Developing an adjunctive mobile application for co-morbid substance use and anxiety disorders: comprehensive user experience testing of the Unwinding Anxiety application

项目总结 患有共病物质使用(SUD)和焦虑症(AD)的患者健康状况明显较差 结果比单独患有SUD的患者更严重，复发的风险增加。然而，不到10% 从事治疗，只有18%的SUD机构和9%的精神卫生组织报告有能力 提供全面的护理。移动医疗技术越来越多地应用于物质使用和 焦虑治疗，以努力创造更全面的、以患者为中心的护理方法。尽管 随着移动应用程序开发的增加，大多数现有计划都是针对SUD或 焦虑症患者中，很少有人使用循证内容或经过临床验证，大多数人没有。 专为SUD-AD患者设计的综合治疗组件。解脱焦虑(UA)手机 APP可以满足这一需求，因为它以手册形式提供基于证据的数字化心理教育培训， 可扩展的、高保真的针对机械路径的方式，与之前的研究一致。这个 拟议的研究将全面评估患有SUD-AD的个人的UA用户体验 正在康复中，并探索探索性行为和心理健康结果的作用(即，物质使用， 在48名长期康复的人中(&gt；6个月)。我们将利用收敛并行 混合方法研究性研究设计，包括收集定量和定性测量 同时。我们将使用系统可用性量表对可用性、可行性和保真度进行定量调查， 教育模块完成，生态签到使用。在质量上，我们将收集有关可用性的数据 受试者(n=18)中的UA每周进行重点访谈(4x；30分钟。会议； N=18)和3个焦点组(k=3；n=15)。我们的次要目标是确定UA参与的程度 探索性结果，特别是物质使用、渴望和焦虑，为未来的试验做准备。完成 这项研究的结果将是：(1)基于患者生活体验的全面定制 它将被用来改进SUD-AD患者的首批移动应用程序之一， 循证辅助治疗；(2)为美国国立卫生研究院博士后资助申请测试提供初步数据 这款定制的移动应用程序可以改进SUD-AD治疗的辅助治疗。

PROJECT SUMMARY Patients with comorbid substance use (SUD) and anxiety disorders (AD) have significantly poorer health outcomes than patients with SUD alone and experience increased risk for relapse. However, less than 10% engage in treatment and only 18% of SUD facilities and 9% of mental health organizations report the capacity to provide comprehensive care. Mobile health technologies have been increasingly applied for substance use and anxiety treatments in an effort to create more comprehensive, patient centered approaches to care. Despite increasing mobile application development, the majority of existing programs are designed to target SUD or anxiety individually, few utilize evidence-based content or are clinically validated, and the majority are not designed as integrative treatment components for patients with SUD-AD. The Unwinding Anxiety (UA) mobile app can fulfill this need as it delivers digital, evidence-based psychoeducational training in a manualized, scalable, and high-fidelity manner targeting mechanistic pathways consistent with previous research. The proposed research will comprehensively assess the user experiences of UA for individuals with SUD-AD who are in recovery and explore the role of exploratory behavioral and mental health outcomes (i.e., substance use, craving, anxiety) among 48 individuals in long term recovery (>6 months). We will utilize a convergent parallel mixed methods research study design involving the collection of both quantitative and qualitative measures concurrently. We will quantitatively investigate usability, feasibility, and fidelity using the Systems Usability Scale, educational module completion, and ecological check-in usage. Qualitatively we will collect data on usability of UA within a sub-sample of participants (n=18) conducting focused interviews weekly (4 x <30 min. sessions; n=18) and 3 focus groups (k=3; n=15). Our secondary aim is to determine the degree to which UA engages exploratory outcomes specifically substance use, craving, and anxiety in preparation for future trials. Completion of this study will result in: (1) comprehensive range of customizations grounded in patients lived experience which will be used to refine one of the first mobile applications for patients with SUD-AD serving as a scalable, evidence-based adjunctive therapy; (2) provide preliminary data for a post-doctoral NIH grant application testing this customized mobile application to improve adjunctive therapies for SUD-AD treatment.