarette use. Among those who had quit smoking after one month, relapse after six months was predicted by intention to quit, frequency of app use, perceived usefulness of the app, level of dependence and nicotine medication use. CONCLUSION Using machine learning algorithms, we identified independent predictors of smoking cessation, smoking reduction and relapse. Studies on the predictors of smoking behavior among users of smoking cessation apps may provide useful insights for the future development of these apps and future experimental studies. CLINICAL TRIAL REGISTRATION ISRCTN Registry: ISRCTN11318024, 17 May 2018. http://www.isrctn.com/ISRCTN11318024 .
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Affiliation(s)
- Jean-François Etter
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Germano Vera Cruz
- Department of Psychology, UR 7273 CRP-CPO, University of Picardie Jules Verne, Chemin du Thil, Amiens, 80025, France.
- Département de Psychiatrie, Service de médecine des addictions, Lausanne University Hospital, Rue du Bugnon 23, Lausanne, 1011, Switzerland.
| | - Yasser Khazaal
- Addiction Medicine, Lausanne University Hospital, Lausanne, Switzerland.
- Lausanne University, Lausanne, Switzerland.
- Department of Psychiatry and Addictology, Montreal University, Montreal, Canada.
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Serre F, Moriceau S, Donnadieu L, Forcier C, Garnier H, Alexandre JM, Dupuy L, Philip P, Levavasseur Y, De Sevin E, Auriacombe M. The Craving-Manager smartphone app designed to diagnose substance use/addictive disorders, and manage craving and individual predictors of relapse: a study protocol for a multicenter randomized controlled trial. Front Psychiatry 2023; 14:1143167. [PMID: 37255691 PMCID: PMC10226427 DOI: 10.3389/fpsyt.2023.1143167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/18/2023] [Indexed: 06/01/2023] Open
Abstract
Background The rate of individuals with addiction who are currently treated are low, and this can be explained by barriers such as stigma, desire to cope alone, and difficulty to access treatment. These barriers could be overcome by mobile technologies. EMI (Ecological Momentary Intervention) is a treatment procedure characterized by the delivery of interventions (messages on smartphones) to people in their daily lives. EMI presents opportunities for treatments to be available to people during times and in situations when they are most needed. Craving is a strong predictor of relapse and a key target for addiction treatment. Studies using Ecological Momentary Assessment (EMA) method have revealed that, in daily life, person-specific cues could precipitate craving, that in turn, is associated with a higher probability to report substance use and relapse in the following hours. Assessment and management of these specific situations in daily life could help to decrease addictive use and avoid relapse. The Craving-Manager smartphone app has been designed to diagnose addictive disorders, and assess and manage craving as well as individual predictors of use/relapse. It delivers specific and individualized interventions (counseling messages) composed of evidence-based addiction treatments approaches (cognitive behavioral therapy and mindfulness). The Craving-Manager app can be used for any addiction (substance or behavior). The objective of this protocol is to evaluate the efficacy of the Craving-Manager app in decreasing use (of primary substance(s)/addictive behavior(s)) over 4 weeks, among individuals on a waiting list for outpatient addiction treatment. Methods/design This multicenter double-blind randomized controlled trial (RCT) will compare two parallel groups: experimental group (full interventional version of the app, 4 weeks, EMA + EMI), versus control group (restricted version of the app, 4 weeks, only EMA). Two hundred and seventy-four participants will be recruited in 6 addiction treatment centers in France. Discussion This RCT will provide indication on how the Craving-Manager app will reduce addictive use (e.g., better craving management, better stimulus control) in both substance and behavioral addictions. If its efficacy is confirmed, the app could offer the possibility of an easy to use and personalized intervention accessible to the greatest number of individuals with addiction. Clinical Trial Registration ClinicalTrials.gov: NCT04732676.
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Affiliation(s)
- Fuschia Serre
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
- Pôle Inter-établissement d’Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - Sarah Moriceau
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
- Pôle Inter-établissement d’Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - Léa Donnadieu
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
- Pôle Inter-établissement d’Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - Camille Forcier
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
- Pôle Inter-établissement d’Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - Hélène Garnier
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
- Pôle Inter-établissement d’Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - Jean-Marc Alexandre
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
- Pôle Inter-établissement d’Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
| | - Lucile Dupuy
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
| | - Pierre Philip
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
| | - Yannick Levavasseur
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
| | - Etienne De Sevin
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
| | - Marc Auriacombe
- University of Bordeaux, Bordeaux, France
- SANPSY, UMR 6033, CNRS, Bordeaux, France
- Pôle Inter-établissement d’Addictologie, CH Ch. Perrens and CHU de Bordeaux, Bordeaux, France
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Vera Cruz G, Aboujaoude E, Khan R, Rochat L, Ben Brahim F, Courtois R, Khazaal Y. Smartphone apps for mental health and wellbeing: A usage survey and machine learning analysis of psychological and behavioral predictors. Digit Health 2023; 9:20552076231152164. [PMID: 36714544 PMCID: PMC9880571 DOI: 10.1177/20552076231152164] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023] Open
Abstract
Objective Despite the availability of thousands of mental health applications, the extent to which they are used and the factors associated with their use remain largely unknown. The present study aims to (a) assess in a representative US-based population sample the use of smartphone apps for mental health and wellbeing (SAMHW), (b) determine the variables predicting the use of SAMHW, and (c) explore how a set of variables related to mental health, smartphone use, and smartphone "addiction" may be associated with the use of SAMHW. Methods Data was collected via online questionnaire from 1989 adults. The data gathered included information on smartphone use behavior, mental health, and the use of SAMHW. Latent class analysis was used to categorize participants. Machine learning and logistic regression analyses were used to determine the most important predictors of SAMHW use and associations between predictors and outcome variables. Results While two-thirds of participants had a statistically high probability for using SAMHW, nearly twice more had high probability for using them to improve wellbeing compared to using them to address mental health problems (43% vs. 18%). In both groups, these participants were more likely to be female and in the younger adult age bracket than male and in the adult or older adult age bracket. According to the machine learning model, the most important predictors for using the relevant smartphone apps were variables associated with smartphone problematic use, COVID-19 impact, and mental health problems. Conclusion Findings from the present study confirm that the use of SAMHW is growing, particularly among younger adult and female individuals who are negatively impacted by problematic smartphone use, COVID-19, and mental health problems. These individuals tend to bypass traditional care via psychotherapy or psychopharmacology, relying instead on smartphones to address mental health conditions or improve wellbeing. Advising users of these apps to also seek professional help and promoting efforts to prove the efficacy and safety of SAMHW would seem necessary.
