This Competitive Revision application is being submitted under the NIH Notice entitled """"""""NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications"""""""" (NOT-OD-09-058). In the parent project to this competitive revision application, we are currently evaluating the comparative effectiveness and cost-effectiveness of a web-based psychosocial treatment intervention with individuals in methadone maintenance treatment (relative to standard methadone maintenance treatment). We are currently randomizing patients entering methadone maintenance treatment (MMT) (target n=180;n=91 enrolled to date) to either 1) standard methadone counseling or 2) standard methadone counseling plus TES (such that they receive the same type of standard drug counseling as those in the first condition, except that half of their scheduled sessions are with a therapist and the other half are replaced by TES). In this Competitive Revision application, we propose to expand the scope of the parent project to develop a prototype of an innovative, mobile phone-based extension of the web-delivered psychosocial treatment intervention we are evaluating in the parent project that allows participants to access key elements of the web-based intervention at any time and outside of their formal treatment setting. We will examine the feasibility, acceptability, and potential utility of this mobile intervention with new participants at the study site where the parent project is currently being implemented. We propose to augment the TES study condition by providing new participants in that arm of the trial (n=25 anticipated) with mobile phones that contain an application that allows them to access content from several module topics included in the web-based TES intervention. Thus, participants in this condition will be able to access the technology-based psychosocial intervention in both their MMT treatment program as well as outside of the treatment setting. The ability to bring psychosocial treatment into an individual's natural environment to provide therapeutic support on- demand via such technology may greatly improve the potency of existing psychosocial interventions. The proposed extension will allow us to expand the scope of this project to obtain novel and clinically important information about the extent to which a mobile phone-based extension of the computer-delivered psychosocial intervention, currently under evaluation in the parent project, whose content is grounded in evidence-based psychosocial treatment, has the potential to enhance treatment outcomes. Consistent with the goals of the American Recovery and Reinvestment Act of 2009, the proposed revision to this project has the potential to accelerate the tempo of research examining the effectiveness of technology-based psychosocial interventions for individuals with substance use disorders and to promote job creation.
To our knowledge, the proposed study is the first to use mobile phone technology to deliver an interactive, science-based psychosocial intervention targeting illicit substance use that can be easily accessed in an individual's natural environment and provide therapeutic support on-demand. This tool may greatly improve the potency of existing psychosocial interventions for substance use disorders. The proposed project may generate clinically important empirical data regarding the use of technology in promoting new models of treatment delivery that may enable rapid and widespread diffusion of science-based interventions.
