Mobile Intervention for Simultaneous Alcohol and Marijuana Use in Young Adults

NCT ID: NCT05991882

Last Updated: 2025-03-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

136 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-01

Study Completion Date

2026-05-01

Brief Summary

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The goal of this treatment development project is to develop an adaptive ecological momentary intervention (a-EMI) for young adults using marijuana and alcohol that is grounded in self-regulation and social cognitive theories. To determine the most efficacious intervention strategies, the investigators will test variations of intervention components to identify the best combination. The study will take place at the Center for Integrated Health Care Research at Kaiser Permanente Hawaii (KPHI), located in Honolulu (island of Oahu). Following pilot testing with 6 participants, the study team will assess the feasibility and efficacy of intervention components on two primary outcomes (negative consequences and protective behavioral strategies \[PBS\]) using a fractional factorial experimental design, with post-intervention assessment and one- and three-month follow-ups. 136 diverse young adults recruited from KPHI who report current simultaneous alcohol and marijuana (SAM) use will be randomly assigned to one of eight groups, representing experimental conditions that include or do not include intervention strategies focused on craving reduction and PBS. As a result of this process, individual and/or combined components that lead to improved outcomes will be retained in a subsequent randomized controlled trial, while ineffective components will be eliminated.

Detailed Description

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Up to one-third of young adults report use of marijuana or alcohol in the past month, with sizable numbers reporting daily marijuana use and heavy episodic drinking. Simultaneous alcohol and marijuana (SAM) use, defined as use of both substances at the same time or within a few hours of each other with overlapping effects, is common among young adults. Recent research has shown that SAM use leads to greater negative consequences compared to use of either substance alone. No current intervention addresses SAM use specifically and few leverage new technological methods (e.g., smartphones) or strategies (e.g., protective behavioral strategies \[PBS\]) to engage young adults.

The goal of this Stage I treatment development project is to develop a fully mobile adaptive ecological momentary intervention (a-EMI) titled "Smartphone App For Effectively Reducing Risk (SAFERR)" that is grounded in self-regulation and social cognitive theories. To determine the most efficacious intervention strategies, the investigators will test variations of intervention components to identify the best combination. They will assess the feasibility and efficacy of intervention components on two outcomes (negative consequences and PBS) using a fractional factorial experimental design.

The study will take place at the Center for Integrated Health Care Research at Kaiser Permanente Hawaii (KPHI), located in Honolulu (island of Oahu). Following pilot testing, the SAFERR a-EMI will be administered to 6 eligible participants. Based on the feedback, the app will be revised and a trial of the SAFERR intervention will begin. 136 diverse young adults who report current SAM use will be recruited from primary care clinics at KPHI. Eligible individuals will complete a baseline assessment and then be randomly assigned (by sex) to one of eight conditions using stratified randomization. Each condition either includes or does not include four different intervention strategies focused on craving reduction and PBS. All participants will complete signal-contingent (random prompts three times per day) and event-related ecological momentary assessment (EMA) for 6 weeks using a smartphone application (app). EMA will continue during the 4-week intervention phase. At the beginning of the intervention, all participants will complete an introduction module via the study app that includes psychoeducation, personalized feedback, and goal setting. Participants will then begin the a-EMI via the study app, with components delivered based on their condition assignment.

Following completion of the intervention, participants will complete a post-intervention assessment and follow-up assessments at one- and three-months. The feasibility of the a-EMI and design will be examined by assessing: study attrition and response rates/time, module completion rates, acceptability (satisfaction, usability), perceived helpfulness, goal attainment, and implementation and intervention engagement. The efficacy of intervention components on negative consequences and PBS during EMA and at post-intervention and one-month and three-month follow-ups will be examined. In a future, larger study, the most useful components will be incorporated into a full intervention package and tested in a randomized controlled trial.

Conditions

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Alcohol Drinking Cannabis Use

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Participants will be randomly assigned to one of eight conditions
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
Participants in the factorial trial will be informed generally of the assigned condition (i.e., introduction module + no daily messages or introduction module + daily messages), but not given detailed content.

Study Groups

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Condition 1: Craving daily+PBS daily

EMA + Introduction Module + Craving reduction and protective behavioral strategy (PBS) messages, each delivered once daily

Group Type EXPERIMENTAL

Condition 1: Craving daily+PBS daily

Intervention Type BEHAVIORAL

Participants in this condition will complete ecological momentary assessment (EMA) for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will then receive craving reduction and protective behavioral strategy (PBS) messages, each delivered once daily, until the end of the six-week period.

Condition 2: Craving daily+PBS trigger

EMA + Introduction Module + Craving reduction messages delivered once daily and PBS trigger messages

Group Type EXPERIMENTAL

Condition 2: Craving daily+PBS trigger

Intervention Type BEHAVIORAL

Participants in this condition will complete EMA for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will then receive craving reduction messages delivered once daily and PBS trigger messages that will be based on responses to signal-contingent EMA questions.

Condition 3: Craving trigger+PBS daily

EMA + Introduction Module + Craving reduction trigger messages and PBS messages delivered once daily

Group Type EXPERIMENTAL

Condition 3: Craving trigger+PBS daily

Intervention Type BEHAVIORAL

Participants in this condition will complete EMA for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will then receive craving reduction messages that will be delivered based on responses to signal-contingent EMA questions and PBS delivered once daily.

