Mobile Technologies Extending Reach of Primary Care for Substance Use Disorders

NCT ID: NCT06208839

Last Updated: 2024-08-29

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

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-25

Study Completion Date

2027-04-30

Brief Summary

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The goal of this clinical trial is to evaluate efficacy of our enhanced version of the CHESS Health eIntervention in a clinical setting for those with moderate risk drug or alcohol use and those at high risk or with Substance Use Disorder (SUD) as measured by the ASSIST and the AUDIT assessment tools. The clinical trial is designed to determine whether SBIRT/eIntervention is significantly more effective than SBIRT/Treatment as usual (TAU) as delivered in a primary care setting. While it is not feasible or practical to individually test all components and features of the planned eIntervention, this design will permit testing of efficacy for reduction of substance use in both risk groups and increased enrollment in treatment for the high risk/SUD group in the SBIRT/eIntervention cohorts compared to the SBIRT/TAU cohorts. Note that the investigators are not including a screening/assessment only or other control condition, as the purpose of this clinical trial is not to test the efficacy of SBIRT itself, but rather to test whether SBIRT/eIntervention improves outcomes and successful referral relative to SBIRT/TAU delivery alone.

Detailed Description

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The investigators will recruit and randomize 200 individuals screening positive on the NIDA Quick Screen.

All participants will receive SBIRT as currently implemented at Western Michigan and as described above. Adult patients would be asked prior to appointments at Western Michigan, either in-person when in a waiting room and/or via email for virtual appointments if they'd would be willing to answer a brief, anonymous online survey regarding their substance use as part of a research study. Upon completing the survey, the results of the survey would be displayed for the patient to see. If the patient's answers to the screening tool indicate their use may be risky or indicates a serious problem regarding assessment, then they would be asked if they would consider participating in a research study (the investigators would provide an online description of the requirements of the study and the payments for participation). If they click through as being interested, the investigators will display more detail about the research study, explain that they will need to review and sign a consent form, and would be required to speak with a research assistant in the coming days. The investigators would present them an electronic consent form and require them to scroll through and, if necessary, could ask them a question or two to confirm their understanding, before allowing them to electronically sign the consent. The investigators would advise them that their participation will not be anonymous. If the patient consents, then the investigators would have them to complete the longer NIDA ASSIST or AUDIT screening tool. If the patient's answers indicate a risk score in the low-risk range for either alcohol or illicit drugs, the investigators will exclude them from continuing in the study.

If the patient's answers indicate a risk score in the moderate to high range, then they would be randomized to the intervention group or the control group. As part of the randomization process, the SBIRT/TAU and the SBIRT/eIntervention groups will have two sub-groups each: (1) those with moderate risk drug or alcohol use and those at high risk or with SUD as measured by the ASSIST and the AUDIT assessment tools). Thus, participants will have been randomized into four cohorts of about 50 subjects each.

If the patient is randomized to the intervention group, then they would be presented a set of digital interventions for them to access then as well as to have access to in the coming weeks/months. If the patient is randomized to the control group, they will receive a 'brief intervention' based on the "Drinker's Checkup" licensed by CHESS Health from San Diego State University.

Whether in the intervention group or the control group, they would be recommended for a referral to treatment. If they're already in SUD treatment, then will exclude them from continuing in the study. If the patient is randomized to the intervention group, then in addition to the referral, they would be given use of the Envoy App with referral details and a TBD set of digital interventions for them to access then as well as to have access to in the coming weeks/months. If the patient is randomized to the control group, then they would only get the referral to treatment plus a basic version of the app that consists solely of the survey engine used for primary data collection. The investigators will conduct a 3-month randomized clinical trial, with a 6-month follow-up.

Conditions

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Substance-Related Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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SBIRT/TAU for those with moderate risk drug or alcohol use

This moderate risk group will receive the standard Screening and Brief Intervention Treatment (SBIRT) along with Treatment as Usual (TAU) at the clinic.

Group Type ACTIVE_COMPARATOR

SBIRT/TAU for those with moderate risk drug or alcohol use

Intervention Type OTHER

Treatment as usual

SBIRT/eIntervention for those with moderate risk drug or alcohol use

Subjects assigned to this condition will be instructed by the research assistant in how to download and use the eIntervention app, which they will be free to use as they like for the duration of the study. The app will contain a personalized suite of programs and activities. Unlike the TAU condition, the patient's referral to treatment would be managed through eIntervention. For example, the app will show the patient their referral details (if a referral to treatment was made), including details on the provider, referred services, and contact information, and will offer them videos of peers and professionals educating them on addiction, treatment, and sharing personal stories of recovery.