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Affiliation(s)
- Germano Vera Cruz
- Department of Psychology, University of Picardie Jules Verne,
Amiens, France,Yasser Khazaal, CHUV, Département de
Psychiatrie, Service de médecine des addictions, Rue du Bugnon 23, 1011
Lausanne, Switzerland.
| | - Elias Aboujaoude
- Department of Psychiatry and Behavioral Sciences, Stanford University School of
Medicine, Stanford, CA, USA
| | - Riaz Khan
- Addiction Psychiatry, Foederatio Medicorum Helveticorum, Geneva,
Switzerland
| | - Lucien Rochat
- Addiction Division, Department of Psychiatry, University Hospitals
of Geneva, Geneva, Switzerland
| | | | - Robert Courtois
- Department of Psychology, University of Tours, Tours, France
| | - Yasser Khazaal
- Addiction Medicine, Lausanne University
Hospital, Lausanne, Switzerland,Department of Psychiatry, Lausanne University, Lausanne,
Switzerland,Department of Psychiatry and Addictology, Montreal University,
Montreal, QC, Canada
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Khazaal Y, El Abiddine FZ, Penzenstadler L, Berbiche D, Bteich G, Valizadeh-Haghi S, Rochat L, Achab S, Khan R, Chatton A. Evaluation of the Psychometric Properties of the Arab Compulsive Internet Use Scale (CIUS) by Item Response Theory Modeling (IRT). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12099. [PMID: 36231401 PMCID: PMC9566183 DOI: 10.3390/ijerph191912099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The psychometric properties of the Arab translation of the Compulsive Internet Use Scale (CIUS) have been previously studied by confirmatory factor analysis (CFA) with AMOS software using the asymptotically distribution-free (ADF) estimator. Unidimensionality has been achieved at the cost of correlating several item variance errors. However, several reviews of SEM software packages and estimation methods indicate that the option of robust standard errors is not present in the AMOS package and that ADF estimation may yield biased parameter estimates. We therefore explored a second analysis through item response theory (IRT) using the parametric graded response model (GRM) and the marginal maximum likelihood (MML) estimation method embedded in the LTM package of R software. Differential item functioning (DIF) or item bias across subpopulations was also explored within IRT framework as different samples were investigated. The objective of the current study is to (1) analyze the Arab CIUS scale with IRT, (2) investigate DIF in three samples, and (3) contribute to the ongoing debate on Internet-use-related addictive behaviors using the CIUS items as a proxy. METHODS We assessed three samples of people, one in Algeria and two in Lebanon, with a total of 1520 participants. RESULTS Almost three out of every five items were highly related to the latent construct. However, the unidimensionality hypothesis was not supported. Furthermore, besides being locally dependent, the scale may be weakened by DIF across geographic regions. Some of the CIUS items related to increasing priority, impaired control, continued use despite harm, and functional impairment as well as withdrawal and coping showed good discriminative capabilities. Those items were endorsed more frequently than other CIUS items in people with higher levels of addictive Internet use. CONCLUSIONS Contrary to earlier ADF estimation findings, unidimensionality of the CIUS scale was not supported by IRT parametric GRM in a large sample of Arab speaking participants. The results may be helpful for scale revision. By proxy, the study contributes to testing the validity of addiction criteria applied to Internet use related-addictive behaviors.
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Affiliation(s)
- Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and Lausanne University, 1015 Lausanne, Switzerland
- Department of Psychiatry and Addictology, Montréal University, Montréal, QC H3T 1J4, Canada
| | - Fares Zine El Abiddine
- Laboratory Psychological and Educational Research, Department of Psychology, University Djillali Liabes of Sidi Bel Abbes, Sidi Bel Abbes 22000, Algeria
| | - Louise Penzenstadler
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Djamal Berbiche
- Charles-LeMoyne Hospital Research Centre, Sherbrooke University, Sherbrooke, QC J1K 2R1, Canada
| | - Ghada Bteich
- Faculty of Public Health, Lebanon University, Tripoli P.O. Box 6573/14, Lebanon
| | - Saeideh Valizadeh-Haghi
- Department of Medical Library and Information Sciences, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Lucien Rochat
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Sophia Achab
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Riaz Khan
- Department of Mental Health and Psychiatry, Frontier Medical College Affiliated to Bahria University Islamabad, Abbottabad 22010, Pakistan
| | - Anne Chatton
- Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
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Bremer W, Sarker A. Recruitment and retention in mobile application-based intervention studies: a critical synopsis of challenges and opportunities. Inform Health Soc Care 2022; 48:139-152. [PMID: 35656732 DOI: 10.1080/17538157.2022.2082297] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Use of mobile health applications (mHealth apps) is becoming increasingly popular for the management of chronic illnesses, but mHealth-based intervention studies often have limitations associated with subject recruitment and retention. In this synopsis, we focus on targeted aspects of mHealth-based intervention studies, specifically: (i) subject recruitment, (ii) cohort sizes, and (iii) retention rates. We used the Google Scholar (meta-search) and Galileo search engines to identify sample articles focusing on mHealth apps and interventions published between 2010 and 2020 and selected 21 papers for detailed review. Most studies recruited relatively small cohorts (minimum: 20, maximum: 510). Retention rates had high variance with only five studies managing >80% subject retention throughout the study duration, 10.4% being the lowest. Eighty-five percent of the studies expressed concerns regarding study duration, app usage, and lack of proper implementation. The use of mHealth interventions generally yielded positive outcomes, but most studies discussed facing challenges associated with recruitment and retention. There is a clear need to identify strategies for recruiting larger cohorts and improving retention rates, and ultimately increasing the reliability of mHealth app-based intervention studies. We advise that potential underutilized opportunities lie at the intersection of mHealth and social media to address the limitations identified in the synopsis.
