CARS: Cannabis and Alcohol Reduction Study

Study Overview
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Brief Summary
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The study will test a computerized treatment with subjects ages 13-17 years who are seeking treatment for alcohol and/or cannabis use. Youth will be recruited from the Center for Drug and Alcohol Programs (CDAP) Clinic in the Department of Psychiatry at MUSC. Follow-up assessments will be conducted at one- and three-months following treatment.

Official Title
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Brief Computerized Intervention for Reducing Adolescent Cannabis and Alcohol Use

Conditions
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Cannabis Use, Alcohol Use, Unspecified, Substance Use, Substance Use Disorders

Intervention / Treatment
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* Behavioral: modified Approach-Avoidance Task (mAAT), which aims to modify automatic approach bias
* Behavioral: modified Approach-Avoidance Task (mAAT) that does not aim to modify automatic approach bias.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: between the ages of 13 and 17 be seeking treatment for either cannabis or alcohol use; report co-occurring alcohol and cannabis use during the past three months (i.e., participants who report using both alcohol and cannabis during the three months prior to participation in the study, regardless of if the use was simultaneous) have a caregiver willing to participate and provide consent. Exclusion Criteria: - being pregnant and/or breastfeeding

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group A: Treatment Group<br> | Behavioral: modified Approach-Avoidance Task (mAAT), which aims to modify automatic approach bias<br>* Participants will undergo a baseline assessment before completing computerized tasks. During the baseline assessment, participants will be asked questions about alcohol and cannabis use. We will also ask questions about the way participants think about things, past life experiences related to substance use, and questions about how participants feel about reducing their substance use. Then, participants will complete a series computerized tasks where they will push and pull a joystick in response to images that are presented on a screen or where they will try to get a high score. During the computerized tasks, we will also be measuring brain activity using EEG. During the study, participants will also be asked to respond to questions about their health and behavior using an app on a smartphone or tablet using a secure program. Participants in the Treatment Group will then complete four sessions of the modified Approach-Avoidance Task (mAAT), which aims to modify automatic approach bias.<br>|
| Sham Comparator: Group B: Control Group<br> | Behavioral: modified Approach-Avoidance Task (mAAT) that does not aim to modify automatic approach bias.<br>* Participants will undergo a baseline assessment before completing computerized tasks. During the baseline assessment, participants will be asked questions about alcohol and cannabis use. We will also ask questions about the way participants think about things, past life experiences related to substance use, and questions about how participants feel about reducing their substance use. Then, participants will complete a series computerized tasks where they will push and pull a joystick in response to images that are presented on a screen or where they will try to get a high score. During the computerized tasks, we will also be measuring brain activity using EEG. During the study, participants will also be asked to respond to questions about their health and behavior using an app on a smartphone or tablet using a secure program. Participants in the Control Group will then complete four sessions of an Approach-Avoidance Task (mAAT) that does not aim to modify automatic approach bias.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in cannabis use as assessed by Timeline Followback | The TLFB is a calendar-assisted semi-structured interview that will be used to assess cannabis and alcohol use since the last assessment. The TLFB will assess the number of days a person used cannabis over the past 90 days compared to the 90 days prior to enrolling in this study. | Baseline and Three-Month Follow-up | 
| Change in alcohol use as assessed by Timeline Followback | The TLFB is a calendar-assisted semi-structured interview that will be used to assess cannabis and alcohol use since the last assessment. The TLFB will assess the number of days a person consumed alcohol over the past 90 days compared to the 90 days prior to enrolling in this study. | Baseline and Three-Month Follow-up | 
| Change in Cannabis Approach Bias (D-Score) | D scores will be calculated for each participant at baseline, posttest, and three-month follow-up. Participants' mean reaction times (RTs) during the approach cannabis trials will be subtracted from the mean avoid cannabis trial RTs. These scores are then divided by the SD across all cannabis trials. Positive scores indicate an approach bias for cannabis stimuli. | Baseline, One-Week Follow-up, and Three-Month Follow-up | 
| Change Cannabis Approach Bias (D-Score) | D scores will be calculated for each participant at baseline, posttest, and three-month follow-up. Participants' mean reaction times (RTs) during the approach alcohol trials will be subtracted from the mean avoid alcohol trial RTs. These scores are then divided by the SD across all alcohol trials. Positive scores indicate an approach bias for alcohol stimuli. | Baseline, One-Week Follow-up, and Three-Month Follow-up |