Developing an Adaptive Mobile Intervention to Address Risky Substance Use Among Adolescents and Emerging Adults: Usability Study

Abstract

Background Substance use among adolescents and emerging adults continues to be an important public health problem associated with morbidity and mortality. Mobile health (mHealth) provides a promising approach to deliver just-in-time adaptive interventions (JITAIs) to prevent escalation of use and substance use–related consequences. Objective This pilot study aims to describe the iterative development and initial feasibility and acceptability testing of an mHealth smartphone app, called MiSARA, designed to reduce escalation in substance use. Methods We used social media advertisements to recruit youth (n=39; aged 16-24 years, who screened positive for past-month binge drinking or recreational cannabis use) with a waiver of parental consent. Participants used the MiSARA app for 30 days, with feasibility and acceptability data reported at a 1-month follow-up. We present descriptive data regarding behavior changes over time. Results The results show that most participants (31/39, 79%) somewhat liked the app at least, with most (29/39, 74%) rating MiSARA as 3 or more stars (out of 5). Almost all participants were comfortable with self-reporting sensitive information within the app (36/39, 92%); however, most participants also desired more interactivity (27/39, 69%). In addition, participants’ substance use declined over time, and those reporting using the app more often reported less substance use at the 1-month follow-up than those who reported using the app less often. Conclusions The findings suggest that the MiSARA app is a promising platform for JITAI delivery, with future trials needed to optimize the timing and dose of messages and determine efficacy.

The growing field of digital psychiatry: current evidence and the future of apps, social media, chatbots, and virtual reality

“…Additional research is needed to better understand what role smartphone app technologies could play towards the treatment, prevention or management of substance use disorders. Although the quality of commercially available apps for these disorders is suboptimal, it is promising to see research teams from around the globe beginning to develop smartphone apps in this area that have a clear underlying evidence‐based framework, capitalize on latest advancements in technology (e.g., gamification, conversational agents), are routinely tested for their usability, involve feedback from end users, and are registered for evaluation in prospective clinical trials 181‐185 .…”

The Effectiveness of Web-Based Interventions to Promote Health Behaviour Change in Adolescents: A Systematic Review

“…From among the 14 included studies, 6 were conducted in the United States of America (42.9%) [ 28 , 30 , 31 , 32 , 33 , 34 ], 3 in European countries (21.4%) [ 35 , 36 , 37 ], 3 in Asian countries (21.4%) [ 38 , 39 , 40 ] and 2 in Mexico (14.3%) [ 41 , 42 ]. Of those, 10 were implemented in an educational setting (71.4%) [ 28 , 30 , 32 , 33 , 37 , 38 , 39 , 40 , 41 , 42 ].…”

Electronic bridge to mental health for college students: A randomized controlled intervention trial.

“…Although we used confidentiality assurances in e Bridge to temper anticipated privacy concerns, these may have persisted. It is interesting to note that one recent pilot study of a smartphone application for risky substance use among adolescents and young adults did not identify such privacy concerns (Coughlin et al, 2021). Nevertheless, this study differed from e Bridge in that it used a two-stage enrollment process and only 55% of those who screened positive in the first stage, making them study eligible, were enrolled in the second stage to provide feedback about the application.…”