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Affiliation(s)
- Whitney Bremer
- Department of Biomedical Informatics, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Abeed Sarker
- Department of Biomedical Informatics, School of Medicine, Emory University, Atlanta, Georgia, USA
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Denecke K, Schmid N, Nüssli S. Implementation of Cognitive Behavioral Therapy in e-Mental Health Apps: Literature Review. J Med Internet Res 2022; 24:e27791. [PMID: 35266875 PMCID: PMC8949700 DOI: 10.2196/27791] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 07/27/2021] [Accepted: 12/28/2021] [Indexed: 12/24/2022] Open
Abstract
Background To address the matter of limited resources for treating individuals with mental disorders, e–mental health has gained interest in recent years. More specifically, mobile health (mHealth) apps have been suggested as electronic mental health interventions accompanied by cognitive behavioral therapy (CBT). Objective This study aims to identify the therapeutic aspects of CBT that have been implemented in existing mHealth apps and the technologies used. From these, we aim to derive research gaps that should be addressed in the future. Methods Three databases were screened for studies on mHealth apps in the context of mental disorders that implement techniques of CBT: PubMed, IEEE Xplore, and ACM Digital Library. The studies were independently selected by 2 reviewers, who then extracted data from the included studies. Data on CBT techniques and their technical implementation in mHealth apps were synthesized narratively. Results Of the 530 retrieved citations, 34 (6.4%) studies were included in this review. mHealth apps for CBT exploit two groups of technologies: technologies that implement CBT techniques for cognitive restructuring, behavioral activation, and problem solving (exposure is not yet realized in mHealth apps) and technologies that aim to increase user experience, adherence, and engagement. The synergy of these technologies enables patients to self-manage and self-monitor their mental state and access relevant information on their mental illness, which helps them cope with mental health problems and allows self-treatment. Conclusions There are CBT techniques that can be implemented in mHealth apps. Additional research is needed on the efficacy of the mHealth interventions and their side effects, including inequalities because of the digital divide, addictive internet behavior, lack of trust in mHealth, anonymity issues, risks and biases for user groups and social contexts, and ethical implications. Further research is also required to integrate and test psychological theories to improve the impact of mHealth and adherence to the e–mental health interventions.
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Affiliation(s)
- Kerstin Denecke
- Institute for Medical Informatics, Bern University of Applied Sciences, Biel, Switzerland
| | | | - Stephan Nüssli
- Institute for Medical Informatics, Bern University of Applied Sciences, Biel, Switzerland
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Khazaal Y, Potvin S, Pennou A, Djomo W, Borgeat F, Lecomte T. Des repères pour la conception des apps ? SANTE MENTALE AU QUEBEC 2021. [DOI: 10.7202/1081512ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectif Proposer quelques repères pour faciliter le processus de création d’applications pour téléphones intelligents (apps) en santé mentale.
Méthode Présentation brève de l’intérêt potentiel des apps et proposition argumentée d’étapes clés pour la création des apps. L’article se base sur une revue narrative, un retour d’expérience et des discussions de groupes d’experts.
Résultats Les apps ont des caractéristiques ubiquitaires particulièrement intéressantes pour le domaine de la santé mentale. Potentiellement connectées à de multiples technologies, mobiles et disponibles en tout temps, elles permettent une grande flexibilité de conception. Afin d’augmenter les chances d’efficacité et de bonne dissémination d’une app donnée, certains principes pourraient guider de manière utile le travail de conception des apps : 9 repères sont proposés, en particulier une bonne intégration des utilisateurs finaux autour d’objectifs cibles bien définis durant tout le processus de création de tels outils.
Conclusion Les repères proposés pourraient faciliter le processus de création d’apps pour la santé mentale.
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Affiliation(s)
- Yasser Khazaal
- Service de médecine des addictions, Département de Psychiatrie CHUV et Université de Lausanne
- Département de psychiatrie et d’addictologie, Université de Montréal
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal
| | - Stéphane Potvin
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal
- Département de psychologie, Université de Montréal
| | - Antoine Pennou
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal
- Département de psychologie, Université de Montréal
| | - William Djomo
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal
| | - François Borgeat
- Département de psychiatrie et d’addictologie, Université de Montréal
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal
| | - Tania Lecomte
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal
- Département de psychologie, Université de Montréal
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Abstract
Background: Substance use disorders are a highly prevalent group of chronic diseases with devastating individual and public health consequences. Current treatment strategies suffer from high rates of relapse, or return to drug use, and novel solutions are desperately needed. Realize Analyze Engage (RAE) is a digital, mHealth intervention that focusses on real time, objective detection of high-risk events (stress and drug craving) to deploy just-in-time supportive interventions. The present study aims to (1) evaluate the accuracy and usability of the RAE system and (2) evaluate the impact of RAE on patient centered outcomes. Methods: The first phase of the study will be an observational trial of N = 50 participants in outpatient treatment for SUD using the RAE system for 30 days. Accuracy of craving and stress detection algorithms will be evaluated, and usability of RAE will be explored via semi-structured interviews with participants and focus groups with SUD treatment clinicians. The second phase of the study will be a randomized controlled trial of RAE vs usual care to evaluate rates of return to use, retention in treatment, and quality of life. Anticipated findings and future directions: The RAE platform is a potentially powerful tool to de-escalate stress and craving outside of the clinical milieu, and to connect with a support system needed most. RAE also aims to provide clinicians with actionable insight to understand patients’ level of risk, and contextual clues for their triggers in order to provide more personalized recovery support.
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Khazaal Y, Chatton A, Rochat L, Hede V, Viswasam K, Penzenstadler L, Berle D, Starcevic V. Compulsive Health-Related Internet Use and Cyberchondria. Eur Addict Res 2021; 27:58-66. [PMID: 33120393 PMCID: PMC7845430 DOI: 10.1159/000510922] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 07/13/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cyberchondria denotes excessive and repeated online health-related searches associated with an increase in health anxiety. Such searches persist in those with cyberchondria, despite the negative consequences, resembling a pattern of compulsive Internet use. OBJECTIVES The aim of the present study was to assess compulsive health-related Internet use in relation to cyberchondria while controlling for related variables. METHOD Adult participants (N = 749) were recruited from an online platform. They completed questionnaires assessing the severity of cyberchondria (via the Cyberchondria Severity Scale [CSS]), compulsive Internet use adapted for online health-related seeking (via the adapted Compulsive Internet Use Scale [CIUS]), and levels of intolerance of uncertainty and anxiety, as well as depressive, somatic, and obsessive-compulsive symptoms. A logistic regression analysis was carried out to identify predictors of scores above a cutoff value on the CIUS, indicating compulsive health-related Internet use. RESULTS The regression output showed that only the CSS total score and sex made a unique, statistically significant contribution to the model, leading to the correct classification of 78.6% of the cases. Of the CSS subscales, compulsion and distress were the most strongly associated with compulsive health-related Internet use. CONCLUSIONS The finding that the adapted CIUS scores are associated with cyberchondria indicates that cyberchondria has a compulsive component, at least in terms of health-related Internet use. It also suggests that compulsive health-related Internet use persists despite the distress associated with this activity. Males may engage in cyberchondria more compulsively than females. These findings have implications for research and clinical practice.
