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Viera A, Ondrusek A, Tengatenga C, McBurney E, Lauckner J, Tran E, Muilenburg J, Kershaw T, Lauckner C. A Qualitative Exploration of Attitudes Toward Global Positioning System Tracking and Ecological Momentary Assessment Among Individuals in Substance Use Treatment. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:260-267. [PMID: 38258809 DOI: 10.1177/29767342231218514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND The use of tracking technology in substance use research can uncover the role of contextual factors, such as social networks and environmental cues, in triggering cravings and precipitating return to use. Few studies have explored the opinions of individuals in substance use treatment related to tracking technology. METHODS We conducted 30 semi-structured interviews with individuals in substance use treatment facilities in Connecticut and Georgia. Interviews were not limited to individuals with any specific substance use disorder. Interviewers described a hypothetical study involving ecological momentary assessment and global positioning system tracking to examine place-based predictors of substance use. Participants were invited to share reactions to this description. We used thematic analysis to identify themes in participant perceptions of this hypothetical research study. RESULTS Most participants shared positive opinions about study participation and expressed little to no concern about the tracking components. Participant concerns focused on the security of their information and the potential burden of responding to study questions. Participants largely understood the importance of study participation for promoting greater understanding of substance use and identified potential therapeutic effects of study participation on their own recovery. CONCLUSIONS Individuals in substance use treatment expressed little concern with research studies or interventions incorporating mobile-tracking elements. Future studies should explore the responsible use of tracking elements in recovery support interventions.
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Affiliation(s)
- Adam Viera
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Ashlin Ondrusek
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Cecil Tengatenga
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Erin McBurney
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - John Lauckner
- Substance Use Research Priority Area, University of Kentucky, Lexington, KY, USA
| | - Emma Tran
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Jessica Muilenburg
- Department of Health Promotion and Behavior, University of Georgia College of Public Health, Athens, GA, USA
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Carolyn Lauckner
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA
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2
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Roberts W, McKee S, Miranda R, Barnett N. Navigating ethical challenges in psychological research involving digital remote technologies and people who use alcohol or drugs. AMERICAN PSYCHOLOGIST 2024; 79:24-38. [PMID: 38236213 PMCID: PMC10798215 DOI: 10.1037/amp0001193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Digital and remote technologies (DRT) are increasingly being used in scientific investigations to objectively measure human behavior during day-to-day activities. Using these devices, psychologists and other behavioral scientists can investigate health risk behaviors, such as drug and alcohol use, by closely examining the causes and consequences of monitored behaviors as they occur naturalistically. There are, however, complex ethical issues that emerge when using DRT methodologies in research with people who use substances. These issues must be identified and addressed so DRT devices can be incorporated into psychological research with this population in a manner that comports the ethical standards of the American Psychological Association. In this article, we discuss the ethical ramifications of using DRT in behavioral studies with people who use substances. Drawing on allied fields with similar ethical issues, we make recommendations to researchers who wish to incorporate DRT into their own research. Major topics include (a) threats to and methods for protecting participant and nonparticipant privacy, (b) shortcomings of traditional informed consent in DRT research, (c) researcher liabilities introduced by real-time continuous data collection, (d) threats to distributive justice arising from computational tools often used to manage and analyze DRT data, and (e) ethical implications of the "digital divide." We conclude with a more optimistic discussion of how DRT may provide safer alternatives to gold standard paradigms in substance use research, allowing researchers to test hypotheses that were previously prohibited on ethical grounds. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Walter Roberts
- Department of Psychiatry, Yale University School of Medicine
| | - Sherry McKee
- Department of Psychiatry, Yale University School of Medicine
| | - Robert Miranda
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Nancy Barnett
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
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3
