Smartphone Addiction Recovery Coach for Young Adults (SARC-YA) Experiment

Study Overview
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Brief Summary
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At discharge from outpatient treatment, researchers will recruit 300 young adults and randomly assign them to recovery support as usual control condition or the Smartphone Addiction Recovery Coach for Young Adults (SARC-YA) experimental condition. Participants in the experimental conditions will receive a smartphone, a calling/texting/data plan, and the SARC-YA mobile applications for the first 6 months post treatment discharge. Experimental participants will 1) complete a 2-3 minute recovery-focused ecological momentary assessment (EMA) at 5 random times a day, receive feedback on their current answers, and provided access to behavioral charting of their past answers over time; and 2) receive continuous access to a suite of self-initiated ecological momentary interventions (EMI) to support their recovery via tool box of coping tools, apps related to getting support, and apps related to maintaining a healthy lifestyle. Data include standardized assessments, urine tests, mobile phone metadata, EMA responses, and EMI utilization. The study's primary aim and hypothesis are: Aim 1: Test the effects of experimental assignment on the frequency of substance use. H1 Relative to the control group, participants in the experimental group will have lower scores on the quarterly Substance Frequency Scale (3, 6, 9 months post- discharge).

Detailed Description
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At discharge from outpatient treatment, researchers will recruit 300 young adults and randomly assign them to recovery support as usual control condition or the Smartphone Addiction Recovery Coach for Young Adults (SARC-YA) experimental condition. Participants in the experimental conditions will receive a smartphone, a calling/texting/data plan, and the SARC-YA mobile applications for the first 6 months post treatment discharge. Experimental participants will 1) complete a 2-3 minute recovery-focused ecological momentary assessment (EMA) at 5 random times a day, receive feedback on their current answers, and provided access to behavioral charting of their past answers over time; and 2) receive continuous access to a suite of self-initiated ecological momentary interventions (EMI) to support their recovery via tool box of coping tools, apps related to getting support, and apps related to maintaining a healthy lifestyle. Data include standardized assessments, urine tests, mobile phone metadata, EMA responses, and EMI utilization. The study's aims and their associated hypotheses are: Aim 1: Test the effects of experimental assignment on the frequency of substance use. H1 Relative to the control group, participants in the experimental group will have lower scores on the quarterly Substance Frequency Scale (3, 6, 9 months post- discharge). Aim 2: Evaluate the extent to which the experimental effects are moderated by baseline substance use frequency. H2 The Substance Frequency Scale Scores at intake will moderate the effects of experimental on the quarterly subsequent Substance Frequency Scale scores. Aim 3: Test the extent to which the frequency of substance use mediates the effects of experimental assignment on other aspects of recovery including SUD symptoms, HIV risk behavior, quality of life, mental wellness, and days of school. H3a Relative to the control group, participants in the experimental group will have better scores on other aspects of recovery (reverse of number of SUD symptoms, reverse of HIV risk behaviors, quality of life, mental wellness, days of school) in the quarterly interviews. H3b Higher Substance Frequency Scale scores (regardless of assignment) in a given quarter will be associated with worse scores on other aspects of recovery in the next quarter. H3c Substance Frequency Scale scores in a given quarter will mediate the impact of the experimental assignment on other aspects of recovery in the next quarter. Aim 4: Within the experimental condition, determine the degree to which EMA responses (e.g., use, withdrawal, craving, negative and positive affect) and EMI utilization predict the duration of abstinence (to be done within experimental condition.) H4a The duration of abstinence will be negatively related to EMA measures of the recency of use, withdrawal, craving, low self-efficacy to resist relapse, increased negative affect, and decreased positive affect. H4b The duration of abstinence will be positively related to immediate and cumulative EMI utilization.