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Affiliation(s)
- Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland,Research Centre, University Institute of Mental Health at Montréal, Montréal, Québec, Canada,*Yasser Khazaal, Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, Lausanne University, Bugnon 23a, CH–1011 Lausanne (Switzerland),
| | - Anne Chatton
- Department of Psychiatry and Mental Health, Geneva University Hospitals, Geneva, Switzerland
| | - Lucien Rochat
- Faculty of Psychology, University of Geneva, Geneva, Switzerland
| | - Vincent Hede
- Department of Psychiatry and Mental Health, Geneva University Hospitals, Geneva, Switzerland
| | - Kirupamani Viswasam
- Department of Psychiatry, Nepean Hospital, Penrith, New South Wales, Australia
| | - Louise Penzenstadler
- Department of Psychiatry and Mental Health, Geneva University Hospitals, Geneva, Switzerland
| | - David Berle
- Discipline of Clinical Psychology, University of Technology Sydney, Sydney, New South Wales, Australia,School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Vladan Starcevic
- Discipline of Psychiatry, Sydney Medical School, Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Michalska P, Chatton A, Penzenstadler L, Izdebski P, Jeannot E, Simon O, Dufour M, Rochat L, Lischer S, Khazaal Y. Perspective of Internet Poker Players on Harm-Reduction Strategies: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239054. [PMID: 33291669 PMCID: PMC7730654 DOI: 10.3390/ijerph17239054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/23/2020] [Accepted: 11/27/2020] [Indexed: 12/19/2022]
Abstract
Background: Internet gambling may increase rates of gambling harm. This current study aimed to assess Internet poker players’ views on various harm-reduction (HR) strategies. It also examined differences in these views according to the games played (poker only vs. poker plus other gambling activities), indebtedness, and problem gambling severity. Methods: Internet poker players (n = 311; 94.2% Male) recruited online between 2012 and 2014 were included in the analyses and completed a survey on indebtedness, problem gambling severity index, and ten statements regarding HR features. Results: Among the whole sample, the most frequently endorsed HR strategy was setting money limits, specialized online help, and peer support forums. People who play poker only (70%) are less prone to endorse the utility of information on excessive gambling and specialized healthcare centers. No differences were found between those people with debt versus those without regarding HR assessment. Participants with severe problem gambling were more skeptical about HR strategies based on information on specialized healthcare centers. Conclusion: Setting money limits, online help, and peer support forums are the most commonly endorsed strategies. Future research is needed to evaluate the effectiveness of online harm reduction strategies.
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Affiliation(s)
- Patrycja Michalska
- Faculty of Psychology, Kazimierz Wielki University, 85-867 Bydgoszcz, Poland; (P.M.); (P.I.); (Y.K.)
| | - Anne Chatton
- Department of Psychiatry, Geneva University Hospital, 1205 Geneva, Switzerland; (A.C.); (L.P.); (L.R.)
| | - Louise Penzenstadler
- Department of Psychiatry, Geneva University Hospital, 1205 Geneva, Switzerland; (A.C.); (L.P.); (L.R.)
| | - Paweł Izdebski
- Faculty of Psychology, Kazimierz Wielki University, 85-867 Bydgoszcz, Poland; (P.M.); (P.I.); (Y.K.)
| | - Emilien Jeannot
- Institute of Global Health, Geneva University, 1211 Geneva, Switzerland
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, 1011 Lausanne, Switzerland;
- Correspondence:
| | - Olivier Simon
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, 1011 Lausanne, Switzerland;
- Faculty of Biology and Medicine, Lausanne University, 1005 Lausanne, Switzerland
| | - Magali Dufour
- Department of Psychology, Université du Québec à Montréal, Montreal, CP 8888, Canada;
| | - Lucien Rochat
- Department of Psychiatry, Geneva University Hospital, 1205 Geneva, Switzerland; (A.C.); (L.P.); (L.R.)
| | - Suzanne Lischer
- Institute for Social Management, Social Policy and Prevention, Lucerne University of Applied Sciences and Arts, 6002 Lucerne, Switzerland;
| | - Yasser Khazaal
- Faculty of Psychology, Kazimierz Wielki University, 85-867 Bydgoszcz, Poland; (P.M.); (P.I.); (Y.K.)
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, 1011 Lausanne, Switzerland;
- Faculty of Biology and Medicine, Lausanne University, 1005 Lausanne, Switzerland
- Research Center, Montreal University Institute of Mental Health, Montreal, QC H3C 3P8, Canada
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12
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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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13
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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: 125] [Impact Index Per Article: 31.3] [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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14
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Vederhus JK, Rørendal M, Bjelland C, Skar AKS, Kristensen Ø. Can a Smartphone App for Cannabis Cessation Gain a Broader User Group than Traditional Treatment Services? Subst Abuse 2020; 14:1178221820902237. [PMID: 32071540 PMCID: PMC6997962 DOI: 10.1177/1178221820902237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 01/03/2020] [Indexed: 12/30/2022]
Abstract
Background: Treatment demand for cannabis use disorders is increasing in Europe. Mobile
phone– and internet-based interventions for cannabis users can possibly help
meet the need. The purpose of this study was to examine whether a recently
developed Norwegian Cannabis Cessation app reaches a broader or different
user group compared to community-based Cannabis Cessation programs (CCP,
Nordic abbreviation: HAP). Method: The app respondents (n = 148) were recruited through an online link in the
app. A comparative sample (n = 102) was recruited in three municipally based
CCPs in Norway. We examined whether app users differed from the CCP
population in sociodemographics, substance use, mental health, and
well-being. Result: The app group included more women than the CCP group (46% versus 26%,
χ2 = 10.9, P = .001), but otherwise the
groups were similar for sociodemographic variables. Severity of cannabis use
did not differ between groups, but the app sample exhibited a higher
depressiveness score on the Hopkins Symptom Checklist (mean difference,
0.24; 95% CI 0.04–0.44; P = .018) and lower perceived
well-being (3.4 point lower score on the Outcome Rating Scale; 95% CI −5.7
to −1.2; P = .003). Well-being was negatively associated
with being in the app group, being older, and having higher levels of mental
distress, and was positively associated with the perceived ability to make
changes (‘self-efficacy of quitting’). Conclusion: The higher proportion of women in the app group indicated that the app did
capture an expanded segment of the cannabis-using population. The app can be
an alternative for those who are not yet prepared to seek treatment in
formal healthcare services. The high level of depressive symptoms and lower
levels of well-being among the app respondents suggest that some app users
might need additional support.
