Background: Mobile health (mHealth) interventions are increasingly used to reduce risk and promote health in real-time, real-life contexts. Engagement is critical for effectiveness of mHealth interventions but may be challenging for young people experiencing depressive symptoms.
Objective: We examined engagement with the 4-week mHealth component of a counseling-plus-mHealth intervention to reduce sexual and reproductive health (SRH) risk among young people with depression (Momentary Affect Regulation - Safer Sex Intervention [MARSSI]) to determine (1) mHealth engagement patterns over time and (2) how sociodemographic characteristics, SRH risks, and depressive symptom severity were associated with these engagement patterns.
BMJ Open
May 2025
Introduction: Youth electronic cigarette (e-cigarette) use is a global health challenge, with multiple jurisdictions wrestling with appropriate responses, in the face of limited evidence available on effective interventions. Identifying and synthesising evidence on the effects of interventions to prevent youth e-cigarette use is required to inform prevention-focussed health policy and practice.
Methods And Analysis: We plan to undertake an individual participant data (IPD) prospective meta-analysis (PMA).
Background: The Global Resilience Oral Workshops (GROW) Free and Strong programs take a strengths-based, positive youth development (PYD) approach to promoting thriving. Through both prevention (GROW Strong) and intervention (GROW Free) exercises, these programs aim to build character and emotional resilience while also lowering unhealthy alcohol use.
Objective: To meaningfully assess the impact of the GROW programs on health and PYD, ecologically and psychometrically valid measures of character strengths were needed, with a focus on the strengths of hope, forgiveness, spirituality, prudence, and self-control (self-regulation) promoted by GROW.
Introduction: To improve treatment access for emerging adults with cannabis use disorder (CUD), we developed a telehealth counseling-plus-mHealth intervention and remotely conducted a single-arm open pilot study to preliminarily evaluate its feasibility in primary care.
Methods: A multidisciplinary team including youth developed the intervention using the structure of the MOMENT intervention: two weekly counselor-delivered Motivational Enhancement Therapy (MET) sessions, then two weeks of smartphone surveys (4 prompted/day) querying socioemotional contexts and cannabis use, with pre-programmed messages on report of personal triggers for use (Ecological Momentary Intervention; EMI). The team adapted the MET for virtual delivery; created material to enhance self-reflection, plan behavior change, and anticipate withdrawal; shortened the sessions; and tested them with five youth actors.
Cannabis is frequently co-used with tobacco/nicotine products, especially among young adults. Little is known about the effects of this co-use on cannabis cessation outcomes. Within a sample of young adults using cannabis frequently (current use of ≥5 days/week in the past 3 months), this study aimed to (a) document sources of exposure to tobacco/nicotine products, whether used simultaneously with cannabis or on different occasions, (b) examine if the level of cumulated exposure to tobacco/nicotine (self-reported or from biochemical testing) could predict time to cannabis lapse during a cannabis abstinence period, and (c) explore the relationship between nicotine/tobacco exposure and time to cannabis lapse according to tobacco cigarette smoking status.
View Article and Find Full Text PDFJMIR Res Protoc
May 2024
Background: Screening, brief intervention, and referral to treatment for adolescents (SBIRT-A) is widely recommended to promote detection and early intervention for alcohol and other drug (AOD) use in pediatric primary care. Existing SBIRT-A procedures rely almost exclusively on adolescents alone, despite the recognition of caregivers as critical protective factors in adolescent development and AOD use. Moreover, controlled SBIRT-A studies conducted in primary care have yielded inconsistent findings about implementation feasibility and effects on AOD outcomes and overall developmental functioning.
View Article and Find Full Text PDFJMIR Res Protoc
May 2024
[This corrects the article DOI: 10.2196/55039.].
View Article and Find Full Text PDFIntroduction: The expansion of new tobacco consumption formats and electronic vapor products threatens to reverse the trend of declining smoking rates that had been observed among younger people in recent decades. Early detection in the health sector requires screening tools that have been adapted and validated in our context. This study aims to translate, culturally adapt, pilot and empirically validate the Hooked on Nicotine Checklist (HONC) with Spanish adolescents.
View Article and Find Full Text PDFJMIR Res Protoc
March 2024
Background: Alcohol and other substance use disorders usually begin with substance use in adolescence. Pediatric primary care offices, where most adolescents receive health care, are a promising venue for early identification of substance use and for brief intervention to prevent associated problems and the development of substance use disorder.
Objective: This study tests the effects of a computer-facilitated screening and brief intervention (cSBI) system (the CRAFFT [Car, Relax, Alone, Forget, Family/Friends, Trouble] Interactive System [CRAFFT-IS]) on heavy episodic drinking, riding with a driver who is substance impaired, or driving while substance impaired among adolescents aged 14 to 17 years presenting for a well visit at pediatric primary care practices.
Purpose: Mindfulness, awareness resulting from attending to the present without judgment, has been associated with improved health. When considered as a time-varying momentary state, mindfulness is associated with other momentary states such as affect. We examined whether momentary mindfulness, specifically mindful attention and awareness (MAA), changed after counseling interventions to reduce cannabis use that included ecological momentary assessment (EMA) and explored associations with negative affect, positive affect, and cannabis desire.
View Article and Find Full Text PDFObjectives: The HIV epidemic in India is concentrated in key populations such as people who inject drugs (PWID). New HIV infections are high among young PWID (≤30 years of age), who are hard to engage in services. We assessed perspectives of young PWID to guide development of youth-specific services.
