Addiction
Conditions
Keywords
Continuing Care, Youth Substance Abuse, Recovery Support, Mobile Texting
Brief summary
The primary purpose of this study is to test the effectiveness of a pilot mobile based continuing care program (monitoring/feedback texting) relative to standard continuing care as usual in reducing relapse and improving psychosocial functioning outcomes in a youth population (under 24) with substance abuse problems.
Detailed description
This study will include approximately 80 participants randomized to either 12 weeks of mobile continuing care (intervention) or standard continuing care as usual (control). Participants will be recruited from the treatment programs in Los Angeles County, including Matrix Institute on Addictions, Tarzana Treatment, Twin Town, Phoenix House, and Cri-Help. During the 12-week active program, participants will be monitored monthly via telephone data collection. Both groups will be followed for 10-months using repeated assessments (self-report and urine specimens) at baseline (month 0) and at follow-up points (months 3, 6, and 9).
Interventions
BEHAVIORALMobile Continuing Care
Behavioral: Mobile Texting 12-week intervention. Delivers daily Recovering monitoring, self-management feedback, and education/social support
Sponsors
National Institute on Drug Abuse (NIDA)
University of California, Los Angeles
Azusa Pacific University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
12 Years to 24 Years
Healthy volunteers
No
Inclusion criteria
1. Youth between 12 and 24 years old 2. Youth in treatment for substance abuse 3. Youth who complete treatment (minimum 12 weeks) 4. Youth who have the cognitive capacity to understand study procedures and agree to participate
Exclusion criteria
1. Presence of an adverse (life threatening) medical condition that could interfere with study participation. 2. Presence of psychiatric co-occurring illness or symptoms warranting safety concerns or continued treatment, including acute suicide risk; and 3. Current homelessness (unless residing in recovery home for which contact information can be provided).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Primary Substance Use (Defined as Substance Received Treatment for) | Baseline, discahrge, 3 month follow-up, 6 month follow-up, 9 month follow-up | Primary substance use relapse was measured by urine tests (0 = negative, 1 = positive). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Participation in Recovery Behaviors Over Time | baseline, discharge, 3-, 6- and 9-month follow-ups | Recovery behaviors defined as mean number of days doing extracurricular/recovery-goal directed activities using repeated measures over time. |
| Recovery Confidence (Self-efficacy) Over Time | baseline, discharge, 3-, 6-, and 9-month follow-ups | Change/improvements in mean recovery confidence score over time (measured by question How confident are you in your ability to be completely abstinent (clean) from alcohol and drugs in the next 30 days? (units on scale included 0=not at all, 1=slightly, 2=moderately, 3=considerably, 4-extremely). |
| Social Support Utilization | Baseline, discahrge, 3 month follow-up, 6 month follow-up, 9 month follow-up | Self-help utilization was measured by the question: In the past 30 days, how many days did you attend self-help meetings like AA or NA to support your recovery? |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Mobile Continuing Care Behavioral: 12-week Structured Texting intervention focused on recovery monitoring, feedback for self-management, social support and education
Mobile Continuing Care: Behavioral: Mobile Texting 12-week intervention. Delivers daily recovering monitoring, self-management feedback, and education/social support | 40 |
| Standard Continuing Care as Usual Continuing care as usual (12-step facilitation) group | 40 |
| Total | 80 |
Baseline characteristics
| Characteristic | Mobile Continuing Care | Standard Continuing Care as Usual | Total |
|---|---|---|---|
| Age, Continuous | 22.1 years STANDARD_DEVIATION 3.1 | 19.0 years STANDARD_DEVIATION 3.1 | 20.4 years STANDARD_DEVIATION 3.5 |
| education | 14.0 years STANDARD_DEVIATION 2.3 | 12.0 years STANDARD_DEVIATION 2 | 12.9 years STANDARD_DEVIATION 2.9 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 10 Participants | 20 Participants | 30 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 30 Participants | 20 Participants | 50 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Asian | 3 Participants | 4 Participants | 7 Participants |
| Race (NIH/OMB) Black or African American | 4 Participants | 4 Participants | 8 Participants |
| Race (NIH/OMB) More than one race | 10 Participants | 20 Participants | 30 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 22 Participants | 12 Participants | 34 Participants |
| Region of Enrollment United States | 40 participants | 40 participants | 80 participants |
| Sex: Female, Male Female | 15 Participants | 8 Participants | 23 Participants |
| Sex: Female, Male Male | 25 Participants | 32 Participants | 57 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 40 | 0 / 40 |
| serious Total, serious adverse events | 0 / 40 | 0 / 40 |
Outcome results
Primary
Primary Substance Use (Defined as Substance Received Treatment for)
Primary substance use relapse was measured by urine tests (0 = negative, 1 = positive).