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Affiliation(s)
| | - Malin Rørendal
- City Centre Outreach Service, Agency for Social and Welfare Services, City of Oslo, Norway
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15
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Pennou A, Lecomte T, Potvin S, Khazaal Y. Mobile Intervention for Individuals With Psychosis, Dual Disorders, and Their Common Comorbidities: A Literature Review. Front Psychiatry 2019; 10:302. [PMID: 31130884 PMCID: PMC6510170 DOI: 10.3389/fpsyt.2019.00302] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/17/2019] [Indexed: 12/24/2022] Open
Abstract
Over 50% of people diagnosed with a severe mental illness, such as schizophrenia or bipolar disorder, will meet criteria for a substance use disorder in their lifetime. This dual disorder often starts during youth and leads to significant societal costs, including lower employability rates, more hospitalizations, and higher risk of homelessness and of suicide attempts when compared to those with a serious mental illness without substance misuse. Moreover, many individuals presenting with comorbid disorders also present with other psychological difficulties as well, such as personality disorders or anxiety and depression, also known as complex comorbid disorders. Transdiagnostic treatments that focus on core difficulties found in people with complex dual disorders, such as emotional regulation, are direly needed. Emotional regulation skills can help reduce distress related to psychotic symptoms and maintain abstinence in substance use disorders. New technologies in the field of communications have developed considerably over the past decade and have the potential to improve access to such treatments, a major problem in many health care settings. As such, this paper aims at: presenting core difficulties present in many individuals with dual disorders, reviewing the scientific literature pertaining to the use of mobile applications in mental health and addictions, and presenting the development and potential of a new application for emotional regulation for people with dual disorders.
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Affiliation(s)
- Antoine Pennou
- Schizophrenia and Psychoses Study Laboratory for Intervention and Recovery, Department of Psychology, University of Montreal, Montreal, QC, Canada
- Research Center of the Montreal Mental Health University Institute, Intervention Axis and Services & Neurobiology and Cognition, Mental Health University Institute of Montreal, Montreal, QC, Canada
| | - Tania Lecomte
- Schizophrenia and Psychoses Study Laboratory for Intervention and Recovery, Department of Psychology, University of Montreal, Montreal, QC, Canada
- Research Center of the Montreal Mental Health University Institute, Intervention Axis and Services & Neurobiology and Cognition, Mental Health University Institute of Montreal, Montreal, QC, Canada
| | - Stéphane Potvin
- Research Center of the Montreal Mental Health University Institute, Intervention Axis and Services & Neurobiology and Cognition, Mental Health University Institute of Montreal, Montreal, QC, Canada
| | - Yasser Khazaal
- Research Center of the Montreal Mental Health University Institute, Intervention Axis and Services & Neurobiology and Cognition, Mental Health University Institute of Montreal, Montreal, QC, Canada
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
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16
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Matheson FI, Hamilton-Wright S, Kryszajtys DT, Wiese JL, Cadel L, Ziegler C, Hwang SW, Guilcher SJT. The use of self-management strategies for problem gambling: a scoping review. BMC Public Health 2019; 19:445. [PMID: 31035978 PMCID: PMC6489359 DOI: 10.1186/s12889-019-6755-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 04/08/2019] [Indexed: 12/18/2022] Open
Abstract
Background Problem gambling (PG) is a serious public health concern that disproportionately affects people experiencing poverty, homelessness, and multimorbidity including mental health and substance use concerns. Little research has focused on self-help and self-management in gambling recovery, despite evidence that a substantial number of people do not seek formal treatment. This study explored the literature on PG self-management strategies. Self-management was defined as the capacity to manage symptoms, the intervention, health consequences and altered lifestyle that accompanies a chronic health concern. Methods We searched 10 databases to identity interdisciplinary articles from the social sciences, allied health professions, nursing and psychology, between 2000 and June 28, 2017. We reviewed records for eligibility and extracted data from relevant articles. Studies were included in the review if they examined PG self-management strategies used by adults (18+) in at least a subset of the sample, and in which PG was confirmed using a validated diagnostic or screening tool. Results We conducted a scoping review of studies from 2000 to 2017, identifying 31 articles that met the criteria for full text review from a search strategy that yielded 2662 potential articles. The majority of studies examined self-exclusion (39%), followed by use of workbooks (35%), and money or time limiting strategies (17%). The remaining 8% focused on cognitive, behavioural and coping strategies, stress management, and mindfulness. Conclusions Given that a minority of people with gambling concerns seek treatment, that stigma is an enormous barrier to care, and that PG services are scarce and most do not address multimorbidity, it is important to examine the personal self-management of gambling as an alternative to formalized treatment. Electronic supplementary material The online version of this article (10.1186/s12889-019-6755-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Flora I Matheson
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
| | - Sarah Hamilton-Wright
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - David T Kryszajtys
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - Jessica L Wiese
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - Lauren Cadel
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Carolyn Ziegler
- Health Information Sciences Library, University of Toronto, Toronto, ON, Canada
| | - Stephen W Hwang
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - Sara J T Guilcher
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
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17
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Lee SJ, Choi MJ, Rho MJ, Kim DJ, Choi IY. Factors Affecting User Acceptance in Overuse of Smartphones in Mobile Health Services: An Empirical Study Testing a Modified Integrated Model in South Korea. Front Psychiatry 2018; 9:658. [PMID: 30631283 PMCID: PMC6315168 DOI: 10.3389/fpsyt.2018.00658] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 11/19/2018] [Indexed: 11/13/2022] Open
Abstract
Smartphones have become crucial in people's everyday lives, including in the medical field. However, as people become close to their smartphones, this leads easily to overuse. Overuse leads to fatigue due to lack of sleep, depressive symptoms, and social relationship failure, and in the case of adolescents, it hinders academic achievement. Self-control solutions are needed, and effective tools can be developed through behavioral analysis. Therefore, the aim of this study was to investigate the determinants of users' intentions to use m-Health for smartphone overuse interventions. A research model was based on TAM and UTAUT, which were modified to be applied to the case of smartphone overuse. The studied population consisted of 400 randomly selected smartphone users aged from 19 to 60 years in South Korea. Structural equation modeling was conducted between variables to test the hypotheses using a 95% confidence interval. Perceived ease of use had a very strong direct positive association with perceived usefulness, and perceived usefulness had a very strong direct positive association with behavioral intention to use. Resistance to change had a direct positive association with behavioral intention to use and, lastly, social norm had a very strong direct positive association with behavioral intention to use. The findings that perceived ease of use influenced perceived usefulness, that perceived usefulness influenced behavioral intention to use, and social norm influenced behavioral intention to use were in accordance with prior related research. Other results that were not consistent with previous research imply that these are unique behavioral findings regarding smartphone overuse. This research identifies the critical factors that need to be considered when implementing systems or solutions in the future for tackling the issue of smartphone overuse.