View Article and Find Full Text PDFPurpose: Gender minority (GM) adolescents, who have a different gender identity than their sex assigned at birth, may use substances as a coping strategy in response to GM-related stressors. This study examined longitudinal effects of gender minority stressors on substance use in GM adolescents, and related risk factors (internalized transphobia, depressive symptoms, anxious symptoms) and protective factors (resilience, gender-related pride, family functioning, social support, gender-related community connectedness).
Methods: Participants were 30 GM adolescents, ages 13-17 years, from the U.
A high prevalence of adolescent substance use, risky consumption patterns and the decrease in the age of initiation, together with the growth of non-substance addictions, represent a huge challenge for Public Health. This suggests the need for a change of focus in the work of the primary care settings, which must be more proactive in the early detection and intervention. Although there are some previous experiences in Spain, we do not have a duly standardised system, based on clinical practice and validated in consulting rooms, which could be used in a general, simple, and guaranteed manner.
View Article and Find Full Text PDFMindfulness-based interventions (MBIs) are effective in adult substance-use treatment and may be helpful for adolescents and young adults (AYAs). One target of MBIs is to improve trait mindfulness, which has been associated with better lifestyle and health outcomes. To inform MBIs for reducing cannabis use in AYAs, we sought to identify how trait mindfulness was associated with cannabis-related problems and quit attempts, as well as with motivation to change use in youth who report frequent use.
View Article and Find Full Text PDFPurpose: The purpose of this study was to evaluate the sensitivity of a tobacco use screening question, modified to include the word "e-cigarette," in detecting past 12-month nicotine vaping and past 12-month tobacco product use inclusive of nicotine vaping, among adolescent primary care patients.
Methods: We conducted secondary analysis of data from a pilot trial of adolescent substance use screening and brief intervention in pediatric primary care. Participants were patients aged 12-18 years (N = 278) presenting for annual well-visits at five practices in Massachusetts in 2015-2017.
Child Adolesc Psychiatr Clin N Am
October 2020
Measurement-based care in adolescent substance use is an important element of the evidence-based framework of Screening, Brief Intervention, and Referral to Treatment (SBIRT). Use of a validated measure for detecting substance use, misuse, and substance use disorders is significantly more effective than the use of unvalidated tools or clinician intuition. There are now a variety of established and new validated screening tools that are available for use with adolescents and that capture the range of adolescent substance use behaviors.
View Article and Find Full Text PDFBackground: Depressed young women have elevated rates of unintended pregnancy and sexually transmitted infections (STIs). The objective of this study was to develop and pilot-test a counseling-plus-mHealth intervention to reduce sexual and reproductive health (SRH) risk in young women with depressive symptoms.
Methods: Using the Behavior-Determinants-Intervention logic model, we developed the Momentary Affect Regulation-Safer Sex Intervention (MARSSI) to address the challenges that depression imposes on SRH risk reduction efforts of high-risk young women: (I) in-person counseling using motivational interviewing (MI) to elicit motivation for safer sex and develop a behavior change plan, and teaching cognitive-behavioral skills to manage negative thoughts and affective states; (II) 4-week Ecological Momentary Intervention (EMI) on a smartphone to report momentary phenomena related to depression and SRH risk, and receive personalized, tailored messages prompting healthy behaviors and encouraging cognitive-behavioral skill use when risk-related cognitions and negative affect are reported; and (III) booster counseling to review behavior change goals and plans and teach a new cognitive-behavioral skill.
This study performs an outcome-wide analysis to prospectively examine the associations of forgiveness (including forgiveness of others, self-forgiveness and divine forgiveness) with a range of psychosocial, mental, behavioral and physical health outcomes. Data from the Nurses' Health Study II and the Growing Up Today Study (Ns ranged from 5,246 to 6,994, depending on forgiveness type and outcome) with 3 or 6 years of follow-up were analyzed using generalized estimating equations. Bonferroni correction was used to correct for multiple testing.
View Article and Find Full Text PDFImportance: Annual preventive health visits provide an opportunity to screen youths for unhealthy substance use and intervene before serious harm results.
Objectives: To assess the feasibility and acceptability and estimate the efficacy of a primary care computer-facilitated screening and practitioner-delivered brief intervention (CSBI) system compared with usual care (UC) for youth substance use and associated risk of riding with an impaired driver.
Design, Setting, And Participants: An intent-to-treat pilot randomized clinical trial compared CSBI with UC among 965 youths aged 12 to 18 years at 5 pediatric primary care offices and 54 practitioners.
Unlabelled: : media-1vid110.1542/5985300176001PEDS-VA_2018-2303 BACKGROUND: Teen mothers often present with depression, social complexity, and inadequate parenting skills. Many have rapid repeat pregnancy, which increases risk for poor outcomes.
View Article and Find Full Text PDFBackground: Ecological momentary interventions (EMIs) influence behavior in real time, in real life. We evaluated trial feasibility and preliminary efficacy of MOMENT, a counseling-plus-EMI to reduce frequent marijuana use in youth in primary care.
Methods: Primary care patients age 15-24 years using marijuana at least 3 times/week were randomized to MOMENT [motivational enhancement therapy (MET)/smartphone-based momentary assessment/responsive motivational messaging] No-messages (MET/momentary assessment) MET-only.
J Stud Alcohol Drugs
July 2018
Objective: Alcohol- and drug-related car crashes are a leading cause of death for adolescents in the United States. This analysis tested the effects of a computer-facilitated Screening and Brief Advice (cSBA) system for primary care on adolescents' reports of driving after drinking or drug use (driving) and riding with substance-using drivers (riding).
Method: Twelve- to 18-year-old patients (N = 2,096) at nine New England pediatric offices completed assessments only during the initial 18-month treatment-as-usual (TAU) phase.