Group Type EXPERIMENTAL

SBIRT/eIntervention for those with moderate risk drug or alcohol use

Intervention Type DEVICE

The Connections App is available on iOS or Android and will be offered to the patient during the referral process and contains the following functionalities:

* Online view of the referrals made for them e.g. to healthcare provider
* Secure messaging with the referring provider
* Secure messaging with the destination provider(s) to support them to adhere to the referral, and/or the patient can seek assistance with the destination provider,
* Informative multimedia content filtered from a library to fit the patient including testimonial content from peers thus showing the patient that others like them have shared their addiction experience and successfully received treatment and achieved recovery,
* Capture structured feedback from the patient

The patient may access more functionality within the Connections App for those who wish to modify behavior using eTherapy and eRecovery. eRecovery includes ecological momentary assessments (EMA) selected by the provider.

SBIRT/TAU for those assessed with high risk.

This high risk group will receive the standard Screening and Brief Intervention Treatment (SBIRT) along with Treatment as Usual (TAU) at the clinic.

Group Type ACTIVE_COMPARATOR

SBIRT/TAU for those assessed with high risk.

Intervention Type OTHER

Treatment as usual for high risk group

SBIRT/eIntervention those assessed with high risk.

Subjects assigned to this condition will be instructed by the research assistant in how to download and use the eIntervention app, which they will be free to use as they like for the duration of the study. The app will contain a personalized suite of programs and activities. Unlike the TAU condition, the patient's referral to treatment would be managed through eIntervention. For example, the app will show the patient their referral details (if a referral to treatment was made), including details on the provider, referred services, and contact information, and will offer them videos of peers and professionals educating them on addiction, treatment, and sharing personal stories of recovery.

Group Type EXPERIMENTAL

SBIRT/eIntervention those assessed with high risk.

Intervention Type DEVICE

The Connections App is available on iOS or Android and will be offered to the patient during the referral process and contains the following functionalities:

* Online view of the referrals made for them e.g. to healthcare provider
* Secure messaging with the referring provider
* Secure messaging with the destination provider(s) to support them to adhere to the referral, and/or the patient can seek assistance with the destination provider,
* Informative multimedia content filtered from a library to fit the patient including testimonial content from peers thus showing the patient that others like them have shared their addiction experience and successfully received treatment and achieved recovery,
* Capture structured feedback from the patient

The patient may access more functionality within the Connections App for those who wish to modify behavior using eTherapy and eRecovery. eRecovery includes ecological momentary assessments (EMA) selected by the provider.

Interventions

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SBIRT/eIntervention for those with moderate risk drug or alcohol use

The Connections App is available on iOS or Android and will be offered to the patient during the referral process and contains the following functionalities:

* Online view of the referrals made for them e.g. to healthcare provider
* Secure messaging with the referring provider
* Secure messaging with the destination provider(s) to support them to adhere to the referral, and/or the patient can seek assistance with the destination provider,
* Informative multimedia content filtered from a library to fit the patient including testimonial content from peers thus showing the patient that others like them have shared their addiction experience and successfully received treatment and achieved recovery,
* Capture structured feedback from the patient

The patient may access more functionality within the Connections App for those who wish to modify behavior using eTherapy and eRecovery. eRecovery includes ecological momentary assessments (EMA) selected by the provider.

Intervention Type DEVICE

SBIRT/eIntervention those assessed with high risk.

The Connections App is available on iOS or Android and will be offered to the patient during the referral process and contains the following functionalities:

* Online view of the referrals made for them e.g. to healthcare provider
* Secure messaging with the referring provider
* Secure messaging with the destination provider(s) to support them to adhere to the referral, and/or the patient can seek assistance with the destination provider,
* Informative multimedia content filtered from a library to fit the patient including testimonial content from peers thus showing the patient that others like them have shared their addiction experience and successfully received treatment and achieved recovery,
* Capture structured feedback from the patient

The patient may access more functionality within the Connections App for those who wish to modify behavior using eTherapy and eRecovery. eRecovery includes ecological momentary assessments (EMA) selected by the provider.

Intervention Type DEVICE

SBIRT/TAU for those with moderate risk drug or alcohol use

Treatment as usual

Intervention Type OTHER

SBIRT/TAU for those assessed with high risk.

Treatment as usual for high risk group

Intervention Type OTHER

Other Intervention Names

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Treatment as usual group[ High risk treatment as usual

Eligibility Criteria

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Inclusion Criteria

* adults aged 18 or over
* receiving primary care at Western Michigan
* identified as having a substance-specific NIDA Modified Assist score of 27 or greater.

Exclusion Criteria

* non-English speaking
* cannot read at a 3rd grade level,
* have current participation in addiction treatment
* determined to be psychiatrically or medically unstable such that completion of the trial is unlikely.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

Western Michigan University

OTHER

Sponsor Role collaborator

Chess Mobile Health

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Hans Morefield

Role: PRINCIPAL_INVESTIGATOR

CHESS Health

Locations

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WMed Health Family Medicine

Kalamazoo, Michigan, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Andrew Quanbeck, PhD

Role: CONTACT

6086097308

Hans Morefield

Role: CONTACT

Facility Contacts

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Lisa Graves, MD

Role: primary

Other Identifiers

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1R44DA050214-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2023-SBIR-ChessHealth

Identifier Type: -

Identifier Source: org_study_id

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