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Affiliation(s)
- Seo-Joon Lee
- Research Institute of Health Science, Korea University, Seoul, South Korea
| | - Mun Joo Choi
- Department of Medical Informatics, The Catholic University of Seoul, Seoul, South Korea
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Mi Jung Rho
- Department of Medical Informatics, The Catholic University of Seoul, Seoul, South Korea
- Catholic Institute for Healthcare Management and Graduate School of Healthcare Management and Policy, The Catholic University of Korea, Seoul, South Korea
| | - Dai-Jin Kim
- Department of Psychiatry, Addiction Research Institute, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - In Young Choi
- Department of Medical Informatics, The Catholic University of Seoul, Seoul, South Korea
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, South Korea
- Catholic Institute for Healthcare Management and Graduate School of Healthcare Management and Policy, The Catholic University of Korea, Seoul, South Korea
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18
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Chib A, Lin SH. Theoretical Advancements in mHealth: A Systematic Review of Mobile Apps. JOURNAL OF HEALTH COMMUNICATION 2018; 23:909-955. [PMID: 30449261 DOI: 10.1080/10810730.2018.1544676] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
There are now few hundred thousand healthcare apps, yet there is a gap in our understanding of the theoretical mechanisms for which, and how, technological features translate into improved healthcare outcomes. In particular, the technological convergence, within mobile health (mHealth) apps, of the processes of mass and interpersonal communication, and human-computer interaction requires greater parsing in the literature. This paper analyzed 85 empirical studies on mHealth apps using the Input-Mechanism-Output model. We found in the literature that, firstly, there is a greater emphasis on technological inputs (87%) of accessibility, usability, usage, and data quality, than health outputs (52%) such as system process efficiencies and individual level behavioral or health outcomes. Secondly, there is little evidence of explanatory mechanisms (19%) of how the effects of mHealth apps are achieved. While we believe that successful apps would require research that incorporates technological inputs, theoretical mechanisms and health outputs, such studies are a rarity (n = 3). There is a minor increase in rigor with randomized control trials (n = 5), and a preponderance of discussion around social influence (n = 8) and gamification (n = 7), albeit in a scattered manner. We discuss the implications of the trend towards socialization and gamification findings in terms of future research, particularly in terms of study design guided by theoretical mechanisms.
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Affiliation(s)
- Arul Chib
- a Wee Kim Wee School of Communication and Information , Nanyang Technological University , Singapore
| | - Sapphire H Lin
- a Wee Kim Wee School of Communication and Information , Nanyang Technological University , Singapore
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Khazaal Y, Chatton A, Achab S, Monney G, Thorens G, Dufour M, Zullino D, Rothen S. Internet Gamblers Differ on Social Variables: A Latent Class Analysis. J Gambl Stud 2018; 33:881-897. [PMID: 28028687 DOI: 10.1007/s10899-016-9664-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Online gambling has gained popularity in the last decade, leading to an important shift in how consumers engage in gambling and in the factors related to problem gambling and prevention. Indebtedness and loneliness have previously been associated with problem gambling. The current study aimed to characterize online gamblers in relation to indebtedness, loneliness, and several in-game social behaviors. The data set was obtained from 584 Internet gamblers recruited online through gambling websites and forums. Of these gamblers, 372 participants completed all study assessments and were included in the analyses. Questionnaires included those on sociodemographics and social variables (indebtedness, loneliness, in-game social behaviors), as well as the Gambling Motives Questionnaire, Gambling Related Cognitions Scale, Internet Addiction Test, Problem Gambling Severity Index, Short Depression-Happiness Scale, and UPPS-P Impulsive Behavior Scale. Social variables were explored with a latent class model. The clusters obtained were compared for psychological measures and three clusters were found: lonely indebted gamblers (cluster 1: 6.5%), not lonely not indebted gamblers (cluster 2: 75.4%), and not lonely indebted gamblers (cluster 3: 18%). Participants in clusters 1 and 3 (particularly in cluster 1) were at higher risk of problem gambling than were those in cluster 2. The three groups differed on most assessed variables, including the Problem Gambling Severity Index, the Short Depression-Happiness Scale, and the UPPS-P subscales (except the sensation seeking subscore). Results highlight significant between-group differences, suggesting that Internet gamblers are not a homogeneous group. Specific intervention strategies could be implemented for groups at risk.
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Affiliation(s)
- Yasser Khazaal
- Geneva University Hospitals, Grand Pré 70C, Geneva, 1206, Switzerland.
- Faculty of Medicine, Geneva University, Geneva, Switzerland.