Time frame: Baseline, discahrge, 3 month follow-up, 6 month follow-up, 9 month follow-up
Population: An intent to treat model was used. The primary outcome measure is primary substance use measured by urine drug test at baseline, discharge as well as at 3-, 6-, and 9-month follow-ups. Study retention at discharge was 95%, 92.5% at 3 months, 86.2% at 6 months, and 82.5% at 9 months.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Mobile Continuing Care | Primary Substance Use (Defined as Substance Received Treatment for) | discharge substace use | 14.7 percentage of positive urines |
| Mobile Continuing Care | Primary Substance Use (Defined as Substance Received Treatment for) | 6-month follow-up substace use | 16.7 percentage of positive urines |
| Mobile Continuing Care | Primary Substance Use (Defined as Substance Received Treatment for) | baseline substance use | 47.5 percentage of positive urines |
| Mobile Continuing Care | Primary Substance Use (Defined as Substance Received Treatment for) | 9-month follow-up substace use | 11.1 percentage of positive urines |
| Mobile Continuing Care | Primary Substance Use (Defined as Substance Received Treatment for) | 3-month follow-up substace use | 21.4 percentage of positive urines |
| Standard Continuing Care as Usual | Primary Substance Use (Defined as Substance Received Treatment for) | 9-month follow-up substace use | 14.3 percentage of positive urines |
| Standard Continuing Care as Usual | Primary Substance Use (Defined as Substance Received Treatment for) | discharge substace use | 62.9 percentage of positive urines |
| Standard Continuing Care as Usual | Primary Substance Use (Defined as Substance Received Treatment for) | 3-month follow-up substace use | 59.3 percentage of positive urines |
| Standard Continuing Care as Usual | Primary Substance Use (Defined as Substance Received Treatment for) | 6-month follow-up substace use | 50.0 percentage of positive urines |
| Standard Continuing Care as Usual | Primary Substance Use (Defined as Substance Received Treatment for) | baseline substance use | 41.5 percentage of positive urines |
p-value: <0.0595% CI: [0.57, 0.99]GEE
Secondary
Participation in Recovery Behaviors Over Time
Recovery behaviors defined as mean number of days doing extracurricular/recovery-goal directed activities using repeated measures over time.
Time frame: baseline, discharge, 3-, 6- and 9-month follow-ups
Population: Intent to treatment model was used. Mixed modeling used to examine differences in recovery behaviors (measured by mean days doing extracurricular/recovery-goal directed activities) over time between study conditions.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Mobile Continuing Care | Participation in Recovery Behaviors Over Time | discharge recovery behaviors | 17.3 days per month | Standard Deviation 8.5 |
| Mobile Continuing Care | Participation in Recovery Behaviors Over Time | 6-month recovery behaviors | 17.5 days per month | Standard Deviation 10.6 |
| Mobile Continuing Care | Participation in Recovery Behaviors Over Time | 3-month recovery behaviors | 14.5 days per month | Standard Deviation 9.5 |
| Mobile Continuing Care | Participation in Recovery Behaviors Over Time | 9-month recovery behaviors | 18.4 days per month | Standard Deviation 10.6 |
| Mobile Continuing Care | Participation in Recovery Behaviors Over Time | baseline recovery behaviors | 12.1 days per month | Standard Deviation 9.7 |
| Standard Continuing Care as Usual | Participation in Recovery Behaviors Over Time | 9-month recovery behaviors | 12.4 days per month | Standard Deviation 16.6 |
| Standard Continuing Care as Usual | Participation in Recovery Behaviors Over Time | baseline recovery behaviors | 14.5 days per month | Standard Deviation 11.7 |
| Standard Continuing Care as Usual | Participation in Recovery Behaviors Over Time | discharge recovery behaviors | 10.3 days per month | Standard Deviation 11.4 |
| Standard Continuing Care as Usual | Participation in Recovery Behaviors Over Time | 3-month recovery behaviors | 11.97 days per month | Standard Deviation 11.96 |
| Standard Continuing Care as Usual | Participation in Recovery Behaviors Over Time | 6-month recovery behaviors | 13.8 days per month | Standard Deviation 12.9 |
Comparison: Mixed modeling using a repeated-measures random-effects model was conducted to test for the effects of treatment (dummy coded with 1 = mobile intervention, 0 = control) and time as well as the treatment x time interaction on the primary outcome measures of recovery behaviors mean days over time (baseline, discharge, 3, 6, and 9-month follow-ups).p-value: <0.00195% CI: [0.219, 0.248]Mixed Models Analysis
Secondary
Recovery Confidence (Self-efficacy) Over Time
Change/improvements in mean recovery confidence score over time (measured by question How confident are you in your ability to be completely abstinent (clean) from alcohol and drugs in the next 30 days? (units on scale included 0=not at all, 1=slightly, 2=moderately, 3=considerably, 4-extremely).