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El Dahr Y, Perquier F, Moloney M, Woo G, Dobrin-De Grace R, Carvalho D, Addario N, Cameron EE, Roos LE, Szatmari P, Aitken M. Feasibility of Using Research Electronic Data Capture (REDCap) to Collect Daily Experiences of Parent-Child Dyads: Ecological Momentary Assessment Study. JMIR Form Res 2023; 7:e42916. [PMID: 37943593 PMCID: PMC10667976 DOI: 10.2196/42916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 05/31/2023] [Accepted: 09/20/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Intensive longitudinal data collection, including ecological momentary assessment (EMA), has the potential to reduce recall biases, collect more ecologically valid data, and increase our understanding of dynamic associations between variables. EMA is typically administered using an application that is downloaded on participants' devices, which presents cost and privacy concerns that may limit its use. Research Electronic Data Capture (REDCap), a web-based survey application freely available to nonprofit organizations, may allow researchers to overcome these barriers; however, at present, little guidance is available to researchers regarding the setup of EMA in REDCap, especially for those who are new to using REDCap or lack advanced programming expertise. OBJECTIVE We provide an example of a simplified EMA setup in REDCap. This study aims to demonstrate the feasibility of this approach. We provide information on survey completion and user behavior in a sample of parents and children recruited across Canada. METHODS We recruited 66 parents and their children (aged 9-13 years old) from an existing longitudinal cohort study to participate in a study on risk and protective factors for children's mental health. Parents received survey prompts (morning and evening) by email or SMS text message for 14 days, twice daily. Each survey prompt contained 2 sections, one for parents and one for children to complete. RESULTS The completion rates were good (mean 82%, SD 8%) and significantly higher on weekdays than weekends and in dyads with girls than dyads with boys. Children were available to respond to their own survey questions most of the time (in 1134/1498, 75.7% of surveys submitted). The number of assessments submitted was significantly higher, and response times were significantly faster among participants who selected SMS text message survey notifications compared to email survey notifications. The average response time was 47.0 minutes after the initial survey notification, and the use of reminder messages increased survey completion. CONCLUSIONS Our results support the feasibility of using REDCap for EMA studies with parents and children. REDCap also has features that can accommodate EMA studies by recruiting participants across multiple time zones and providing different survey delivery methods. Offering the option of SMS text message survey notifications and reminders may be an important way to increase completion rates and the timeliness of responses. REDCap is a potentially useful tool for researchers wishing to implement EMA in settings in which cost or privacy are current barriers. Researchers should weigh these benefits with the potential limitations of REDCap and this design, including staff time to set up, monitor, and clean the data outputs of the project.
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Affiliation(s)
- Yola El Dahr
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Florence Perquier
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Madison Moloney
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Guyyunge Woo
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Faculty of Arts & Science, University of Toronto, Toronto, ON, Canada
| | - Roksana Dobrin-De Grace
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Daniela Carvalho
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Nicole Addario
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Emily E Cameron
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Leslie E Roos
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Institute of Manitoba, Winnipeg, MB, Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Madison Aitken
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Psychology, York University, Toronto, ON, Canada
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4
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Ozga JE, Paquette C, Syvertsen JL, Pollini RA. Mobile phone and internet use among people who inject drugs: Implications for mobile health interventions. Subst Abuse 2022; 43:592-597. [PMID: 34491889 PMCID: PMC9536021 DOI: 10.1080/08897077.2021.1975871] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background: Mobile health (mHealth) interventions have the potential to improve substance use treatment engagement and outcomes, and to reduce risk behaviors among people who inject drugs (PWID). However, there are few studies assessing mobile technology use among PWID and none have investigated continuity of mobile phone use. Methods: We surveyed 494 PWID. We used bivariate (independent-sample t- and chi-square tests) and multivariate (logistic regression) analyses to determine whether mobile phone and/or internet use differed as a function of participant- and/or injection-related characteristics. Results: Most participants (77%) had a mobile phone, with 67% having a phone that was free of charge. Participants with a phone were significantly less likely to be homeless (AOR = 0.28), to have shared syringes (AOR = 0.53), and to have reused syringes (AOR = 0.26) in the past 3 months. We observed high rates of phone and number turnover, with more than half reporting that they got a new phone (57%) and/or number (56%) at least once within the past 3 months. Most participants were familiar with using the internet (80% ever use), though participants who had ever used the internet were younger (AOR = 0.89), were less likely to be homeless (AOR = 0.38), were less likely to have shared syringes (AOR = 0.49), and were more likely to have injected methamphetamine by itself (AOR = 2.49) in the past 3 months. Conclusions: Overall, mobile technology and internet use was high among our sample of PWID. Several factors should be considered in recruiting diverse samples of PWID to minimize bias in mHealth study outcomes, including mobile phone access and protocol type (text- vs internet-based).
