Treating Young Adult Cannabis Use Disorder with Text Message-Delivered Peer Network Counseling

项目摘要 与其他年龄组相比，年轻人（18至25岁）的大麻使用率最高 使用障碍（CUD）（SAMHSA，2018），并且最不可能寻求CUD治疗（Kerridge et 例如，2017年）。数字化治疗的最新进展为这一人群带来了希望。 除了与传统疗法相比数字治疗的成本效益之外， 好处是增加隐私的感觉，这可以减少年轻人的耻辱 (Hoch例如，2016）。年轻人每天与大约128条文本互动（Burke，2016）。 支持这种治疗方式。青少年社会背景和接触之间的联系， 文献中明确证实了大麻的吸食和持续使用。一个大型国家 一项对接受药物治疗的年轻人的研究发现，同龄人对药物治疗有着强烈而持久的影响。 大麻使用，其中同伴物质使用的增加使治疗结果恶化（Davis et 例如，2016）。除了同伴效应，环境效应，比如邻里关系障碍， 已被证明对大麻的使用具有重要和强有力的影响（Mason等人，2017）.年轻 成年人在有意义的地方与同龄人互动，塑造他们的健康行为， 轨迹，强调地方和同伴的互动性质（梅森，2010）。尽管如此 同龄人和地方对大麻使用的影响的证据，很少有关于 将社会和环境因素纳入大麻干预措施。对等网络 咨询文本（PNC-txt）明确针对同伴和环境背景，可以 通过个性化的自动短信发送。PNC-txt是一种物质使用干预 它关注基于场所的同伴关系，将其作为行为改变的机制。PNC-txt的 假设的有效成分是“同伴网络健康”，这是风险和保护的总和 一个年轻人的亲密同伴网络的行为。PNC-txt提供112个自动化、个性化 短信超过4周，以及助推器消息交付PRN。与会者的主要答复 基线评估自动填充每个参与者定制的 干预PNC-txt非常适合熟悉这项技术的年轻人。我们 具体目标是：目标1。测试PNC-txt对1000名青少年停止使用大麻的效果 成人大麻使用障碍次级目标1.测试的成本效益和可扩展性 PNC-txt在两所大型州立大学。目标2.测试PNC的直接影响程度- txt由参与者的对等网络健康度介导，而对等网络健康度又由参与者的 性别.目标3。测试PNC-txt是否减少压力，渴望和活动空间的影响 暴露于高风险大麻使用环境对大麻使用的长期影响。

Project Summary Young adults (ages 18 to 25) compared to other age groups, have the highest rate of cannabis use disorder (CUD) (SAMHSA, 2018) and are the least likely to seek CUD treatment (Kerridge et al., 2017). Recent advances in digitally delivered treatments show promise for this population. Beyond the cost-effectiveness of digital treatments compared to traditional therapies, an advantage is the perception of increased privacy, which can lessen stigmatization for young adults (Hoch et al., 2016). Young adults interact with approximately 128 texts per day (Burke, 2016), supporting this treatment modality. The association between youth social context and exposure, uptake, and continuation of cannabis use is strongly established in the literature. A large national study of young adults in substance use treatment found strong and persistent effects of peers on cannabis use, where increases in peer substance use worsened treatment outcomes (Davis et al., 2016). Beyond peer effects, environmental effects, such has neighborhood disorder have been shown to be an important and potent influence on cannabis use (Mason et al., 2017).Young adults interact with peers grounded in meaningful places, shaping their health behavior trajectories, underscoring the interactive nature of place and peers (Mason, 2010). Despite this evidence of peers and place influences on cannabis use, there has been little research on the integration of social and environmental components within cannabis interventions. Peer Network Counseling-txt (PNC-txt) explicitly targets the peer and environmental context and can be delivered via personalized, automated text messages. PNC-txt is a substance use intervention that focuses on place-based peer relations as a mechanism for behavioral change. PNC-txt's hypothesized active ingredient is “peer network health,” which is the sum of risk and protective behaviors of a young adult's close peer network. PNC-txt delivers 112 automated, personalized texts over 4 weeks, as well as booster messages delivered PRN. Key responses from participant's baseline assessment automatically populate the content of each participant's tailored intervention. PNC-txt is ideally suited for young adults comfortable with this technology. Our specific aims are: Aim 1. Test the efficacy of PNC-txt on cannabis use cessation with 1000 young adults with Cannabis Use Disorder. Sub-Aim 1. Test the cost-effectiveness and scalability of PNC-txt in two large state universities. Aim 2. Test the extent to which the direct effect of PNC- txt is mediated by participants' peer network health, which in turn is moderated by participants' gender. Aim 3. Test whether PNC-txt reduces the effect of stress, craving, and activity space exposure to high-risk cannabis use environments on cannabis use over time.