Mindfulness Mobile App to Reduce Adolescent Substance Use
Condition: Adolescent Drinking; Adolescent Problem Behavior
MeSH terms: Substance-Related Disorders; Problem Behavior; Underage Drinking
Study type: Interventional

Summary: 
      Substance-abusing youth - especially those who are involved in the juvenile justice system -
      are at higher risk than nonusers for mental health problems, including depression, conduct
      problems, personality disorders, suicidal thoughts, attempted suicide, and completed suicide.
      The proposed Phase II project aims to develop and test the efficacy of a mobile app, called
      Rewire, that is geared toward helping high risk adolescent substance users reduce or quit
      their substance use. The Rewire app is based on the primary substance use cessation
      components tested in our previous work with juvenile justice-involved adolescents and on
      intervention components shown to be central to smoking cessation; it applies a mindfulness
      approach as the guiding framework for the intervention.
    

Detailed description: 
      There is growing evidence that interventions based on mindfulness have been an efficacious
      intervention for a variety of problems, including substance use among adolescents. We propose
      to adapt and test the feasibility and efficacy of a smart phone application (app)
      intervention prototype that would help adolescent substance users reduce or quit their
      substance use through the development of stress reduction, emotion regulation, and
      mindfulness skills. During the development process, 20 high-risk adolescents will be
      recruited for participation in focus groups and usability testing of early versions of the
      app; their initial reactions to content and functionality will help guide final iterations.
      Rewire is a twelve module program, and each module consists of a teaching component and a
      practice component. Modules take 5 minutes or less to complete. Module topics include
      developing an awareness of mind and body states, mindful decision making, and maintaining
      sobriety.

      In this study, the Rewire app will be evaluated with 400 high risk adolescents that are
      involved in the juvenile justice system; the first 20 adolescents will be involved in the
      development process and the remaining 380 participants will be randomly and equally assigned
      to the Rewire condition (n = 190) or the Department of Youth Services standard treatment
      condition (n = 190). Youth will be assessed at baseline and will be instructed to attempt to
      reduce substance use with a target quit date of 28 days in the future. The Rewire group will
      receive instructions for using the app in the 28 days following baseline. All youth will
      complete 1 and 3 month followups. Assessments will consist of online surveys asking about
      substance use, emotion regulation, family demographics, and mindfulness practices. The Rewire
      group will also be asked for their thoughts and opinions on the app. Biochemical verification
      of self-reported substance use, a urine sample, will be collected at each interview.
    

Intervention name(s): Rewire app users
Intervention type(s): Behavioral
Intervention description(s): Use of the Rewire app involves completing 12 modules and 12 practice sessions over 30 days.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This study will recruit 400 adolescents to test an app designed to increase mindfulness skills and reduce substance use. Participants will be randomly assigned in equal numbers to the intervention group (and will use the app) or the control group.
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Adolescent; Alcohol; Marijuana; Mindfulness