Condition 4: Craving trigger+PBS trigger

EMA + Introduction Module + Craving reduction trigger and PBS trigger messages

Group Type EXPERIMENTAL

Condition 4: Craving trigger+PBS trigger

Intervention Type BEHAVIORAL

Participants in this condition will complete EMA for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will then receive craving reduction and PBS messages delivered based on responses to signal-contingent EMA questions.

Condition 5: PBS daily+ PBS trigger

EMA + Introduction Module + PBS delivered once daily and PBS trigger messages

Group Type EXPERIMENTAL

Condition 5: PBS daily+ PBS trigger

Intervention Type BEHAVIORAL

Participants in this condition will complete EMA for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will then receive PBS messages delivered once daily and PBS trigger messages that will be based on responses to signal-contingent EMA questions.

Condition 6: Craving daily+Craving trigger

EMA + Introduction Module + Craving reduction delivered once daily and craving reduction trigger messages

Group Type EXPERIMENTAL

Condition 6: Craving daily+Craving trigger

Intervention Type BEHAVIORAL

Participants in this condition will complete EMA for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will then receive craving reduction messages delivered once daily and craving reduction trigger messages that will be based on responses to signal-contingent EMA questions.

Condition 7: Craving daily+Craving trigger+PBS daily+PBS trigger

EMA + Introduction Module + Craving reduction delivered once daily, craving reduction trigger messages, PBS delivered once daily, and PBS trigger messages

Group Type EXPERIMENTAL

Condition 7: Craving daily+Craving trigger+PBS daily+PBS trigger

Intervention Type BEHAVIORAL

Participants in this condition will complete EMA for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will then receive craving reduction and PBS messages delivered once daily and non-repetitive craving reduction and PBS trigger messages that will be based on responses to signal-contingent EMA questions.

Condition 8: No daily or trigger craving or PBS

EMA + Introduction Module + no other messages

Group Type OTHER

Condition 8: No daily or trigger craving or PBS

Intervention Type BEHAVIORAL

Participants in this condition will complete EMA for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will not receive any further intervention strategies.

Interventions

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Condition 1: Craving daily+PBS daily

Participants in this condition will complete ecological momentary assessment (EMA) for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will then receive craving reduction and protective behavioral strategy (PBS) messages, each delivered once daily, until the end of the six-week period.

Intervention Type BEHAVIORAL

Condition 2: Craving daily+PBS trigger

Participants in this condition will complete EMA for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will then receive craving reduction messages delivered once daily and PBS trigger messages that will be based on responses to signal-contingent EMA questions.

Intervention Type BEHAVIORAL

Condition 3: Craving trigger+PBS daily

Participants in this condition will complete EMA for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will then receive craving reduction messages that will be delivered based on responses to signal-contingent EMA questions and PBS delivered once daily.

Intervention Type BEHAVIORAL

Condition 4: Craving trigger+PBS trigger

Participants in this condition will complete EMA for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will then receive craving reduction and PBS messages delivered based on responses to signal-contingent EMA questions.

Intervention Type BEHAVIORAL

Condition 5: PBS daily+ PBS trigger

Participants in this condition will complete EMA for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will then receive PBS messages delivered once daily and PBS trigger messages that will be based on responses to signal-contingent EMA questions.

Intervention Type BEHAVIORAL

Condition 6: Craving daily+Craving trigger

Participants in this condition will complete EMA for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will then receive craving reduction messages delivered once daily and craving reduction trigger messages that will be based on responses to signal-contingent EMA questions.

Intervention Type BEHAVIORAL

Condition 7: Craving daily+Craving trigger+PBS daily+PBS trigger

Participants in this condition will complete EMA for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will then receive craving reduction and PBS messages delivered once daily and non-repetitive craving reduction and PBS trigger messages that will be based on responses to signal-contingent EMA questions.

Intervention Type BEHAVIORAL

Condition 8: No daily or trigger craving or PBS

Participants in this condition will complete EMA for six weeks. Following the initial two weeks of EMA, participants in this condition will complete an introduction module including psychoeducation, personalized feedback, and goal setting. Participants will not receive any further intervention strategies.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* resident of state of Hawai'i and island of O'ahu
* age 18-30 years
* has sought services at Kaiser Permanente Hawaii within the past year
* report marijuana use, heavy drinking, and simultaneous alcohol and marijuana use
* report confidence in ability to use protective behavioral strategies
* endorse at least 3 recent negative consequences from marijuana and/or alcohol
* own a smartphone

Exclusion Criteria

• any substance use treatment within the past 3 months
Minimum Eligible Age

18 Years

Maximum Eligible Age

30 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

Kaiser Permanente

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kristina Phillips, PhD

Role: PRINCIPAL_INVESTIGATOR

Kaiser Permanente

Locations

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Kaiser Permanente Hawaii, Center for Integrated Health Care Research

Honolulu, Hawaii, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Kristina Phillips, PhD

Role: CONTACT

808-432-4687

Kara Tsuzaki, PharmD

Role: CONTACT

808-432-5500 ext. 1466

Facility Contacts

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Kara Tsuzaki, PharmD

Role: primary

808-272-5276

Kristina Phillips, PhD

Role: backup

808-432-4687

Other Identifiers

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R34DA056759

Identifier Type: NIH

Identifier Source: secondary_id

View Link

R34DA056759

Identifier Type: NIH

Identifier Source: org_study_id

View Link

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