RCT of Woebot for Substance Use Disorders

项目摘要/摘要 治疗物质使用障碍的Woebot(W-SUDS)是由NIDA资助的两阶段SBIR。目前， W-SODS是一种新型的数字疗法，正在进行第一阶段的试点评估。第二阶段将 研究W-SODS与主动控制条件下的疗效比较。从最初的奖项开始， 在短短几个月内，新冠肺炎成为一种全球流行病，世界各地的用户开始 沃博特对此进行了讨论并寻求帮助。该公司的回应是构建和部署Covid- 19个具体节目(W-C19)，2020年3月。W-C19元素已集成到 W-SODS；我们认为这是及时和适当的，以解决用户对大流行的担忧 并证明Woebot对这场危机是“聪明的”。专家预计新冠肺炎的S直接和 对患有肥皂泡的人的间接影响尤其严重。这些人经常 身体脆弱，这会增加死于新冠肺炎的相对风险，并且面临 有限的医疗保健机会--考虑到经常并发的精神疾病，这从根本上具有挑战性。 此外，较高的住房不安全率阻碍了对就地住房和社会保障的遵守。 疏远建议，从而增加传染风险。这一建议，具有及时性 增加了一项随机对照试验，比较W-SUDS和等待名单对照(WL)， 在调查新冠肺炎对S影响的同时扩大对W-SODS疗效的理解 南德人。鉴于新冠肺炎，预计物质使用增加的长期趋势 压力源(例如，原地避难所、疾病担忧、经济冲突、就业不足/失业)。 因此，WL条件对于测试W-SUDS缓解这些新冠肺炎的有效性是必不可少的 相关的下游影响。这一建议通过以下方式延长了父母补助金：(I)增加了一个随机的 W-SUDS与WL的对照评估和(Ii)研究组之间的潜力 在(A)物质使用、(B)新冠肺炎相关成分(例如，社交距离； 就业和父母因素)，以及(C)其他SUD治疗承诺。而2020万 (8.4%)美国成年人在过去的一年里患上了sud，只有20%的人接受了治疗， 重大的治疗获取障碍[1]。W-SODS：(I)准备减少或消除常见的 然而，传统的SUD治疗存在重大障碍；(Ii)提供虚拟访问，对社交来说是最佳的 保持距离和就地避难；(3)具有不受约束的即时规模 (4)提供最适合参与的基于文本的对话内容。本研究 在资源受限、社交距离较远的环境中提供即时数字治疗服务 为本已脆弱和服务不足的人群提供医疗保健生态系统，可能面临 随之而来的心理挑战。

PROJECT SUMMARY / ABSTRACT Woebot for Substance Use Disorders (W-SUDs) is a two-phase NIDA-funded SBIR. Presently, W-SUDs, a novel digital therapeutic, is being evaluated in the Phase I pilot. Phase II will investigate W-SUDs’s efficacy compared to an active control condition. Since the initial award, and across mere months, Covid-19 became a global pandemic, and users worldwide came to Woebot to discuss it and seek help. The company responded by building and deploying Covid- 19 specific programming (W-C19) in March 2020. W-C19 elements have been integrated into W-SUDs; we felt it was timely and appropriate to address users' concerns about the pandemic and demonstrate that Woebot was ‘intelligent’ to the crisis. Experts expect Covid-19’s direct and indirect impact upon individuals with SUDs to be particularly heavy. These individuals often have physical vulnerabilities, which increase the relative risk of death from Covid-19, and face limited health care access -- fundamentally challenging given often comorbid mental illness. Moreover, high rates of housing insecurity hinders compliance with shelter-in- place and social distancing recommendations, thereby increasing contagion risk. This proposal, with the timely addition of a randomized controlled trial comparing W-SUDs to a waitlist control (WL), expands understanding of W-SUDs’ efficacy whilst investigating Covid-19’s impact upon the SUD population. Secular trends of increased substance use are anticipated given Covid-19 stressors (e.g., shelter-in- place, disease concerns, economic strife, under-/unemployment). Hence, the WL condition is essential for testing W-SUDs’ efficacy in mitigating these Covid-19 related downstream effects. This proposal extends the parent grant by: (i) adding a randomized controlled evaluation of W-SUDs compared to WL and (ii) investigating potential between group differences on (a) substance use, (b) Covid-19 related components (e.g., social distancing; employment and parental factors), and (c) other SUD treatment engagement. While 20.2 million (8.4%) American adults had a SUD within the past year, only 20% received treatment, given significant treatment access barriers [1]. W-SUDs: (i) is poised to reduce or eliminate common yet significant barriers to traditional SUD treatment; (ii) offers virtual access, optimal for socially distancing and shelter-in-place adherence; (iii) has unconstrained and immediate scale potential; and (iv) delivers content text-based conversation, optimal for engagement. This study offers immediate access to a digital therapeutic in a resource constrained, socially distanced healthcare ecosystem for an already vulnerable and underserved population, likely faced with readily growing psychological challenges.