Phone app for grounding (de-escalation) of substance-abusing transition-age youth

用于帮助药物滥用的过渡年龄青少年接地（降级）的手机应用程序

• 批准号: 9565482
• 负责人: LISA M NAJAVITS
• 金额: $ 56.23万
• 依托单位: TREATMENT INNOVATIONS, LLC
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9565482
• 关键词: Accidents; Addictive Behavior; Adolescence; Adult; Age; Aging; Alcohol or Other Drugs use; Anger; Anxiety; Benchmarking; Books; Caring; Client; Clinical; Clinical Research; Complex; Consult; Development; Distress; Emotional; Emotions; Environment; Evaluation; Family; Feedback; Feeling; Goals; HIV; Heart; Heart Rate; Home environment; Hormones; Impaired cognition; Impulsivity; Individual; Knowledge; Learning; Location; Manuals; Measures; Mental Health; Mental disorders; Methodology; Methods; Military Personnel; Mind; Modeling; Outcome Measure; Pathway interactions; Phase; Physiological; Population; Proxy; Psyche structure; Psychiatric Diagnosis; Psychiatric Hospitals; Public Health; Randomized Controlled Trials; Risk; Safety; Sensory; Series; Social Network; Stress; Substance Use Disorder; Substance abuse problem; Technology; Telephone; Testing; Time; Violence; Walking; Work; Youth; base; college; craving; design; driving under influence; emerging adulthood; emotion regulation; evidence base; experience; fighting; foster care; handheld mobile device; high risk; innovation; innovative technologies; legal drinking age; mobile application; novel; power analysis; primary outcome; product development; programs; scale up; secondary outcome; sexual assault; skills; smartphone Application; statistics

Abstract Substance use disorder (SUD) is the second most common psychiatric diagnosis in the U.S. population, with 14.6% developing it in their lifetime. Transition-age youth (TAY) from ages 18-25 are especially vulnerable to substance use and SUD. This time period, termed the “age of instability", is now understood to represent a distinct stage separate from adolescence and later adulthood. It includes tasks such as leaving home to enter college, the workforce, or the military; clarifying vocational goals; attaining legal drinking age; and, for some, aging out of foster care or state custody, which end at age 18. This period is also prime for experimentation with substance use and associated risks such as driving under the influence, accidents, fighting and violence, HIV, and vulnerability to sexual assault. In this project, we focus on a major strategy, grounding, to help TAY de-escalate (reduce) intense negative emotions and impulses. Grounding has long been used in psychiatric hospitals to provide a safe, quick, and powerful way to reduce any intense negative feeling such as impulses to hurt self or others, substance craving, anger, anxiety, etc. Described in detail in the book Seeking Safety (SS), grounding using three pathways to focus the mind (mental), body (physical), and heart (soothing). Grounding provides a way to regulate emotion, which is a major challenge for TAY, especially given their hormone changes and emotional intensity. Indeed substance use is often described as a short-term way to regulate emotion. Grounding is a key module of SS, a widely-implemented, evidence-based SUD treatment model. In this proposal we focus exclusively on grounding as it is an essential skill and widely identified as easy to learn for even the most complex and vulnerable clients. In phase 1 we developed a beta version of a grounding app. The app promotes the use of grounding in any environment in which emotions and impulses need to be regulated. It capitalizes on TAYs’ widespread use of mobile devices; and because grounding is a stand-alone skill and sensory-oriented, it lends itself wonderfully to an app approach. We used an iterative product development methodology based on end-user feedback and studied the impact of the app in a pilot randomized controlled trial (RCT) with 24 TAY. Half received the app and the other half received grounding handouts. Results showed that the app was consistently more positively rated than the handouts and was associated with significantly more use of grounding and a higher score on a grounding knowledge test. All phase 1 benchmarks were met. In phase 2 we propose to scale up both the app and the evaluation of it. We have two specific aims: (1) To enhance the mobile grounding app by using exciting, innovative technology approaches as well as expanding the grounding content in amount and type. (2) To conduct an RCT with 68 TAY to evaluate the grounding app versus a control app. The control app would control for both the use of a mobile device and the grounding content. However it would lack the gamification and technology innovations of the experimental app so that we can determine the impact of these. Our primary outcome is based on power analysis from our phase 1 pilot; we also include other outcomes and measures. The RCT uses rigorous scientific methods in its design, measures, and statistics. Our team represents an exceptional mix of expertise in SUD, TAY, app and gaming technology, grounding, SBIRs, and public health oriented products based on evidence-based care.

抽象的 物质使用障碍 (SUD) 是美国人口中第二常见的精神疾病诊断，占 14.6% 18-25 岁的过渡年龄青年 (TAY) 特别容易受到药物滥用和药物滥用的影响。 SUD 这个时期被称为“不稳定时代”，现在被理解为代表了一个与此不同的阶段。 它包括离开家进入大学、工作或参军等任务； 明确职业目标；对于某些人来说，达到法定饮酒年龄；以及超出寄养或国家监管的年龄； 到 18 岁为止。这个时期也是尝试药物使用和相关风险（例如在车下驾驶）的黄金时期。 影响、事故、战斗和暴力、艾滋病毒以及性侵犯的脆弱性在这个项目中，我们关注的是。 主要策略是接地，帮助TAY降级（减少）强烈的负面情绪和冲动。 已被精神病医院使用，以提供一种安全、快速、有效的方法来减少任何强烈的负面情绪，例如 如伤害自己或他人的冲动、物质渴求、愤怒、焦虑等。《寻求安全》一书中有详细描述 (SS)，使用三种途径来集中思想（精神）、身体（身体）和心灵（舒缓）。 提供了一种调节情绪的方法，这对 TAY 来说是一个重大挑战，特别是考虑到他们的激素变化和 事实上，物质使用通常被描述为调节情绪的短期方法。 SS 模块是一种广泛实施的、基于证据的 SUD 治疗模型。在本提案中，我们只关注于 SS 的模块。 基础，因为它是一项基本技能，并且被广泛认为即使对于最复杂和最脆弱的客户来说也很容易学习。 在第一阶段，我们开发了接地应用程序的测试版，该应用程序提倡在任何环境中使用接地。 它利用了 TAY 广泛使用的移动设备；以及 因为接地是一项独立的技能并且以感官为导向，所以它非常适合我们使用的应用程序方法。 基于最终用户反馈的迭代产品开发方法，并在试点中研究了应用程序的影响 随机对照试验 (RCT) 进行了 24 次 TAY，一半收到了应用程序，另一半收到了接地讲义。 结果显示，该应用程序的评价始终高于讲义，并且与 接地的使用显着增加，并且接地知识测试的得分更高。所有第一阶段基准均得到满足。 在第二阶段，我们建议扩大应用程序及其评估范围。我们有两个具体目标：(1) 增强应用程序的性能。 移动接地应用程序，通过使用令人兴奋的创新技术方法以及扩展接地内容 (2) 使用 68 TAY 进行 RCT，以评估接地应用程序与控制应用程序。 应用程序将控制移动设备的使用和基础内容，但它缺乏游戏化。 以及实验应用程序的技术创新，以便我们能够确定这些的影响。我们的主要成果是。 基于我们第一阶段试点的功率分析；我们还包括 RCT 使用严格的其他结果和措施。 我们的团队在设计、测量和统计方面采用了科学方法，代表了 SUD、 TAY、应用程序和游戏技术、接地、SBIR 以及基于循证护理的公共卫生导向产品。