Phone app for grounding (de-escalation) of substance-abusing transition-age youth

描述（由申请人提供）：物质使用障碍（SUD）是美国人口中第二常见的精神病诊断，14.6%的人在一生中发展。18-24岁的过渡年龄青年（TAY）特别容易受到物质使用，滥用和SUD的影响。这个发展时期，被称为“不稳定的年龄”，包括诸如离家、进入大学、第一次工作、身体和性行为的变化、与同龄人群体的融合，以及对一些人来说，在18岁时结束的寄养或国家监护的老化。这一时期也是尝试药物使用和相关风险的黄金时期，如酒后驾车、事故、打架和暴力、艾滋病毒和易受性侵犯。在这个项目中，我们专注于一个主要的策略，接地，帮助降级（减少）强烈的负面情绪和冲动。接地长期以来一直被用于精神病医院，以提供一种安全，快速和强大的方式来减少任何强烈的负面情绪，包括伤害自己或他人的冲动，物质渴望，愤怒，焦虑等在书中详细描述“寻求安全”（SS），接地使用三种途径来集中思想（精神），身体（身体）和心脏（舒缓）。接地提供了一种调节情绪的方法，这对年轻人来说是一个重大挑战，特别是考虑到他们的荷尔蒙变化和情绪强度。事实上，物质使用通常被描述为调节情绪的短期方式。基础是SS的一个关键模块，SS是一个广泛实施的循证SUD治疗模型。在本提案中，我们专门关注接地，因为它是一项基本技能，即使是最复杂和最脆弱的客户也被广泛认为是易于学习的。我们建议把接地变成一个智能手机应用程序，因为接地应该在经历痛苦的环境中使用;它利用了智能手机的TAY使用;促进自我调节;并且是一种独立的技能和感官导向，因此非常适合移动的 app方法我们的具体目标是：（1）开发一个新产品，智能手机接地应用程序。这将是一个令人兴奋的，互动的Android应用程序，使用最先进的游戏技术，让TAY参与接地，与一家优秀的公司合作，负责该项目的技术方面。(2)使用基于最终用户反馈的迭代产品开发方法。我们提出了各种方法来获得初始输入TAY与SUD开始之前，应用程序编程。(3)对该应用程序进行小型可行性研究。该横向试点将获得有关最终用户体验，使用情况和对应用程序的满意度的信息，这些信息可以为第二阶段研究提供信息。我们将24名患有SUD的TAY分配给接地应用程序（n = 12），而不是从SS书中接收硬拷贝接地讲义（n=12），以评估应用程序的相对影响。我们的团队代表了SUD，TAY，应用程序和游戏技术创新，接地，SBIR，治疗开发以及基于循证护理的公共卫生导向产品的专业知识。

DESCRIPTION (provided by applicant): Substance use disorder (SUD) is the second most common psychiatric diagnosis in the U.S. population, with 14.6% developing it in their lifetime. Transition-age youth (TAY) from ages 18-24 are especially vulnerable to substance use, misuse, and SUD. This developmental period, termed the "age of instability" includes tasks such as leaving home; entering college; working for the first time; body and sexuality changes; coalescing with a peer group; and for some, aging out of foster care or state custody, which end at age 18. This period is also prime for experimentation with substance use and associated risks such as driving under the influence, accidents, fighting and violence, HIV, and vulnerability to sexual assault. In this project, we focus on a major strategy, grounding, for helping to de-escalate (reduce) intense negative emotions and impulses. Grounding has long been used in psychiatric hospitals to provide a safe, quick, and powerful way to reduce any intense negative feeling, including impulses to hurt self or others, substance craving, anger, anxiety, etc. Described in detail in the book "Seeking Safety" (SS), grounding uses three pathways to focus the mind (mental), the body (physical), and the heart (soothing). Grounding provides a way to regulate emotion, which is a major challenge for youth, especially given their hormone changes and emotional intensity. Indeed, substance use is often described as a short-term way to regulate emotion. Grounding is a key module of SS, a widely-implemented, evidence-based SUD treatment model. In this proposal we focus exclusively on grounding as it is an essential skill and widely identified as easy to learn across even the most complex and vulnerable clients. We propose to turn grounding into a smartphone app because grounding should be used in the environment in which the distress is experienced; it capitalizes on TAY use of smartphones; promotes self-regulation; and is a stand- alone skill and sensory-oriented, thus ideal for a mobile app approach. Our specific aims are: (1) to develop a new product, a smartphone Grounding App. This will be an exciting, interactive Android app that uses state-of- the-art gaming technology to engage TAY in grounding, in collaboration with an outstanding company for the technology side of the project. (2) To use an iterative product development methodology based on end-user feedback. We propose various methods to obtain initial input from TAY with SUD before beginning app programming. (3) To conduct a small feasibility study of the app. This cross-sectional pilot will obtain information on end-users experience, usage, and satisfaction with the app, which can inform a phase II study. We will assign 24 TAY with SUD to the grounding app (n=12) versus receiving hard-copy grounding handouts from the SS book (n=12), to evaluate the relative impact of the app. Our team represents an exceptional mix of expertise in SUD, TAY, app and gaming technology innovation, grounding, SBIRs, treatment development, and public-health oriented products based on evidence-based care.