Prospective acceptability of digital phenotyping among pregnant and parenting people with opioid use disorder: A multisite qualitative study

Abstract

BackgroundWhile medications for opioid use disorder (MOUD) effectively treat OUD during pregnancy and the postpartum period, poor treatment retention is common. Digital phenotyping, or passive sensing data captured from personal mobile devices, namely smartphones, provides an opportunity to understand behaviors, psychological states, and social influences contributing to perinatal MOUD non-retention. Given this novel area of investigation, we conducted a qualitative study to determine the acceptability of digital phenotyping among pregnant and parenting people with opioid use disorder (PPP-OUD).MethodsThis study was guided by the Theoretical Framework of Acceptability (TFA). Within a clinical trial testing a behavioral health intervention for PPP-OUD, we used purposeful criterion sampling to recruit 11 participants who delivered a child in the past 12 months and received OUD treatment during pregnancy or the postpartum period. Data were collected through phone interviews using a structured interview guide based on four TFA constructs (affective attitude, burden, ethicality, self-efficacy). We used framework analysis to code, chart, and identify key patterns within the data.ResultsParticipants generally expressed positive attitudes about digital phenotyping and high self-efficacy and low anticipated burden to participate in studies that collect smartphone-based passive sensing data. Nonetheless, concerns were noted related to data privacy/security and sharing location information. Differences in participant assessments of burden were related to length of time required and level of remuneration to participate in a study. Interviewees voiced broad support for participating in a digital phenotyping study with known/trusted individuals but expressed concerns about third-party data sharing and government monitoring.ConclusionDigital phenotyping methods were acceptable to PPP-OUD. Enhancements in acceptability include allowing participants to maintain control over which data are shared, limiting frequency of research contacts, aligning compensation with participant burden, and outlining data privacy/security protections on study materials.

A Qualitative Exploration of Attitudes Toward Global Positioning System Tracking and Ecological Momentary Assessment Among Individuals in Substance Use Treatment

“…Our findings that participants were mostly unconcerned with the use of tracking elements in research and intervention are supported by high rates of feasibility and acceptability of both ecological momentary assessment 9,24 -26 and GPS tracking 16,27 in similar populations of people who use substances. Participant concerns around confidentiality 28 and the time and effort burden of data collection have been documented elsewhere among people who use drugs.…”

“…Participant concerns around confidentiality 28 and the time and effort burden of data collection have been documented elsewhere among people who use drugs. 16,29,30 Similarly, perceived participant benefits related to study participation, including increased self-worth and social support along with decreased substance use, have also been observed elsewhere. 31 To our knowledge, this is the first study discussing specific perceived benefits to participation in studies using ecological momentary assessment and GPS tracking among people who use substances.…”

“…Participant concerns around confidentiality 28 and the time and effort burden of data collection have been documented elsewhere among people who use drugs. 16,29,30…”

“…To our knowledge, researchers have not explored in depth the attitudes and perceptions of people in SUD treatment on the use of such tracking technology, especially GPS tracking, for research purposes. Charron et al 16 recently found high levels of acceptability for different sensing technologies, but did not examine attitudes toward more active methodologies (ie, ecological momentary assessment). To this end, we conducted semi-structured qualitative interviews with individuals in treatment for a variety of SUD.…”

Acceptability and content validity of suicidality screening items: a qualitative study with perinatal women

“…The TFA defines acceptability as a multifaceted construct, comprising of seven domains (affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy, see Table 1 for construct definitions) that can be applied at different timepoints (before, during or after an intervention) to assess the prospective, concurrent, or retrospective acceptability of an intervention. Perinatal research has used the TFA to assess acceptability in a variety of healthcare contexts (e.g., 57 – 61 ), including the use of exposure therapy among pregnant women with elevated anxiety ( 62 ), and a systematic review on the acceptability of implementing patient reported measures in routine maternity care ( 63 ). However, the authors know of no research that has used the TFA to assess the acceptability of suicide-related screening items to perinatal women.…”