End User–Informed Mobile Health Intervention Development for Adolescent Cannabis Use Disorder: Qualitative Study

Background The rates of cannabis use continue to increase among adolescents and the current interventions have modest effects and high rates of relapse following treatment. There is increasing evidence for the efficacy of mobile technology–based interventions for adults with substance use disorders, but there is limited study of this technology in adolescents who use cannabis. Objective The goal of our study was to elucidate elements of an app-based adjunctive intervention for cannabis cessation that resonate with adolescents who use cannabis. Methods Adolescents, aged between 14 and 17 years, who used cannabis were recruited from San Diego County high schools. Semistructured focus groups (6 total; N=37) were conducted to examine the ways in which participants used smartphones, including the use of any health behavior change apps, as well as to elicit opinions about elements that would promote engagement with an app-based intervention for adolescent cannabis cessation. An iterative coding structure was used with first cycle structural coding, followed by pattern coding. Results Themes that emerged from the analysis included (1) youth valued rewards to incentivize the progressive reduction of cannabis use, which included both nontangible rewards that mimic those obtained on social media platforms and prosocial activity-related rewards, (2) having the ability to self-monitor progression, (3) peer social support, (4) privacy and confidentiality discrete logo and name and usernames within the app, and (5) individualizing frequency and content of notifications and reminders. Conclusions Integrating content, language, interfaces, delivery systems, and rewards with which adolescents who use cannabis are familiar, engage with on a day-to-day basis, and identify as relevant, may increase treatment engagement and retention for adolescents in substance use treatment. We may increase treatment effectiveness by adapting and individualizing current evidence-based interventions, so that they target the needs of adolescents and are more easily incorporated into their everyday routines.

[1]  Z. Demetrovics,et al.  Potential of an Interactive Drug Prevention Mobile Phone App (Once Upon a High): Questionnaire Study Among Students , 2018, JMIR serious games.

[2]  K. Malterud,et al.  Sample Size in Qualitative Interview Studies , 2016, Qualitative health research.

[3]  A. Winstock,et al.  Examining the profile of high-potency cannabis and its association with severity of cannabis dependence , 2015, Psychological Medicine.

[4]  K. Griffiths,et al.  Technology-based interventions for tobacco and other drug use in university and college students: a systematic review and meta-analysis , 2015, Addiction Science & Clinical Practice.

[5]  Mei-Chen Hu,et al.  WEB-BASED TREATMENT FOR SUBSTANCE USE DISORDERS: DIFFERENTIAL EFFECTS BY PRIMARY SUBSTANCE , 2015, Addictive behaviors.

[6]  M. Litt,et al.  The Efficacy of Contingency Management for Adolescent Cannabis Use Disorder: A Controlled Study , 2014, Substance abuse.

[7]  Margaret M. Thorsen,et al.  Acceptability, language, and structure of text message-based behavioral interventions for high-risk adolescent females: a qualitative study. , 2014, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[8]  Carrie D. Patnode,et al.  Primary Care Behavioral Interventions to Prevent or Reduce Illicit Drug Use and Nonmedical Pharmaceutical Use in Children and Adolescents: A Systematic Evidence Review for the U.S. Preventive Services Task Force , 2014, Annals of Internal Medicine.

[9]  Tracy L. Brewer,et al.  A review of clinical manifestations in adolescent and young adults after use of synthetic cannabinoids. , 2014, Journal for specialists in pediatric nursing : JSPN.

[10]  K. Brady,et al.  Cannabis use disorders are comparatively prevalent among nonwhite racial/ethnic groups and adolescents: a national study. , 2014, Journal of psychiatric research.

[11]  N. Petry,et al.  A randomized trial of assertive continuing care and contingency management for adolescents with substance use disorders. , 2014, Journal of consulting and clinical psychology.

[12]  K. Gray.  New Developments in Understanding and Treating Adolescent Marijuana Dependence. , 2014, Adolescent psychiatry.

