Web-Based Mindfulness Treatment to Prevent Relapse to Substance Use

项目摘要 物质使用障碍（SUD）治疗后复发仍然是常态，而不是例外。 正念治疗是一种特别有效的门诊善后方法，可以减少复发， 从更密集的SUD治疗中退出的个体（例如，住院或重症门诊）。 不幸的是，由于临床医生的培训有限，大多数患者无法获得术后正念治疗 机会和缺乏有效的执行战略。例如，迄今为止， 基于技术的（例如，基于网络的）善后正念治疗，以防止复发的物质使用。 也缺乏对SUD正念治疗变化机制的研究（即，如何以及为什么 治疗工作）。生态瞬时评估（EMA），或通过 智能手机，捕捉动态，高分辨率的数据在近实时。正念，消极/积极的影响， 压力和渴望--这些都是在一天中不断变化的瞬间状态--是公认的 正念治疗SUD的机制。对SUD的正念治疗理论上可以削弱或 “解耦”的负面影响与渴望，压力与渴望，和（低）积极的瞬间协会 受渴望的影响。然而，迄今为止，还没有研究使用EMA来评估这些假定的瞬时 正念治疗后的解耦机制。 拟议中的K23职业发展奖提供培训，以支持科里鲁什博士成为 一个独立的以病人为导向的研究人员，专注于以技术为基础的成瘾治疗， 成瘾恢复的变化机制。该奖项的培训目标侧重于基于技术的 治疗开发，严格的临床试验研究，EMA和正念机制。鲁什博士会 通过专家、课程、会议和实践的直接指导，接受这些目标方面的培训 研究活动。 该K23应用程序的拟议研究项目涉及开发和评估UrgeSurfer， 第一个基于网络的正念治疗，用于预防SUD患者复发药物使用。 Web程序将通过以用户为中心的设计框架迭代开发， 反馈和可用性测试。然后，我们将进行一项试点随机对照试验，以评估UrgeSurfer 作为一种预防复发的门诊后续治疗。此外，作为审判的一部分， 使用EMA研究假定的变化解耦机制。这个K23奖将推动鲁什博士成为一个 成功的职业生涯作为一个独立的面向患者的成瘾治疗研究员。

Project Summary Relapse following treatment for substance use disorder (SUD) remains the norm, not the exception. Mindfulness treatment is a particularly efficacious outpatient aftercare approach for reducing relapse among individuals stepping down from more intensive SUD treatment (e.g., residential or intensive outpatient). Unfortunately, aftercare mindfulness treatment is inaccessible to most patients, due to limited clinician training opportunities and a lack of effective implementation strategies. For example, to date there are no existing technology-based (e.g., web-based) aftercare mindfulness treatments for preventing relapse to substance use. Research is also lacking on mechanisms of change in mindfulness treatment for SUD (i.e., how and why this treatment works). Ecological momentary assessment (EMA), or intensive longitudinal measurement via smartphone, captures dynamic, high-resolution data in near real-time. Mindfulness, negative/positive affect, stress, and craving - which are momentary states that change over the course of a day - are central to putative mechanisms of mindfulness treatment for SUD. Mindfulness treatment for SUD is theorized to weaken or “decouple” the momentary associations of negative affect with craving, stress with craving, and (low) positive affect with craving. However, no studies to date have used EMA to evaluate these putative momentary decoupling mechanisms following mindfulness treatment for SUD. The proposed K23 career development award provides training to support Dr. Corey Roos in becoming an independent patient-oriented researcher focused on technology-based addiction treatment and mechanisms of change in addiction recovery. The training goals of this award focus on technology-based treatment development, rigorous clinical trial research, EMA, and mechanisms of mindfulness. Dr. Roos will receive training in these goals through direct mentorship from experts, coursework, conferences, and hands-on research activities. The proposed research project of this K23 application involves developing and evaluating UrgeSurfer, the first web-based mindfulness treatment for preventing relapse substance use among individuals with SUDs. The web program will be iteratively developed through a user-centered design framework involving client feedback and usability testing. We will then conduct a pilot randomized controlled trial to evaluate UrgeSurfer as an adjunctive outpatient aftercare treatment for preventing relapse. Moreover, as part of this trial, will investigate putative decoupling mechanisms of change using EMA. This K23 award will propel Dr. Roos into a successful career as an independent patient-oriented addiction treatment researcher.