Substance Use
Conditions
Brief summary
The purpose of this research study is to test whether completion of a new personalized feedback program is associated with reductions in risky substance use among emerging adults (18-25 years of age).
Detailed description
There has been tremendous advances in gene identification. From large-scale, well-powered genome wide association studies (GWAS), polygenic scores (PGS) can now be calculated that sum risk alleles across the genome and weight them by their effect size, creating an index of genetic liability for any given individual. But genetic influences are only part of what contributes to substance use disorders; the environment also plays a critical role. Accordingly, understanding the development of substance use outcomes necessitates integrating both genetic and environmental information. The rationale for this line of research is that the integration of genetic and environmental information will provide the foundation for precision medicine, and that the provision of this personalized risk information will help prevent the development of problems and/or allow for earlier intervention before problems have become severe. Our research team is creating a new prevention/intervention program, consisting of an on-line platform for individuals to receive their personalized risk estimates for addiction risk, created by integrating information about their genetic, behavioral, and environmental risk factors followed by information about how to reduce risk. The investigators are enrolling a sample of emerging adults (18-25 years of age) into a randomized controlled trial consisting of 4 conditions. All four conditions will involve completion of a behavioral/environmental risk survey and the provision of saliva to determine genetic risk. Three active conditions involve individuals receiving their personalized risk estimates, followed by (condition 1) psychoeducation about ways to reduce substance use and associated harm; (condition 2) the on-line CBT-based module to assist with controlling substance use; or (condition 3) a follow-up appointment with a genetic counselor (GC). The fourth condition will be a waitlist control, in which individuals will receive psychoeducation only at the time that the active conditions receive their personalized risk estimates. At the first time point (T0), participants will be randomly selected into one of four conditions. Participants have an equal chance of being assigned to any one of the conditions. Across all conditions, the investigators will measure substance use and problems at enrollment (T0), at the time of receipt of risk estimates (\ 8 weeks later; or at the time other participants receive their results (\ 8 weeks later) in the case of control condition) (T1), 1 month (T2), and 3 months (T3) after completion of the program. After the final survey (T3), participants in the control condition will receive their personalized risk estimates. All participants, regardless of their initial group, will be invited to receive access to the content of conditions in which they did not take part (e.g., online modules, appointment with a genetic counselor). Findings from this study have great potential to enhance our ability to use precision medicine to prevent the development of substance use disorders and/or intervene earlier in the progression to disorder.
Interventions
BEHAVIORALAddiction Risk Feedback Program
This novel prevention/intervention program will be accessed via an on-line interactive website where individuals receive their personalized risk estimates, based on their genetic, behavioral, and environmental risk factors (part 1 of the program), accompanied by information to help them reduce risk (part 2 of the program). The information in part 2 of the program will vary between arms.
Sponsors
Rutgers, The State University of New Jersey
National Institute on Drug Abuse (NIDA)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Masking description
Participants will not be made aware of their condition at baseline; however, they will know their condition once they receives their estimates (or not, in the case of the control condition) and are taken to their follow-up resources.
Eligibility
Sex/Gender
ALL
Age
18 Years to 25 Years
Healthy volunteers
Yes
Inclusion criteria
* This study is for emerging adults between 18-25 years who reside in the United States. These individuals must also be English-speaking.
