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

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).

Study Overview

• Status: Recruiting
• Conditions: Substance Use Disorders
• Intervention / Treatment: Other: Recovery support as usual; Other: Smartphone assisted relapse prevention

Detailed Description

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.

• Study Type: Interventional
• Enrollment (Estimated): 300
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Michael L Dennis; Phone Number: 309-451-7801; Email: mdennis@chestnut.org
• Study Contact Backup: Name: Christy K Scott; Phone Number: 312-664-4324; Email: cscott@chestnut.org

Study Locations

• United States
  • Illinois
    • Bloomington, Illinois, United States, 61701
      • Recruiting
      • Chestnut Health Systems
      • Contact: Michael L Dennis, Ph.D.; Phone Number: 309-451-7801; Email: mdennis@chestnut.org
      • Contact: Kelli Wright; Phone Number: 309-451-7855; Email: kwright@chestnut.org
      • Principal Investigator: Michael L Dennis, Ph.D.
    • Chicago, Illinois, United States, 60610
      • Recruiting
      • Chestnut Health Systems
      • Contact: Christy K Scott, Ph.D.; Phone Number: 312-664-4321; Email: cscott@chestnut.org
      • Contact: Belinda Willis, MA; Phone Number: 3126644321; Email: bwillis@chestnut.org
      • Principal Investigator: Christy K Scott, Ph.D.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 26 years (Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. discharge from an adolescent outpatient SUD treatment program to the community;
2. substance use during the 90 days prior to treatment;

3. aged 18 to 26 at the time of discharge;

   Exclusion Criteria:

4. inability to read and communicate in English;
5. does NOT reside or plan to stay in Chicago during the next 9 months;

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Recovery Support as Usual Control; Participants in the control and experimental condition will have access to post treatment recovery support services as usual.	Other: Recovery support as usual; same as arm; Other: Smartphone assisted relapse prevention; same as arm; Other Names: Relapse Prevention
Experimental: Smartphone Addiction Recovery Coach (SARC) - Assisted Relapse Prevention; 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; same as arm; Other Names: Relapse Prevention

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: Chestnut Health Systems
• Investigators: Principal Investigator: Michael L Dennis, Ph.D., Chestnut Health Systems

Study record dates

Study Major Dates

• Study Start (Actual): October 30, 2020
• Primary Completion (Estimated): February 28, 2025
• Study Completion (Estimated): April 30, 2025

Study Registration Dates

• First Submitted: September 27, 2017
• First Submitted That Met QC Criteria: September 29, 2017
• First Posted (Actual): October 4, 2017

Study Record Updates

• Last Update Posted (Estimated): February 7, 2024
• Last Update Submitted That Met QC Criteria: February 6, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: Smartphone; Young Adults; Relapse Prevention; Recovery Support
• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Compulsive Behavior; Impulsive Behavior; Behavior, Addictive; Technology Addiction; Substance-Related Disorders; Internet Addiction Disorder
• Other Study ID Numbers: DA011323-15

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: We use standardized measures and have a history of established relationships with several investigators who have had their own funds to conduct secondary analyses or need very limited support and are open to others. For EMA/EMI data from the pilot (and for this study, if funded) we are explicitly collaborating with Dr. Susan Murphy at the University of Michigan in her efforts to develop and evaluate Machine Learning algorithms on how to increase EMI utilization and prevent relapse even more effectively. Our data sharing practices have and will continue to include a mixture of publishing traditional peer-reviewed publications; making forms, reports, and normative tables available via the internet (or by request); providing analytic runs upon request; collaborating with other researchers; and providing copies of the de-identified data sets to eligible researchers. The later require data sharing agreements and commitments not to attempt re-identification.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No