Toward Increasing Engagement in Substance Use Data Collection: Development of the Substance Abuse Research Assistant App and Protocol for a Microrandomized Trial Using Adolescents and Emerging Adults
Toward Increasing Engagement in Substance Use Data Collection: Development of the Substance Abuse Research Assistant App and Protocol for a Microrandomized Trial Using Adolescents and Emerging Adults
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DOI：
10.2196/resprot.9850
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发表时间：
2018-07-01
影响因子：
1.7
通讯作者：
Murphy, Susan
中科院分区：
文献类型：
--
作者：
Rabbi, Mashfiqui;Kotov, Meredith Philyaw;Murphy, Susan
背景：药物使用是一个令人震惊的公共卫生问题，与严重的发病率和死亡率有关。青少年和初出茅庐的成年人风险特别高，因为物质使用通常在这一发育期开始并达到顶峰。移动健康应用程序是一种很有前途的数据收集和干预交付工具，适用于使用药物的青少年，因为大多数青少年和年轻人都拥有手机。然而，大多数移动健康应用程序对数据收集的参与度很低，通常情况下，很大一部分用户在使用一周后停止提供数据。目的：物质滥用研究助理(SARA)是一种移动应用程序，用于增加或维持加班收集物质数据的参与度。Sara提供了多种参与策略来鼓励数据收集：应用程序中的虚拟水族馆随着鱼类和水产资源的增长而增长；偶尔会提供有趣或鼓舞人心的内容(例如，表情包或短信)来产生积极的情绪。我们计划通过进行一项微随机试验来评估Sara参与策略随着时间的推移的有效性，在该试验中，参与策略将被顺序操纵。方法：我们的目标是招募参与者(14-24岁)，他们报告在过去一个月中有过酗酒或使用大麻的行为。参与者被指示使用SARA 1个月。在此期间，参与者被要求每天从晚上6点到午夜完成一项调查和两项积极任务。通过调查，我们评估了参与者的日常情绪、压力水平、孤独感和希望，而通过积极的任务，我们测量了反应时和空间记忆。为了激励和支持数据收集，使用了各种参与策略。首先，预先收集数据的策略包括：(1)下午4点，可能会发出带有当代名人励志信息的推送通知；或(2)在下午6点，可能会发出推送通知，提醒有关数据收集和激励。其次，后期数据收集策略包括各种奖励，例如可以用来种植鱼和其他珍宝的虚拟水族馆的积分和适度的金钱奖励(最高12美元；每连续3天1美元)；此外，参与者可能会收到有趣或鼓舞人心的内容，如模因或礼物或先前数据的可视化。在研究期间，参与者每天都会被随机分配，以接受不同的参与策略。在初步分析中，我们将评估下午4点分别发布推送通知或表情包或gif是否会增加当天或次日的自我报告。结果：微随机试验于2017年8月21日开始，试验于2018年2月28日结束。招募了73名参与者。数据分析目前正在进行中。结论：据我们所知，SARA是第一款系统地操纵参与度策略的手机应用程序，以确定让参与者参与数据收集的最佳策略序列。一旦确定了收集数据的最佳战略，SARA的未来版本将使用这些数据提供及时的适应性干预，以减少青年中的药物使用。
Background: Substance use is an alarming public health issue associated with significant morbidity and mortality. Adolescents and emerging adults are at particularly high risk because substance use typically initiates and peaks during this developmental period. Mobile health apps are a promising data collection and intervention delivery tool for substance-using youth as most teens and young adults own a mobile phone. However, engagement with data collection for most mobile health applications is low, and often, large fractions of users stop providing data after a week of use.Objective: Substance Abuse Research Assistant (SARA) is a mobile application to increase or sustain engagement of substance data collection overtime. SARA provides a variety of engagement strategies to incentivize data collection: a virtual aquarium in the app grows with fish and aquatic resources; occasionally, funny or inspirational contents (eg, memes or text messages) are provided to generate positive emotions. We plan to assess the efficacy of SARA's engagement strategies over time by conducting a micro-randomized trial, where the engagement strategies will be sequentially manipulated.Methods: We aim to recruit participants (aged 14-24 years), who report any binge drinking or marijuana use in the past month. Participants are instructed to use SARA for 1 month. During this period, participants are asked to complete one survey and two active tasks every day between 6 pm and midnight. Through the survey, we assess participants' daily mood, stress levels, loneliness, and hopefulness, while through the active tasks, we measure reaction time and spatial memory. To incentivize and support the data collection, a variety of engagement strategies are used. First, predata collection strategies include the following: (1) at 4 pm, a push notification may be issued with an inspirational message from a contemporary celebrity; or (2) at 6 pm, a push notification may be issued reminding about data collection and incentives. Second, postdata collection strategies include various rewards such as points which can be used to grow a virtual aquarium with fishes and other treasures and modest monetary rewards (up to US $12; US $1 for each 3-day streak); also, participants may receive funny or inspirational content as memes or gifs or visualizations of prior data. During the study, the participants will be randomized every day to receive different engagement strategies. In the primary analysis, we will assess whether issuing 4 pm push-notifications or memes or gifs, respectively, increases self-reporting on the current or the following day.Results: The microrandomized trial started on August 21, 2017 and the trial ended on February 28, 2018. Seventy-three participants were recruited. Data analysis is currently underway.Conclusions: To the best of our knowledge, SARA is the first mobile phone app that systematically manipulates engagement strategies in order to identify the best sequence of strategies that keep participants engaged in data collection. Once the optimal strategies to collect data are identified, future versions of SARA will use this data to provide just-in-time adaptive interventions to reduce substance use among youth.