Evaluating user perceptions of an e-Health intervention for cannabis use: Focus Group Study (Preprint)

Abstract

BACKGROUND Cannabis is the most used illicit drug and admissions for cannabis use disorders (CUDs) are rising worldwide, posing a significant public health problem. Despite its negative consequences, an important number of problematic users do not access treatment. Digital health interventions (DHIs) have spread over the past two decades, as they are easily accessible and cost-effective solutions. CANreduce is one of the eHealth interventions that has proven effective in reducing cannabis use (CU), although it exhibited suboptimal adherence rates. OBJECTIVE This study aims to enhance the effectiveness, adherence, and user experience of the Spanish version of CANreduce 2.0, by using focus groups (FGs), in the context of a patient-centered design approach that engages both patients and clinicians. METHODS Separate FGs were conducted for users and clinicians with a total of 10 participants. Each session was facilitated by two interviewers and conducted remotely via Zoom using a semi-structured script that allowed to discuss user’s perspectives on specific topics related to the acceptability, usability and utility of the DHI. A qualitative analysis of the transcripts was conducted using MAXQDA software. Content analysis methodology was used to identify and define themes that captured essential topics of interest from the data gathered. RESULTS Codes identified in the qualitative analysis were categorized into 3 main themes: "motivation and awareness," "guidance and use," and "content and design". Strengths and deficiencies of the intervention, as well as outlines on how to address them, were identified for each theme. The main findings highlighted the suitability of CANreduce 2.0 as a complement to in-person therapy serving as an educational and monitoring tool. Additionally, the importance of notifications, gamification, and personalization to was emphasized to enhance motivation and adherence. CONCLUSIONS This study highlights the complexity of designing effective DHIs for CU. Personalization, robust motivational strategies, and an interactive design are crucial for the process' success. Collaboration between technology developers, healthcare professionals, and patients should be in the center of developing DHIs, with user perspectives being key to reaching practical and effective solutions.