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Affiliation(s)
- Jenny E. Ozga
- Department of Behavioral Medicine & Psychiatry, West
Virginia University, Morgantown, WV, USA
| | - Catherine Paquette
- Pacific Institute for Research and Evaluation, Calverton,
MD, USA.,Department of Psychology and Neuroscience, University of
North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Robin A. Pollini
- Department of Behavioral Medicine & Psychiatry, West
Virginia University, Morgantown, WV, USA.,Pacific Institute for Research and Evaluation, Calverton,
MD, USA.,Department of Epidemiology, West Virginia University,
Morgantown, WV, USA
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5
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Markowski KL, Smith JA, Gauthier GR, Harcey SR. Patterns of Missing Data With Ecological Momentary Assessment Among People Who Use Drugs: Feasibility Study Using Pilot Study Data. JMIR Form Res 2021; 5:e31421. [PMID: 34464327 PMCID: PMC8501406 DOI: 10.2196/31421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/15/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ecological momentary assessment (EMA) is a set of research methods that capture events, feelings, and behaviors as they unfold in their real-world setting. Capturing data in the moment reduces important sources of measurement error but also generates challenges for noncompliance (ie, missing data). To date, EMA research has only examined the overall rates of noncompliance. OBJECTIVE In this study, we identify four types of noncompliance among people who use drugs and aim to examine the factors associated with the most common types. METHODS Data were obtained from a recent pilot study of 28 Nebraskan people who use drugs who answered EMA questions for 2 weeks. We examined questions that were not answered because they were skipped, they expired, the phone was switched off, or the phone died after receiving them. RESULTS We found that the phone being switched off and questions expiring comprised 93.34% (1739/1863 missing question-instances) of our missing data. Generalized structural equation model results show that participant-level factors, including age (relative risk ratio [RRR]=0.93; P=.005), gender (RRR=0.08; P=.006), homelessness (RRR=3.80; P=.04), personal device ownership (RRR=0.14; P=.008), and network size (RRR=0.57; P=.001), are important for predicting off missingness, whereas only question-level factors, including time of day (ie, morning compared with afternoon, RRR=0.55; P<.001) and day of week (ie, Tuesday-Saturday compared with Sunday, RRR=0.70, P=.02; RRR=0.64, P=.005; RRR=0.58, P=.001; RRR=0.55, P<.001; and RRR=0.66, P=.008, respectively) are important for predicting expired missingness. The week of study is important for both (ie, week 2 compared with week 1, RRR=1.21, P=.03, for off missingness and RRR=1.98, P<.001, for expired missingness). CONCLUSIONS We suggest a three-pronged strategy to preempt missing EMA data with high-risk populations: first, provide additional resources for participants likely to experience phone charging problems (eg, people experiencing homelessness); second, ask questions when participants are not likely to experience competing demands (eg, morning); and third, incentivize continued compliance as the study progresses. Attending to these issues can help researchers ensure maximal data quality.
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Affiliation(s)
- Kelly L Markowski
- Rural Drug Addiction Research Center, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Jeffrey A Smith
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - G Robin Gauthier
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Sela R Harcey
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, United States
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6
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Markowski KL, Smith JA, Gauthier GR, Harcey SR. Practical problems and positive experiences with ecological momentary assessment: reflections from people who use drugs. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:311-318. [PMID: 34010582 PMCID: PMC8266763 DOI: 10.1080/00952990.2021.1910700] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 12/20/2022]
Abstract
Background: Ecological momentary assessment (EMA) is an increasingly popular and feasible form of data collection, but it can be intensive and intrusive. Especially for at-risk, vulnerable populations like people who use drugs (PWUD), poor experiences with EMA may exacerbate existing chronic struggles while decreasing response rates. However, little research queries participants' experiences with EMA studies.Objectives: We explore participants' positive and negative experiences with EMA, identifying what they liked about the study, the problems they experienced, and suggested solutions to these problems.Methods: Results come from semi-structured interviews from 26 PWUD (6 women; 20 men) in Nebraska who participated in a two-week EMA pilot study on drug use with a study-provided smartphone. Participant responses were recorded by interviewers into open-text fields in Qualtrics. Data were analyzed with an iterative open coding procedure.Results: We found that many participants enjoyed the study and seamlessly incorporated the phone into their daily lives. There were a number of negative study aspects identified, however, as many participants experienced functional issues (e.g., running out of high-speed data, trouble keeping the phone charged, not able to answer questions within the two-hour timeframe) that detracted from their experience, especially if they were homeless.Conclusion: Our findings provide methodological considerations for studies with EMA components among at-risk, vulnerable populations, like PWUD. These suggestions are targeted toward the continued ethical collection of high-quality data in clinical and non-clinical settings.