Time frame: baseline, discharge, 3-, 6-, and 9-month follow-ups
Population: Used an intent to treat design. Examined the effects of the intervention (mobile continuing care) compared to aftercare as usual on change in recovery self-confidence over time.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Mobile Continuing Care | Recovery Confidence (Self-efficacy) Over Time | 6-month follow-up confidence rating | 3.20 units on a scale | Standard Deviation 1.02 |
| Mobile Continuing Care | Recovery Confidence (Self-efficacy) Over Time | baseline confidence rating | 2.40 units on a scale | Standard Deviation 1.3 |
| Mobile Continuing Care | Recovery Confidence (Self-efficacy) Over Time | discharge confidence rating | 2.73 units on a scale | Standard Deviation 1.03 |
| Mobile Continuing Care | Recovery Confidence (Self-efficacy) Over Time | 3-month follow-up confidence rating | 2.67 units on a scale | Standard Deviation 1.3 |
| Mobile Continuing Care | Recovery Confidence (Self-efficacy) Over Time | 9-month follow-up confidence rating | 2.85 units on a scale | Standard Deviation 1.3 |
| Standard Continuing Care as Usual | Recovery Confidence (Self-efficacy) Over Time | 9-month follow-up confidence rating | 2.73 units on a scale | Standard Deviation 1.3 |
| Standard Continuing Care as Usual | Recovery Confidence (Self-efficacy) Over Time | 3-month follow-up confidence rating | 2.43 units on a scale | Standard Deviation 1.4 |
| Standard Continuing Care as Usual | Recovery Confidence (Self-efficacy) Over Time | baseline confidence rating | 2.53 units on a scale | Standard Deviation 1.2 |
| Standard Continuing Care as Usual | Recovery Confidence (Self-efficacy) Over Time | 6-month follow-up confidence rating | 2.51 units on a scale | Standard Deviation 1.5 |
| Standard Continuing Care as Usual | Recovery Confidence (Self-efficacy) Over Time | discharge confidence rating | 2.57 units on a scale | Standard Deviation 1.5 |
Comparison: Mixed modeling using a repeated-measures random-effects model was conducted to test for the effects of treatment (dummy coded with 1 = mobile intervention, 0 = control) and time as well as the treatment x time interaction on the outcome measure of recovery confidence mean score over time.p-value: <0.00195% CI: [0.106, 0.123]Mixed Models Analysis
Secondary
Social Support Utilization
Self-help utilization was measured by the question: In the past 30 days, how many days did you attend self-help meetings like AA or NA to support your recovery?
Time frame: Baseline, discahrge, 3 month follow-up, 6 month follow-up, 9 month follow-up
Population: Intent to treat model was used to assess the effects of the intervention (mobile continuing care) compared to aftercare as usual in terms of improvements in social support service utilization over time (baseline, discharge and follow-ups: 3-, 6- and 9-months post-discharge).
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Mobile Continuing Care | Social Support Utilization | discharge social support utilization | 8.6 days per month | Standard Deviation 10.1 |
| Mobile Continuing Care | Social Support Utilization | 6-month upport utilization | 6.1 days per month | Standard Deviation 8.5 |
| Mobile Continuing Care | Social Support Utilization | 3-month follow-up social support utilization | 7.4 days per month | Standard Deviation 9.5 |
| Mobile Continuing Care | Social Support Utilization | 9-month upport utilization | 4.9 days per month | Standard Deviation 7.7 |
| Mobile Continuing Care | Social Support Utilization | baseline social support utilization | 12.8 days per month | Standard Deviation 10.3 |
| Standard Continuing Care as Usual | Social Support Utilization | 9-month upport utilization | 2.8 days per month | Standard Deviation 7.2 |
| Standard Continuing Care as Usual | Social Support Utilization | baseline social support utilization | 9.8 days per month | Standard Deviation 8.1 |
| Standard Continuing Care as Usual | Social Support Utilization | discharge social support utilization | 2.8 days per month | Standard Deviation 6.6 |
| Standard Continuing Care as Usual | Social Support Utilization | 3-month follow-up social support utilization | 2.4 days per month | Standard Deviation 6 |
| Standard Continuing Care as Usual | Social Support Utilization | 6-month upport utilization | 2.8 days per month | Standard Deviation 7.3 |
Comparison: Mixed modeling using a repeated-measures random-effects model was conducted to test for the effects of treatment (dummy coded with 1 = mobile intervention, 0 = control) and time as well as the treatment x time interaction on the outcome measure of self-help utilization (mean days in past month) over the study period (baseline, discharge, and 3-, 6-, and 9-month follow-ups).p-value: <0.00195% CI: [0.2, 0.233]Mixed Models Analysis