A Real-time, Contextual Intervention Using Mobile Technology to Reduce Marijuana Use in Youth
Condition: Marijuana Abuse
MeSH terms: Marijuana Abuse; Marijuana Use
Study type: Interventional

Summary: 
      The purpose of this study is to further develop and test the Momentary Self-Monitoring and
      Feedback + Motivational Enhancement Therapy (MOMENT) intervention, a real-time, contextual
      intervention to reduce marijuana use among primary care patients.
    

Detailed description: 
      This study proposes a pilot randomized trial to further develop and test the Momentary
      Self-Monitoring and Feedback + Motivational Enhancement Therapy (MOMENT) intervention, a
      real-time, contextual intervention to reduce marijuana use over three months in
      15-to-24-year-old primary care patients who use frequently. We will randomize youth to one of
      two arms (goal 30 per arm completing 3-month follow-up): 1) MOMENT (MET + momentary
      self-monitoring + context-dependent feedback), or 2) MET-only. The two study arms will permit
      evaluation of the contributions of the self-monitoring and feedback components of the
      intervention above-and-beyond the MET and directly test the influence of the intervention on
      the link between momentary context and marijuana-related outcomes.

      The specific aims of the study are

      Specific Aim 1: Continued Feasibility Evaluation. In our preliminary work, we demonstrated
      that 1) youth perceive MOMENT to be easy to understand, comfortable, motivating, and helpful
      in reducing their marijuana use, 2) we can recruit 4 participants/month (minimum rate for the
      proposed study), and 3) we can successfully implement a MOMENT intervention study in the
      proposed recruitment sites. Based on this work, we have identified additional areas of
      feasibility on which to focus in the proposed study. Specifically, we aim to achieve:

      1a. A signal response rate of at least 70% during each of three periods of momentary data
      collection - baseline, intervention, and 3-month follow-up.

      1b. A diary response rate of at least 70% during each momentary data collection period

        1. c. A retention rate of at least 80% of participants at the 3-month follow-up.

           Specific Aim 2. Early-Stage Efficacy Exploration. Our preliminary work showed that both
           momentary and individual-level outcomes improved from baseline to three months
           post-intervention. The primary momentary outcomes are desire to use marijuana when in a
           triggering context and likelihood of use following exposure to a triggering context. The
           primary individual-level outcomes are number of use events/week, 30-day percent of days
           abstinent, dose/use event, and measures of motivation (importance of, readiness for, and
           confidence about reducing use). Based on the preliminary findings, we will explore these
           early-stage efficacy questions:

        2. a. Will improvements in momentary outcomes be observed with MOMENT, but not MET-only?

      (1) The association between exposure to self-identified trigger contexts and momentary desire
      to use marijuana will be attenuated at three months, compared to pre-intervention.

      (2) The likelihood of marijuana use following exposure to a trigger context will be reduced
      at three months.

      2b. Will improvements in individual-level outcomes be greater with MOMENT vs. MET-only?

        1. The reduction in marijuana use frequency (events/week and 30-day percent of days
           abstinent) and dose (per use event) will be greater at three months.

        2. The increase in motivation to reduce or discontinue use will be greater at three months.
    

Intervention name(s): MET; MOMENT
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Motivational Enhancement Therapy only; The full MOMENT intervention: Motivational Enhancement Therapy + momentary and daily mobile self-monitoring + motivational feedback messages prompting participants to consider their individualized coping strategies to avoid using marijuana
Other intervention name(s): Motivational Enhancement Therapy
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: marijuana; intervention; adolescent, young adult; primary care; mobile