Feasibility of a Mobile Health App for Routine Outcome Monitoring and Feedback in Mutual Support Groups Coordinated by SMART Recovery Australia: Protocol for a Pilot Study
Authors: Kelly Peter J , Beck Alison K , Baker Amanda L , Deane Frank P , Hides Leanne , Manning Victoria , Shakeshaft Anthony , Larance Briony , Neale Joanne , Kelly John , Oldmeadow Christopher , Searles Andrew , Treloar Carla , Gray Rebecca M , Argent Angela , McGlaughlin Ryan 
Published: May 2020

Background
Despite the importance and popularity of mutual support groups, there have been no systematic attempts to
implement and evaluate routine outcome monitoring (ROM) in these settings. Unlike other mutual support groups for addiction,
trained facilitators lead all Self-Management and Recovery Training (SMART Recovery) groups, thereby providing an opportunity
to implement ROM as a routine component of SMART Recovery groups.

Objective
This study protocol aims to describe a stage 1 pilot study designed to explore the feasibility and acceptability of a
novel, purpose-built mobile health (mHealth) ROM and feedback app (Smart Track) in SMART Recovery groups coordinated by SMART Recovery Australia (SRAU) The secondary objectives are to describe Smart Track usage patterns, explore psychometric properties of the ROM items (ie, internal reliability and convergent and divergent validity), and provide preliminary evidence for participant reported outcomes (such as alcohol and other drug use, self-reported recovery, and mental health).

Methods
Participants (n=100) from the SMART Recovery groups across New South Wales, Australia, will be recruited to a nonrandomized, prospective, single-arm trial of the Smart Track app. There are 4 modes of data collection: (1) ROM data collected from group participants via the Smart Track app, (2) data analytics summarizing user interactions with Smart Track, (3) quantitative interview and survey data of group participants (baseline, 2-week follow-up, and 2-month follow-up), and (4) qualitative interviews with group participants (n=20) and facilitators (n=10). Feasibility and acceptability (primary objectives) will be analyzed using descriptive statistics, a cost analysis, and a qualitative evaluation.

Results
At the time of submission, 13 sites (25 groups per week) had agreed to be involved. Funding was awarded on August 14, 2017, and ethics approval was granted on April 26, 2018 (HREC/18/WGONG/34; 2018/099). Enrollment is due to commence in July 2019. Data collection is due to be finalized in October 2019.

Conclusions
To the best of our knowledge, this study is the first to use ROM and tailored feedback within a mutual support group setting for addictive behaviors. Our study design will provide an opportunity to identify the acceptability of a novel mHealth ROM and feedback app within this setting and provide detailed information on what factors promote or hinder ROM usage within this context. This project aims to offer a new tool, should Smart Track prove feasible and acceptable, that service providers, policy makers, and researchers could use in the future to understand the impact of SMART Recovery groups.

Trial Registration
Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000686101; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377336.

International Registered Report Identifier (IRRID)
PRR1-10.2196/15113