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

项目摘要 与其他年龄段相比，年轻人(18至25岁)吸食大麻的比率最高 使用障碍(CUD)(SAMHSA，2018)，并且最不可能寻求CUD治疗(Kerbridge et Al.，2017)。数字治疗方面的最新进展为这一人群显示了希望。 除了数字治疗与传统治疗相比的成本效益之外，还有 好处是人们对隐私的感知增加，这可以减少对年轻人的污名 (Hoch等人，2016)。年轻人每天与大约128条短信互动(Burke，2016)， 支持这种治疗方式。青年社会环境与暴露之间的联系， 吸食和继续使用大麻的情况在文献中得到了很好的证实。一个大国家 对年轻人进行物质使用治疗的研究发现，同龄人对 大麻的使用，在这种情况下，同伴物质的使用增加会使治疗结果恶化(Davis et Al.，2016)。除了同龄人的影响，环境的影响，这样的邻里混乱也有 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)。 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，强调地点和同行的互动性质(Mason，2010)。尽管如此 尽管有同龄人的证据和对大麻使用的影响，但关于 将社会和环境因素纳入大麻干预措施。对等网络 咨询-txt(pnc-txt)明确针对同伴和环境上下文，并且可以 通过个性化、自动化的文本消息发送。PNC-TXT是一种物质使用干预 它侧重于将基于地点的同伴关系作为行为改变的一种机制。PNC-TXT的 假设的有效成分是“同伴网络健康”，它是风险和保护的总和。 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 超过4周的短信，以及发送的PRN助推器消息。来自参与者的关键回复 基线评估自动填充每个参与者量身定做的内容 干预。PNC-TXT非常适合对这项技术感到满意的年轻人。我们的 具体目标是：目的1.测试PNC-TXT对1000名青少年戒烟的效果 患有大麻的成年人使用障碍。次级目标1.测试以下项目的成本效益和可扩展性 Pnc-txt在两所大型州立大学。目的2.检验PNC的直接影响程度-- TXT由参与者的同伴网络健康调节，而同伴网络健康又由参与者的 性别。目的3.测试PNC-TXT是否减少压力、渴求和活动空间的影响 随着时间的推移，暴露于高风险大麻使用环境对大麻使用的影响。

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.