- Research Center, Montreal University Institute of Mental Health, Montreal, Canada.
| | - Anne Chatton
- Geneva University Hospitals, Grand Pré 70C, Geneva, 1206, Switzerland
| | - Sophia Achab
- Geneva University Hospitals, Grand Pré 70C, Geneva, 1206, Switzerland
| | - Gregoire Monney
- Geneva University Hospitals, Grand Pré 70C, Geneva, 1206, Switzerland
| | - Gabriel Thorens
- Geneva University Hospitals, Grand Pré 70C, Geneva, 1206, Switzerland
- Faculty of Medicine, Geneva University, Geneva, Switzerland
| | | | - Daniele Zullino
- Geneva University Hospitals, Grand Pré 70C, Geneva, 1206, Switzerland
- Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - Stephane Rothen
- Geneva University Hospitals, Grand Pré 70C, Geneva, 1206, Switzerland
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20
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A pilot study of a smartphone application supporting recovery from drug addiction. J Subst Abuse Treat 2018; 88:51-58. [PMID: 29606226 DOI: 10.1016/j.jsat.2018.02.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 02/23/2018] [Accepted: 02/23/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Mobile health (mHealth) technologies have the potential to facilitate self-monitoring and self-management for individuals with substance use disorders (SUD). S-Health is a bilingual smartphone application based on cognitive behavioral principles and is designed to support recovery from drug addiction by trigger recognition so as to allow practice in-the-moment coping to prevent relapse. METHOD For this pilot randomized controlled study, 75 participants were recruited from methadone maintenance treatment clinics and the social worker consortium in Shanghai, China. Participants in the control group (N=25) received text messages from S-Health (e.g., HIV prevention and other educational materials). Participants in the intervention group (N=50) received both text messages and daily surveys on cravings, affects, triggers, responses to triggers, and social contexts. RESULTS At the end of the 1-month study trial, 26.2% of the intervention group and 50% of the control group had positive urine test results (p=0.06). Also, the number of days using drug in the past week was significantly lower among participants in the intervention group (Mean=0.71, SD=1.87) relative to the control group (Mean=2.20, SD=3.06) (p<0.05). The two groups did not differ in slopes (i.e., rates of change in outcomes measured weekly) based on the mixed effects model. Participants in the intervention group also preferred answering questions on the cellphone (46.8%) relative to in-person interviews (36.2%). CONCLUSIONS This pilot demonstrated the feasibility and potential benefits to deliver mobile health intervention among participants with SUD. Further research with larger samples over a longer period of time is needed to test the effectiveness of S-Health as a self-monitoring tool supporting recovery from addiction.
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21
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Koffel E, Kuhn E, Petsoulis N, Erbes CR, Anders S, Hoffman JE, Ruzek JI, Polusny MA. A randomized controlled pilot study of CBT-I Coach: Feasibility, acceptability, and potential impact of a mobile phone application for patients in cognitive behavioral therapy for insomnia. Health Informatics J 2016; 24:3-13. [PMID: 27354394 DOI: 10.1177/1460458216656472] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There has been growing interest in utilizing mobile phone applications (apps) to enhance traditional psychotherapy. Previous research has suggested that apps may facilitate patients' completion of cognitive behavioral therapy for insomnia (CBT-I) tasks and potentially increase adherence. This randomized clinical trial pilot study ( n = 18) sought to examine the feasibility, acceptability, and potential impact on adherence and sleep outcomes related to CBT-I Coach use. All participants were engaged in CBT-I, with one group receiving the app as a supplement and one non-app group. We found that patients consistently used the app as intended, particularly the sleep diary and reminder functions. They reported that it was highly acceptable to use. Importantly, the app did not compromise or undermine benefits of cognitive behavioral therapy for insomnia and patients in both groups had significantly improved sleep outcomes following treatment.
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Affiliation(s)
- Erin Koffel
- Minneapolis Veteran Affairs Health Care System, USA; University of Minnesota Medical School, USA
| | - Eric Kuhn
- National Center for PTSD (NCPTSD), Dissemination and Training (D&T) Division, USA; Department of Veterans Affairs Palo Alto Health Care System (VAPAHCS), USA
| | | | - Christopher R Erbes
- Minneapolis Veteran Affairs Health Care System, USA; University of Minnesota Medical School, USA
| | | | - Julia E Hoffman
- National Center for PTSD (NCPTSD), Dissemination and Training (D&T) Division, USA; Department of Veterans Affairs Palo Alto Health Care System (VAPAHCS), USA
| | - Josef I Ruzek
- National Center for PTSD (NCPTSD), Dissemination and Training (D&T) Division, USA; Department of Veterans Affairs Palo Alto Health Care System (VAPAHCS), USA
| | - Melissa A Polusny
- Minneapolis Veteran Affairs Health Care System, USA; University of Minnesota Medical School, USA
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Realising the technological promise of smartphones in addiction research and treatment: An ethical review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 36:47-57. [PMID: 27455467 DOI: 10.1016/j.drugpo.2016.05.013] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 05/25/2016] [Accepted: 05/25/2016] [Indexed: 01/20/2023]
Abstract
BACKGROUND Smartphone technologies and mHealth applications (or apps) promise unprecedented scope for data collection, treatment intervention, and relapse prevention when used in the field of substance abuse and addiction. This potential also raises new ethical challenges that researchers, clinicians, and software developers must address. AIMS This paper aims to identify ethical issues in the current uses of smartphones in addiction research and treatment. METHODS A search of three databases (PubMed, Web of Science and PsycInfo) identified 33 studies involving smartphones or mHealth applications for use in the research and treatment of substance abuse and addiction. A content analysis was conducted to identify how smartphones are being used in these fields and to highlight the ethical issues raised by these studies. RESULTS Smartphones are being used to collect large amounts of sensitive information, including personal information, geo-location, physiological activity, self-reports of mood and cravings, and the consumption of illicit drugs, alcohol and nicotine. Given that detailed information is being collected about potentially illegal behaviour, we identified the following ethical considerations: protecting user privacy, maximising equity in access, ensuring informed consent, providing participants with adequate clinical resources, communicating clinically relevant results to individuals, and the urgent need to demonstrate evidence of safety and efficacy of the technologies. CONCLUSIONS mHealth technology offers the possibility to collect large amounts of valuable personal information that may enhance research and treatment of substance abuse and addiction. To realise this potential researchers, clinicians and app-developers must address these ethical concerns to maximise the benefits and minimise risks of harm to users.
