The goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to develop the candidate, Dr. Zachary Adams, into an independent investigator prepared to lead large-scale, rigorously designed studies evaluating the utility of mobile health (mHealth) technologies in improving treatment efficiency, efficacy, and reach among high-risk youth with substance use disorders (SUD) and comorbid mental illness. Comorbidity is common in adolescence and often complicates treatment progress. Use of mHealth approaches-such as mobile applications that tailor content to patients' specific needs, enhance patient engagement, and facilitate existing evidence-based treatments-holds great promise in reducing the public health burden of addiction and mental illness. This application proposes training and Stage IA-IB intervention development research that is directly in line with NIDA-supported initiatives and represents a logical progression from the candidate's prior research and training to address career development goals in six areas: (1) development of mobile applications for adolescent mental health, (2) etiology and treatment of comorbid SUD and trauma-related mental illness in adolescents, (3) conduct and evaluation of clinical trials, (4 multilevel and longitudinal data analysis, (5) grant management, and (6) research ethics. Goals will be accomplished through high caliber didactic training, participation in national conferences and institutes, and hands-on research experience. Activities will be completed under the mentorship of an accomplished team of expert on-site investigators in the fields of adolescent comorbidity and integrated treatments (Danielson), mHealth methodologies and evaluation (Treiber), technology-based mental health interventions (Ruggiero), [qualitative and mixed methods research (Pope)], and analysis of longitudinal, clinical trials data (Ramakrishnan). The candidate will apply these skills through completion of a three-component research project: (I) initial design and programming of a novel web-based mobile application to enhance outpatient treatment for comorbid SUD and posttraumatic stress disorder, (II) mixed method usability testing of the application by adolescents and providers to guide design and content refinements, and (III) a pilot trial to demonstrate the feasibility of the proposed methodology and to evaluate the preliminary efficacy of the application to guide design of an randomized controlled efficacy trial. An iterative, patient- and provider- centered development process will be employed to ensure relevance to the target population. The central hypothesis is that developmentally tailored mobile applications that incorporate evidence-based treatment principles can facilitate increased patient engagement in and between sessions, thus improving the efficiency, efficacy, and reach of treatments for this highly vulnerable population. After completing these projects, there will be a better understanding of how mHealth approaches can be used to augment existing treatments for comorbid SUD and mental illness. The experience, and data gained from this project will position the candidate to pursue future NIH funding to build this line of researc and to adapt and test future mHealth tools for adolescent substance abuse and mental health problems.

Public Health Relevance

There is great need to improve the efficiency, effectiveness, and reach of existing treatments for substance use disorders and co-occurring mental illness, particularly among at-risk adolescents. This project involves the development and evaluation of a web-based mobile application that is designed to target co-occurring problems, tailor content to patients' specific needs, enhance patient treatment engagement, and contribute to lasting improvements in teens' mental health.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DA038257-02
Application #
9043846
Study Section
Risk, Prevention and Intervention for Addictions Study Section (RPIA)
Program Officer
Aklin, Will
Project Start
2015-04-01
Project End
2020-03-31
Budget Start
2016-04-01
Budget End
2017-03-31
Support Year
2
Fiscal Year
2016
Total Cost
Indirect Cost
Name
Medical University of South Carolina
Department
Psychiatry
Type
Schools of Medicine
DUNS #
183710748
City
Charleston
State
SC
Country
United States
Zip Code
29403
Adams, Zachary W; Sieverdes, John C; Brunner-Jackson, Brenda et al. (2018) Meditation smartphone application effects on prehypertensive adults' blood pressure: Dose-response feasibility trial. Health Psychol 37:850-860
Danielson, Carla Kmett; Cohen, Joseph R; Adams, Zachary W et al. (2017) Clinical Decision-Making Following Disasters: Efficient Identification of PTSD Risk in Adolescents. J Abnorm Child Psychol 45:117-129
W Adams, Zachary; McClure, Erin A; Gray, Kevin M et al. (2017) Mobile devices for the remote acquisition of physiological and behavioral biomarkers in psychiatric clinical research. J Psychiatr Res 85:1-14
Bountress, Kaitlin; Adams, Zachary W; Gilmore, Amanda K et al. (2017) Associations among impulsivity, trauma history, and alcohol misuse within a young adult sample. Addict Behav 64:179-184
Sieverdes, John C; Adams, Zachary W; Nemeth, Lynne et al. (2017) Formative evaluation on cultural tailoring breathing awareness meditation smartphone apps to reduce stress and blood pressure. Mhealth 3:44
Dir, Allyson L; Bell, Richard L; Adams, Zachary W et al. (2017) Gender Differences in Risk Factors for Adolescent Binge Drinking and Implications for Intervention and Prevention. Front Psychiatry 8:289
Mirhashem, Rebecca; Allen, Holley C; Adams, Zachary W et al. (2017) The intervening role of urgency on the association between childhood maltreatment, PTSD, and substance-related problems. Addict Behav 69:98-103
Cohen, Joseph R; Adams, Zachary W; Menon, Suvarna V et al. (2016) How should we screen for depression following a natural disaster? An ROC approach to post-disaster screening in adolescents and adults. J Affect Disord 202:102-9
Adams, Zachary W; McCauley, Jenna L; Back, Sudie E et al. (2016) Clinician Perspectives on Treating Adolescents with Co-occurring Post-Traumatic Stress Disorder, Substance Use, and Other Problems. J Child Adolesc Subst Abuse 25:575-583
Adams, Zachary W; Schacht, Joseph P; Randall, Patrick et al. (2016) The Reasons for Heavy Drinking Questionnaire: Factor Structure and Validity in Alcohol-Dependent Adults Involved in Clinical Trials. J Stud Alcohol Drugs 77:354-61

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