A CBT-Based Text Messaging Intervention for Methamphetamine Dependence

描述(由申请人提供)：这项申请建议通过开发一种创新的认知行为疗法(CBT)短信干预来改善甲基苯丙胺(MA)依赖患者的治疗结果。虽然CBT减少了MA的使用，但它和其他心理社会疗法的效果有限，而且接受MA依赖治疗的患者复发率很高。因此，存在治疗MA依赖的附加疗法的重大需求。我们正在使用一个迭代过程来开发和改进这种干预。我们召集了一个专家小组，对MA依赖的受试者进行了三个焦点小组，采访了25名接受MA依赖治疗的受试者，并进行了五个受试者的可行性试验。我们将重新召集专家小组审查我们的候选短信和研究方法。活动和控制文本消息将被上传到我们为此开发的基于Web的应用程序中。我们将进行一项预测试，其中10名受试者将收到两周的活动短信和两周的控制短信；这些条件将以随机、平衡的顺序进行，为期一周。信息每天将被“推送”给主题四次，也可以根据要求被“拉出”。受试者将参加以CBT为基础的小组治疗，每周三次，每次一小时。我们将收集尿样进行毒理学分析，MA使用的自我报告，渴望评分，以及在受试者完成每个条件后对干预的效用和可接受性的评级定性访谈将评估该方法的感知效用、对信息内容的偏好和可接受性。当所有科目都完成后，我们将举行专题小组会议，并重新召集专家小组。在对短信或程序进行任何有指示的修改后，我们将实施第二次交叉试验，包括40名受试者，与第二次试验中的受试者进行另一次焦点小组，再次召集专家小组，并选择短信用于随后的大型随机平行小组试验。这将是一种利用负担得起且广泛可用的技术--基本蜂窝电话--部署的廉价干预措施。这种干预的低强度、高频率和始终可用的特点与传统的门诊治疗形成对比，可能是对它的有价值的补充。它将很容易扩展，既适用于无法接受正式治疗的MA使用者，也适用于依赖其他药物的个人。

DESCRIPTION (provided by applicant): This application proposes to improve treatment outcomes for methamphetamine- (MA-) dependent subjects through development of an innovative cognitive behavioral therapy- (CBT-) based text messaging intervention. While CBT reduces MA use, it and other psychosocial therapies have limited effectiveness, and patients treated for MA dependence have a high rate of relapse. Thus, a significant need exists for add-on therapy for treatment of MA dependence. We are using an iterative process to develop and refine this intervention. We have convened an expert panel, conducted three focus groups with MA-dependent subjects, interviewed 25 subjects being treated for MA dependence, and conducted a five-subject feasibility trial. We will reconvene the expert panel to review our candidate text messages and study methods. Active and control text messages will be uploaded into a web-based application that we have developed for this purpose. We will conduct a pre-test in which 10 subjects receive two weeks of the active text messages and two weeks of control text messages; these conditions will be in random, counterbalanced order with a one-week washout. Messages will be "pushed" to subjects four times per day and can also be "pulled" on an as-requested basis. Subjects will attend one-hour CBT-based group therapy sessions three times per week. We will collect urine samples for toxicological analyses, self-reports of MA use, craving scores, and ratings of the utility and acceptability of the intervention Qualitative interviews after subjects complete each condition will assess the perceived utility of the approach, preferences for message content, and acceptability. When all subjects have completed, we will hold a focus group and reconvene the expert panel. After making any indicated revisions to the text messages or procedures, we will implement a second crossover trial with 40 subjects, conduct another focus group with subjects who were in the second trial, reconvene the expert panel again, and select text messages to be used in a subsequent large randomized parallel group trial. This will be an inexpensive intervention to deploy that utilizes technology that is affordable and widely available - basic cellular telephones. The low-intensity, high-frequency, and always available characteristics of this intervention contrast to conventional outpatient treatment and may be a valuable complement to it. It will be readily extensible, both to MA users who cannot attend formal treatment, and also to individuals dependent on other drugs.