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Affiliation(s)
- Kelly L. Markowski
- Rural Drug Addiction Research Center, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Jeffrey A. Smith
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - G. Robin Gauthier
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Sela R. Harcey
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, USA
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7
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Privacy, Confidentiality, and Safety Considerations for Conducting Geographic Momentary Assessment Studies Among Persons Who Use Drugs and Men Who Have Sex with Men. J Urban Health 2020; 97:306-316. [PMID: 30324355 PMCID: PMC7101455 DOI: 10.1007/s11524-018-0315-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Geographic momentary assessments (GMA) collect real-time behavioral data in one's natural environment using a smartphone and could potentially increase the ecological validity of behavioral data. Several studies have evaluated the feasibility and acceptability of GMA among persons who use drugs (PWUD) and men who have sex with men (MSM), but fewer have discussed privacy, confidentiality, and safety concerns, particularly when illegal or stigmatized behavioral data were collected. This study explores perceptions regarding privacy, confidentiality, and safety of GMA research among PWUD and MSM recruited in three different settings (rural Appalachia, a mid-sized city in the South, and a mid-Atlantic city). Between November 2014 and April 2017, we recruited 35 PWUD from rural Appalachian Kentucky (N = 20) and Baltimore, Maryland (N = 15) and 20 MSM from Lexington, Kentucky to complete semi-structured qualitative interviews. Through thematic analyses, we identified and compared privacy, confidentiality, and safety concerns by demographic characteristics, risk behaviors, and setting. Privacy, confidentiality, and safety concerns varied by setting, age, smartphone ownership, use of illegal drugs, and history of drug-related arrests. Among those who used drugs, participants reported concerns with being tracked and burden associated with carrying and safeguarding study phones and responding to survey prompts. Privacy and confidentiality concerns were noted in each setting, but tracking concerns were greatest among Baltimore participants and led many to feel that they (or others) would be unwilling to participate or comply with study procedures. While locations considered to be sensitive varied by setting, participants in all settings said they would take measures to prevent sensitive information from being collected (i.e., intentionally disable devices, leave phones at home, alter response times). Privacy, confidentiality, and safety concerns may limit the accuracy of risk location information, study compliance, and participation. As concerns were often greatest among those engaging in illegal behaviors and with the highest risk behaviors, selection bias and non-response bias could negatively influence the representativeness and validity of study findings.
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8
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Lewczuk K, Gorowska M, Li Y, Gola MK. Mobile Internet Technologies, Ecological Momentary Assessment, and Intervention-Poison and Remedy for New Online Problematic Behaviors in ICD-11. Front Psychiatry 2020; 11:807. [PMID: 32903803 PMCID: PMC7438912 DOI: 10.3389/fpsyt.2020.00807] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/27/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszyński University, Warsaw, Poland
| | - Monika Gorowska
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yonghui Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Mateusz Kazimierz Gola
- Swartz Center for Computational Neuroscience, Institute for Neural Computation, University of California, San Diego, San Diego, CA, United States.,Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
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Wolford-Clevenger C, Hugley MJ, McNulty J, Elledge LC, Cropsey K, Stuart GL. The risk-benefit ratio of studying psychiatric symptoms via daily diary methods. Account Res 2019; 26:498-511. [PMID: 31738573 DOI: 10.1080/08989621.2019.1694913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Ethics committee members and researchers have deliberated about the risk-benefit ratio of researching sensitive issues such as psychiatric symptoms. Although research has suggested that inquiring about psychiatric symptoms in research generally does not cause harm, these findings have primarily arisen from cross-sectional studies. We examined whether this generalized to repeated, daily assessments of psychiatric symptoms. We collected daily survey data on psychiatric symptoms over 90 days from a sample of 206 college students. A subset of the sample (n = 80) provided reactions to study participation administered on the 90th day. Individuals who did not complete the 90th day survey reported higher levels of suicidal ideation and hopelessness than those who did. For individuals who completed the 90th, final assessment, reactions primarily fell within the neutral to positive range, with variation depending on their baseline levels of psychiatric symptoms and identification as religious. This study adds to past work by demonstrating that individuals who remained in the study had neutral to positive experiences. However, participants with greater suicidal ideation and hopelessness were likely to attrit, warranting caution in assuming a low risk-benefit ratio of these studies. Management of risks involved in repeated assessment studies may be informed by this work.
