A CBT-Based Text Messaging Intervention for Methamphetamine Dependence

描述（由申请人提供）：本申请提出通过开发基于创新认知行为疗法（CBT）的短信干预来改善甲基苯丙胺（MA）依赖受试者的治疗结果。虽然CBT减少了MA的使用，但它和其他心理社会疗法的有效性有限，并且接受MA依赖治疗的患者复发率很高。因此，存在对用于治疗MA依赖的附加疗法的显著需求。 我们正在使用一个迭代过程来开发和完善这种干预措施。我们召集了一个专家小组，进行了三个焦点小组与MA依赖的主题，采访了25个主题正在接受治疗的MA依赖，并进行了五个主题的可行性试验。 我们将重新召集专家小组，审查我们的候选短信和研究方法。主动和控制文本消息将被上传到我们为此目的开发的基于Web的应用程序中。我们将进行一项预测试，其中10名受试者接受两周的活动短信和两周的对照短信;这些条件将以随机、平衡的顺序进行，并有一周的洗脱期。每天将向受试者“推送”四次消息，也可以根据要求“拉取”消息。受试者将参加每周三次的基于CBT的一小时团体治疗。我们将收集尿液样本进行毒理学分析，自我报告的MA使用，渴望分数，和评级的效用和可接受的干预后，受试者完成每个条件的定性访谈将评估的方法，信息内容的偏好，和可接受性的感知效用。当所有课题完成后，我们将举行一个焦点小组，并重新召集专家小组。在对短信或程序进行任何必要的修改后，我们将对40名受试者进行第二次交叉试验，对第二次试验中的受试者进行另一个焦点小组，再次召集专家小组，并选择短信用于随后的大型随机平行组试验。 这将是一种部署费用不高的干预措施，利用负担得起和广泛可用的技术-基本蜂窝电话。这种干预的低强度、高频率和随时可用的特点与传统的门诊治疗形成对比，可能是一种有价值的补充，它将很容易扩展到无法接受正式治疗的MA使用者和依赖其他药物的个人。

DESCRIPTION (provided by applicant): This application proposes to improve treatment outcomes for methamphetamine- (MA-) dependent subjects through development of an innovative cognitive behavioral therapy- (CBT-) based text messaging intervention. While CBT reduces MA use, it and other psychosocial therapies have limited effectiveness, and patients treated for MA dependence have a high rate of relapse. Thus, a significant need exists for add-on therapy for treatment of MA dependence. We are using an iterative process to develop and refine this intervention. We have convened an expert panel, conducted three focus groups with MA-dependent subjects, interviewed 25 subjects being treated for MA dependence, and conducted a five-subject feasibility trial. We will reconvene the expert panel to review our candidate text messages and study methods. Active and control text messages will be uploaded into a web-based application that we have developed for this purpose. We will conduct a pre-test in which 10 subjects receive two weeks of the active text messages and two weeks of control text messages; these conditions will be in random, counterbalanced order with a one-week washout. Messages will be "pushed" to subjects four times per day and can also be "pulled" on an as-requested basis. Subjects will attend one-hour CBT-based group therapy sessions three times per week. We will collect urine samples for toxicological analyses, self-reports of MA use, craving scores, and ratings of the utility and acceptability of the intervention Qualitative interviews after subjects complete each condition will assess the perceived utility of the approach, preferences for message content, and acceptability. When all subjects have completed, we will hold a focus group and reconvene the expert panel. After making any indicated revisions to the text messages or procedures, we will implement a second crossover trial with 40 subjects, conduct another focus group with subjects who were in the second trial, reconvene the expert panel again, and select text messages to be used in a subsequent large randomized parallel group trial. This will be an inexpensive intervention to deploy that utilizes technology that is affordable and widely available - basic cellular telephones. The low-intensity, high-frequency, and always available characteristics of this intervention contrast to conventional outpatient treatment and may be a valuable complement to it. It will be readily extensible, both to MA users who cannot attend formal treatment, and also to individuals dependent on other drugs.