Official Title
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Smartphone Addiction Recovery Coach for Young Adults (SARC-YA) Experiment

Conditions
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Substance Use Disorders

Intervention / Treatment
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* Other: Recovery support as usual
* Other: Smartphone assisted relapse prevention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: discharge from an adolescent outpatient SUD treatment program to the community; substance use during the 90 days prior to treatment; aged 18 to 26 at the time of discharge; Exclusion Criteria: inability to read and communicate in English; does NOT reside or plan to stay in Chicago during the next 9 months;

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 26 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants in the control and experimental condition will have access to post treatment recovery support services as usual. Participants in the experimental condition will receive a smartphone, a calling/texting/data plan, and the SARC-A mobile applications for the first 6 months post treatment discharge. Experimental participants will 1) complete a 2-3 minute recovery-focused ecological momentary assessment (EMA) at 5 random times a day, receive feedback on their current answers, and provided access to behavioral charting of their past answers over time; and 2) receive continuous access to a suite of self-initiated ecological momentary interventions (EMI) to support their recovery via tool box of coping tools, apps related to getting support, and apps related to maintaining a healthy lifestyle.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Recovery Support as Usual Control<br>Participants in the control and experimental condition will have access to post treatment recovery support services as usual. | Other: Recovery support as usual<br>* same as arm<br>Other: Smartphone assisted relapse prevention<br>* same as arm<br>* Other names: Relapse Prevention;|
| Experimental: Smartphone Addiction Recovery Coach (SARC) - Assisted Relapse Prevention<br>Participants in the experimental condition will receive a smartphone, a calling/texting/data plan, and the SARC-YA mobile applications for the first 6 months post treatment discharge. Experimental participants will 1) complete a 2-3 minute recovery-focused ecological momentary assessment (EMA) at 5 random times a day, receive feedback on their current answers, and provided access to behavioral charting of their past answers over time; and 2) receive continuous access to a suite of self-initiated ecological momentary interventions (EMI) to support their recovery via tool box of coping tools, apps related to getting support, and apps related to maintaining a healthy lifestyle. | Other: Smartphone assisted relapse prevention<br>* same as arm<br>* Other names: Relapse Prevention;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in GAIN's Substance Frequency Scale from baseline to 6 months (effect of providing the intervention) | The GAIN's Substance Frequency Scale (SFS; alpha=.85; test-retest rho=.94) ranges from 0 to 100% and is calculated as the average percent of days in the past 90 that adolescents reported alcohol, cannabis, stimulates, opioids, and other substance use, days of heavy substance use, and days of problems from substance use. Thus it incorporates the frequency of use, range of substances used, amount used, and degree to which use is causing problems. | 6 month SFS minus baseline SFS | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in GAIN's Substance Frequency Scale from 6 to 9 months (effect of withdrawing the intervention) | The GAIN's Substance Frequency Scale (SFS; alpha=.85; test-retest rho=.94) ranges from 0 to 100% and is calculated as the average percent of days in the past 90 that adolescents reported alcohol, cannabis, stimulates, opioids, and other substance use, days of heavy substance use, and days of problems from substance use. Thus it incorporates the frequency of use, range of substances used, amount used, and degree to which use is causing problems. | 9 months SFS minus 6 month SFS | 
| Change in GAIN Substance Disorder Screener (SDScr) from baseline to 6 months | Count of 5 past 90 day substance use disorder symptoms (alpha=.90) from the GAIN-Q3 | 6 month minus baseline | 
| Change in GAIN Risk Behavior Screener (RBScr) from baseline to 6 months | Count of 6 past 90 day of HIV risk behaviors (test-retest rho=.80) including needle use, needle sharing, unprotected sex, multiple sexual partners, trading sex, and victimization from the GAIN-Q3 | 6 month minus baseline | 
| Change in European Quality of Life 5 dimensions (EQ5D) from baseline to 6 months | Count of 6 quality of life items (alpha=.83) from the EQ5D | 6 month minus baseline | 
| Change in Mental Health Continuum Short Form (MHC-SF) from baseline to 6 months | Count of 14 items related to mental wellness (alpha=.94) from the MHC-SF | 6 month minus baseline | 
| Change in the days of school from baseline to 6 months | The days of being in school during the past quarter (test-retest rho=.88) from the GAIN-Q3 | 6 month minus baseline | 
| Duration of abstinence after a given EMA | The duration of abstinence is the time from each completed EMA to the next indication of use - measured in days. | Measured at 5 random times per day over 6 months in the experimental condition | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Young Adults, Relapse Prevention, Smartphone, Recovery Support