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Affiliation(s)
| | - Mickeah J Hugley
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James McNulty
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | | | - Karen Cropsey
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gregory L Stuart
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
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10
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Acceptability of an Opioid Relapse Prevention Text-message Intervention for Emergency Department Patients. J Addict Med 2018; 11:475-482. [PMID: 28858888 DOI: 10.1097/adm.0000000000000351] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To explore whether a text message-based relapse prevention intervention (Preventing and Interrupting Early Relapse [PIER]1) is acceptable to treatment-seeking adults with opioid use disorder (OUD) after Emergency Department (ED) discharge using mixed-methods design. METHODS Adults seeking care in an urban ED for OUD (n = 20; mean age 22; 55% female; 75% white race) completed a baseline survey, and were invited to enroll in PIER1, which was delivered in 7-day blocks, with the option to re-enroll at the end of each block, up to 4 blocks. PIER1 included a morning "push" message focused on positive thinking, adaptive coping feedback tailored to twice-daily assessments of craving severity and contextual correlates of craving, and end-of-day feedback on daily opioid use and goal commitment. Participants were asked to complete a follow-up phone interview after the first 7 days of PIER1. Transcripts were thematically coded. RESULTS Seventeen out of 20 participants enrolled in PIER1. In the first 7 days, response rates to text-message assessments averaged 30%. Ten out of 17 participants re-enrolled after 7 days. Main themes from follow-up interviews (n = 9) included ease of use, social connection, and self-empowerment. Participants desired more personalized support and the ability to communicate through text messaging with another person about their struggles. Event-level data suggest that higher craving severity increased risk of opioid lapses. CONCLUSIONS In this mixed-methods intervention development study, we found conflicting evidence supporting an automated text-message intervention providing relapse prevention support for treatment-seeking individuals with OUD discharged from the ED. Qualitative feedback suggests that PIER1 could be useful and acceptability enhanced through personalized human support.
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11
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Roth AM, Felsher M, Reed M, Goldshear JL, Truong Q, Garfein RS, Simmons J. Potential benefits of using ecological momentary assessment to study high-risk polydrug use. Mhealth 2017; 3:46. [PMID: 29184898 PMCID: PMC5682359 DOI: 10.21037/mhealth.2017.10.01] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 08/30/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND While studies have documented both the feasibility and acceptability of using ecological momentary assessment (EMA) to study drug use, there is little empirical research assessing participants' perceptions of utilizing this technology-driven approach. METHODS Participants were English-speaking persons ≥18 years old who reported injection drug use and sequential (e.g., alcohol followed by opioid use) or simultaneous (i.e., injecting heroin and cocaine in one shot) polydrug use within 30 days recruited in San Diego, CA and Philadelphia, PA. Participants (N=36) completed two cell phone-based EMA simulations assessing mood, drug use, HIV risk behaviors, and daily activities, followed by semi-structured interviews that probed for potential benefits of participation over time. Qualitative analysis involved an iterative process of reviewing texts from the interviews to create a coding framework, which was then applied to all transcripts to identify themes. RESULTS Findings suggest participants may derive indirect benefits from participation in EMA studies including: improved self-worth from helping others; experiencing increased social support through utilization of the study-provided mobile device for non-research purposes; and most importantly, increased self-reflection, which could lead to therapeutic and intervention-like effects such as decreased substance use or reduced HIV risk. CONCLUSIONS Participants identified a variety of potential benefits from participating in a study that utilizes EMA. This research suggests that benefits are highly salient for individuals involved in studies of polydrug use.
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Affiliation(s)
- Alexis M. Roth
- Drexel University, Dornsife School of Public Health, Philadelphia, USA
| | - Marisa Felsher
- Drexel University, Dornsife School of Public Health, Philadelphia, USA
| | - Megan Reed
- Drexel University, Dornsife School of Public Health, Philadelphia, USA
| | - Jesse L. Goldshear
- Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, USA
| | - Quan Truong
- Palo Alto Medical Foundation Research Institute, Mountain View, CA, USA
| | - Richard S. Garfein
- Department of Medicine, Division of Global Public Health, University of California, San Diego, USA
| | - Janie Simmons
- National Development and Research Institutes, Inc., New York, USA
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