[13]  N. Newton,et al.  A systematic review of school-based alcohol and other drug prevention programs facilitated by computers or the internet. , 2013, Drug and alcohol review.

[14]  D. Hine,et al.  Effectiveness of a Self-Guided Web-Based Cannabis Treatment Program: Randomized Controlled Trial , 2013, Journal of medical Internet research.

[15]  C. S. Andreassen,et al.  Development of a Facebook Addiction Scale , 2012, Psychological reports.

[16]  A. Barbuti,et al.  A pilot study of low-cost contingency management to increase attendance in an adolescent substance abuse program. , 2012, The American journal on addictions.

[17]  S. Henggeler,et al.  Enhancing the effectiveness of juvenile drug courts by integrating evidence-based practices. , 2012, Journal of consulting and clinical psychology.

[18]  Hans-Peter Tossmann,et al.  A Controlled Trial of an Internet-Based Intervention Program for Cannabis Users , 2011, Cyberpsychology Behav. Soc. Netw..

[19]  Heleen Riper,et al.  Effectiveness of E-Self-help Interventions for Curbing Adult Problem Drinking: A Meta-analysis , 2011, Journal of medical Internet research.

[20]  G. Schippers,et al.  Internet therapy versus internet self-help versus no treatment for problematic alcohol use: A randomized controlled trial. , 2011, Journal of consulting and clinical psychology.

[21]  W. Bickel,et al.  An initial trial of a computerized behavioral intervention for cannabis use disorder. , 2011, Drug and alcohol dependence.

[22]  E. Thorsteinsson,et al.  Computer-delivered interventions for alcohol and tobacco use: a meta-analysis. , 2010, Addiction.

[23]  C. Stanger,et al.  A randomized trial of contingency management for adolescent marijuana abuse and dependence. , 2009, Drug and alcohol dependence.

[24]  Simon Jencius,et al.  Effectiveness of very low-cost contingency management in a community adolescent treatment program. , 2009, Drug and alcohol dependence.

[25]  Amanda L Baker,et al.  Computer-based psychological treatment for comorbid depression and problematic alcohol and/or cannabis use: a randomized controlled trial of clinical efficacy. , 2009, Addiction.

[26]  B. Rounsaville,et al.  Enduring effects of a computer-assisted training program for cognitive behavioral therapy: a 6-month follow-up of CBT4CBT. , 2009, Drug and alcohol dependence.

[27]  J. Copeland,et al.  Cannabis use disorder: Epidemiology and management , 2009, International review of psychiatry.

[28]  B. Rounsaville,et al.  Computer-assisted delivery of cognitive-behavioral therapy for addiction: a randomized trial of CBT4CBT. , 2008, The American journal of psychiatry.

[29]  W. Hall.  Cannabis use and the Mental Health of Young People , 2006, The Australian and New Zealand journal of psychiatry.

[30]  C. Stanger,et al.  A contingency management intervention for adolescent marijuana abuse and conduct problems. , 2005, Journal of the American Academy of Child and Adolescent Psychiatry.

[31]  Thomas Babor,et al.  The Cannabis Youth Treatment (CYT) Study: main findings from two randomized trials. , 2004, Journal of substance abuse treatment.

[32]  Marc Laruelle,et al.  The role of endogenous sensitization in the pathophysiology of schizophrenia: Implications from recent brain imaging studies , 2000, Brain Research Reviews.

[33]  S. Tapert,et al.  Psychometric evaluation of the Customary Drinking and Drug Use Record (CDDR): a measure of adolescent alcohol and drug involvement. , 1998, Journal of studies on alcohol.

[34]  Jack Durell,et al.  National Institute on Drug Abuse , 2020, Definitions.

[35]  K. Carey,et al.  Evaluation of a web-based intervention for college marijuana use , 2012 .

[36]  Peter Brimblecombe,et al.  Monitoring the future , 2010 .

[37]  B. Banahan,et al.  Potency trends of delta9-THC and other cannabinoids in confiscated marijuana from 1980-1997. , 2000, Journal of forensic sciences.