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Khazaal Y, Chatton A, Rothen S, Achab S, Thorens G, Zullino D, Gmel G. Psychometric properties of the 7-item game addiction scale among french and German speaking adults. BMC Psychiatry 2016; 16:132. [PMID: 27160387 PMCID: PMC4862221 DOI: 10.1186/s12888-016-0836-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 04/27/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The 7-item Game Addiction Scale (GAS) is a used to screen for addictive game use. Both cross cross-linguistic validation and validation in French and German is needed in adult samples. The objective of the study is to assess the factorial structure of the French and German versions of the GAS among adults. METHODS Two samples of men from French (N = 3318) and German (N = 2665) language areas of Switzerland were assessed with the GAS, the Major Depression Inventory (MDI), the Brief Sensation Seeking Scale, and the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ-50-cc). They were also assessed for cannabis and alcohol use. RESULTS The internal consistency of the scale was satisfactory (Cronbach α = 0.85). A one-factor solution was found in both samples. Small and positive associations were found between GAS scores and the MDI, as well as the Neuroticism-Anxiety and Aggression-Hostility subscales of the ZKPQ-50-cc. A small negative association was found with the ZKPQ-50-cc Sociability subscale. CONCLUSION The GAS, in its French and German versions, is appropriate for the assessment of game addiction among adults.
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Affiliation(s)
- Yasser Khazaal
- Department of Mental health and psychiatry, Geneva University Hospitals, Geneva, Switzerland. .,Department of psychiatry, Geneva University, Geneva, Switzerland.
| | - Anne Chatton
- Department of Mental health and psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Stephane Rothen
- Department of Mental health and psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Sophia Achab
- Department of Mental health and psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Gabriel Thorens
- Department of Mental health and psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Daniele Zullino
- Department of Mental health and psychiatry, Geneva University Hospitals, Geneva, Switzerland ,Department of psychiatry, Geneva University, Geneva, Switzerland
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Chung T, Pelechrinis K, Faloutsos M, Hylek L, Suffoletto B, Feldstein Ewing SW. Innovative Routes for Enhancing Adolescent Marijuana Treatment: Interplay of Peer Influence Across Social Media and Geolocation. CURRENT ADDICTION REPORTS 2016. [DOI: 10.1007/s40429-016-0095-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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25
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Benarous X, Edel Y, Consoli A, Brunelle J, Etter JF, Cohen D, Khazaal Y. Ecological Momentary Assessment and Smartphone Application Intervention in Adolescents with Substance Use and Comorbid Severe Psychiatric Disorders: Study Protocol. Front Psychiatry 2016; 7:157. [PMID: 27703435 PMCID: PMC5028912 DOI: 10.3389/fpsyt.2016.00157] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 08/30/2016] [Indexed: 01/18/2023] Open
Abstract
CONTEXT Substance use disorders (SUDs) are highly prevalent among inpatient adolescents with psychiatric disorders. In this population, substance use and other psychiatric outcomes can reinforce one another. Despite the need for integrated interventions in youths with dual diagnoses, few specific instruments are available. App-based technologies have shown promising results to help reduce substance use in adolescents, but their applicability in youths with associated severe psychiatric disorders is poorly documented. We aim to evaluate the feasibility of an ecological momentary assessment (EMA) intervention for all substance users, and of a smartphone application for cannabis users (Stop-Cannabis), for outpatient treatment after hospital discharge. METHODS AND ANALYSIS All inpatient adolescents with psychiatric disorders hospitalized between 2016 and 2018 in a university hospital will be systematically screened for SUD and, if positive, will be assessed by an independent specialist addiction team. Participants with confirmed SUDs will be invited and helped to download an EMA app and, if required, the Stop-Cannabis app, the week preceding hospital discharge. Information about the acceptability and use of both apps and the validity of EMA data in comparison to clinical assessments will be assessed after 6 months and 1 year. DISCUSSION This research has been designed to raise specific issues for consideration regarding the sequence between substance use, contextual factors, and other psychiatric symptoms among adolescents with comorbid severe psychiatric disorders. A better understanding of the mechanisms involved will inform the development of integrated treatment for dual disorders at that age. ETHICS AND DISSEMINATION The study has already been approved and granted. Dissemination will include presentations at international congresses as well as publications in peer-reviewed journals. TRIAL REGISTRATION European Clinical Trials Database: Number 2016-001999-30.
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Affiliation(s)
- Xavier Benarous
- Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpêtrière , Paris , France
| | - Yves Edel
- Department of Addiction, Hôpital Pitié-Salpêtrière , Paris , France
| | - Angèle Consoli
- Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpêtrière , Paris , France
| | - Julie Brunelle
- Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpêtrière , Paris , France
| | | | - David Cohen
- Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpêtrière, Paris, France; UMR 7222, Institute of Intelligent Systems and Robotics, Université Pierre et Marie Curie, Paris, France
| | - Yasser Khazaal
- Faculty of Medicine, Geneva University Hospitals, University of Geneva, Geneva, Switzerland; Geneva University Hospitals, Geneva, Switzerland
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Penzenstadler L, Chatton A, Van Singer M, Khazaal Y. Quality of Smartphone Apps Related to Alcohol Use Disorder. Eur Addict Res 2016; 22:329-338. [PMID: 27598779 DOI: 10.1159/000449097] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 08/14/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Apps for smartphones are opening an important range of opportunities for improving the care of people with alcohol use disorders (AUDs). AIMS This study aimed to evaluate the quality of English language apps for AUDs and to compare paid and free apps. The keywords 'alcohol', 'alcohol addiction', 'alcohol help' and 'stop drinking' were entered into the iTunes Store search engine. Apps were evaluated using a standardized assessment designed to rate the quality of apps in terms of accountability, interactivity, self-help score and evidence-based content. The Brief DISCERN score and the criteria of the 'Health on the Net' label were also used as content quality indicators. RESULTS AND CONCLUSIONS Of the 137 unique apps identified, 52 met the inclusion criteria. Overall, the content quality and self-help scores of these AUD apps were poor. The main quality indicators were not linked to payment status. Multiple linear regressions showed that the Brief DISCERN score significantly predicted content quality. Poor content quality and self-help scores of AUD smartphone apps underline the gap between their potential promises and the overall quality of available products in stores. The quality indicators used in the present study may be used for further app developments.
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Affiliation(s)
- Louise Penzenstadler
- Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
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