Exclusion criteria
* Participants will be excluded from the study if they are younger than 18 years old, older than 25 years old, reside outside of the United States, or if they do not provide informed consent. These
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Alcohol Consumption | 3 months | Alcohol consumption will be measured using the Alcohol Use Disorders Identification Test (AUDIT) consumption subscale. The AUDIT-C consists of 3 items (e.g., "how often do you have a drink containing alcohol"). Items are rated on a 5-point scale. Items will be summed to create subscale totals with higher scores representing higher levels of that behavior (e.g., higher alcohol consumption. Scores can range from 0 to 12. |
| Alcohol Problems | 3 months | Alcohol problems will be measured using the AUDIT problems subscale ( Bohn, Babor, \& Kranzler, 1995). The AUDIT-P consists of 6 items (e.g., "how often do you have a drink containing alcohol"). Items are rated on a 5-point scale. Items will be summed to create subscale totals with higher scores representing higher levels of that behavior (e.g., higher alcohol problems). Scores can range from 0 to 24. |
| Drug Use Problems | 3 months | Drug Use problems will be measured using the Drug Use Disorders Identification Test (DUDIT) scale. The DUDIT consists of 11 items (e.g., "how often do you use drugs other than alcohol"). Items are rated on a 5-point scale. Items will be summed to create subscale totals with higher scores representing higher levels of that behavior (e.g., higher drug consumption). Scores can range from 0 to 44. |
| Readiness to change | 3 months | The Readiness to Change Questionnaire is a 12-item measure that provides scores for three subscales (Precontemplation, Contemplation, and Action) representing stages of change. Items (e.g., "I am trying to drink/ use other drugs less than I used to") are rated on a 5-point scale with response options ranging from "strongly disagree" to "strongly agree." Items will be summed to create three total subscale scores. Based on subscale scores, individuals will be categorized to one of the three categories. We will assess change in the percent of individuals in each category. |
| Future substance use intentions | 3 months | Future substance use intentions will be assessed with three items: "how often do you plan to drink alcohol next month," "how often do you plan to get drunk next month," and "how often do you plan to use drugs next month" with response options of "less than last month," "the same as last month," and "more than last month." We will assess change in the percent of individuals in each category (less, same, more than last month) for all three items. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Worry About Substance Use Disorders | Baseline to 3 months | An adapted version of the Cancer Worry Scale will be used to assess worry about developing substance use disorders within the past 30-days. The scale consists of 8 items (e.g., "How often do you worry about developing alcohol or other drug use disorder?") rated on a 4-point scale. Items will be summed to create a total scale score with higher scores reflecting higher levels of worry about substance use disorders. |
| Perceived Susceptibility | 3 months | Perceived susceptibility of developing alcohol use or other drug use disorder will be assessed using the Health Beliefs about Mental Illness Instrument (Saleeby, 2000). The scale consists of 5-items (e.g., "my chances of having alcohol or other drug problems are great") rated on a 5-point scale with response options ranging from "strongly agree" to "strongly disagree." Items will be summed to create a total scale score with higher scores reflecting higher perceived susceptibility for substance use disorders. |
| Well-Being | 3 months | Well-being will be assessed with the Mental Health Continuum-Short Form. The scale consists of 14-items which assess aspects of positive mental health (e.g., "I felt happy") over the past 30-days. The items are rated on a 6-point scale with response options ranging from "never" to "every day." Items will be summed to create a total scale score with higher scores reflecting higher levels of positive well-being |
| Anxiety and Depressive Symptoms | Baseline to 3 months | Abbreviated scales from the Symptom Checklist-90 will be used to assess anxiety and depressive symptoms occurring within the past 30-days. The anxiety (e.g., "nervousness or shakiness inside") and depressive symptoms (e.g., "feeling no interest in things) subscales consist of four items each. Items are rated on a 5-point Likert-type scale with response options ranging from "not at all to "extremely." Items will be summed to create total subscale scores with higher scores reflecting higher levels of anxiety and depressive symptoms. |
| Addiction Risk Program Satisfaction | immediately after the intervention | Satisfaction with the addiction risk program will be assessed with 12 items after participants receive their personalized risk estimates. Example items include "I learned new information as part of this program," "I enjoyed receiving my personalized risk profile," and "The online delivery method of the information was convenient." The items are rated on a 5-point scale with response options ranging from "strongly agree" to "strongly disagree."This will only be administered to the three active interventions. |
| Feelings About Results | immediately after the intervention | Feelings about receiving results will be assessed with an adapted version of the Feelings About Genomic Testing Results Questionnaire. 10 items will be used to measure how participants feel about their personalized risk estimates. The items will be rated on a 5-point scale with response options ranging from "not at all" to "a great deal." Items will be summed to create a total scale score, with higher scores reflecting more positive feelings about receiving genetic test results. This will only be administered to the three active interventions. |
| Satisfaction with the Assigned Conditions | 3 months | Satisfaction with the three conditions (psychoeducation, CBT, and genetic counseling) will be assessed with 10 items. Beyond the name of the condition referred to in each of the items ("education content," "modules," and "genetic counseling", respectively) the satisfaction items are the same for each of the three conditions (e.g., "I learned useful information as part of the modules"). The items are rated on a 5-point scale with response options ranging from "strongly agree" to "strongly disagree." The satisfaction items will be administered to the waitlist control in the T1part 2 survey, and it will be administered to the three active conditions in the T2 and T3 follow-up surveys. If the participant completed the satisfaction items at T2, they will not receive them again at T3. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORDanielle Dick, PhD
Rutgers Robert Wood Johnson Medical School
Outcome results
None listed