title: Real-time, contextual intervention using mobile technology to reduce marijuana use among youth: a pilot study.
abstract: We evaluated the feasibility, acceptability, and potential efficacy of MOMENT, an intervention to reduce youth marijuana use that combines brief motivational enhancement therapy with mobile self-monitoring and responsive messaging. At baseline, primary care patients ages 15-24 who used marijuana frequently (at least 3 times per week) completed a recall assessment, then 1 week of mobile momentary and daily reports on use-related factors. For the intervention, youth participated in two motivational enhancement therapy sessions, during which they identified their top-3 social and emotional triggers for use and discussed healthy ways to manage them. They then completed two weeks of mobile reports. Upon reporting a top-3 trigger for use, desire to use, or recent use, they received a message supporting self-efficacy and prompting consideration of coping strategies. Generalized estimating equations examined changes in momentary-, daily-, and individual-level measures on 3-month recall and mobile assessments. Twenty-seven youth (M=19.2 years, 70% female) enrolled; there were 377-677 momentary and 50-106 daily reports per study phase. Participants reported reading the messages and finding them motivating, being comfortable with participation, and not experiencing the study as burdensome. Although proportion of momentary reports of being in a top-3 trigger context did not change (36%-43%), marijuana desire in a top-3 trigger context and marijuana use after top-3 trigger exposure decreased over the study (p<.0001 and p=.03, respectively). Daily- and individual-level measures showed similar, non-significant, improvements. The MOMENT intervention appears feasible, well-accepted, and potentially efficacious for youth who use marijuana frequently.
authors.affiliation: Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA. Electronic address: lydia.shrier@childrens.harvard.edu.
authors.forename: Lydia A
authors.initials: LA
authors.lastname: Shrier
authors.forename: Amanda
authors.initials: A
authors.lastname: Rhoads
authors.forename: Pamela
authors.initials: P
authors.lastname: Burke
authors.forename: Courtney
authors.initials: C
authors.lastname: Walls
authors.forename: Emily A
authors.initials: EA
authors.lastname: Blood
mesh_terms: D000293:Adolescent; D040421:Cell Phone; D034201:Computers, Handheld; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000517:prevention & control*; D009042:Motivation; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D011614:Psychotherapy, Brief / Q000379:methods*; D020377:Self Efficacy; D060145:Text Messaging; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Intervention; Marijuana; Mobile; Momentary; Youth