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

项目摘要 患有共病物质使用（SUD）和焦虑症（AD）的患者的健康状况明显较差 与单独SUD患者相比，患者的预后更好，复发风险增加。然而，不到10%的 只有18%的SUD设施和9%的精神卫生组织报告有能力 提供全面的护理。移动的保健技术越来越多地用于药物使用， 焦虑治疗，努力创造更全面的，以病人为中心的护理方法。尽管 随着移动的应用程序开发的不断增加，大多数现有程序都是针对SUD或 个别焦虑，很少利用循证内容或临床验证，大多数不是 作为SUD-AD患者的综合治疗成分。放松焦虑（UA）移动的 应用程序可以满足这一需求，因为它提供了数字化的，以证据为基础的心理教育培训， 可扩展的，高保真的方式靶向机制途径与以前的研究一致。的 拟议的研究将全面评估SUD-AD患者的UA用户体验， 正在恢复中，并探索探索性行为和心理健康结果的作用（即，物质使用， 渴望、焦虑）。我们将利用一个收敛的平行 混合方法研究设计，包括定量和定性测量的收集 同时。我们将使用系统可用性量表定量研究可用性、可行性和保真度， 教育模块完成，生态签到使用。我们将收集有关可用性的数据， 参与者（n=18）的子样本中的UA每周进行一次重点访谈（4 x <30分钟。 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 本研究的结果将导致：（1）基于患者生活经验的全面定制 其将用于改进SUD-AD患者的首批移动的应用程序之一， 循证治疗;（2）为博士后NIH资助申请测试提供初步数据 这种定制的移动的应用程序可以改善SUD-AD治疗的连续疗法。

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.