Feasibility of a Mobile Phone App to Support Recovery From Addiction in China: Secondary Analysis of a Pilot Study

Abstract

BackgroundMobile health technologies have been found to improve the self-management of chronic diseases. However, there is limited research regarding their feasibility in supporting recovery from substance use disorders (SUDs) in China.ObjectiveThe objective of this study was to examine the feasibility of a mobile phone-based ecological momentary assessment (EMA) app by testing the concordance of drug use assessed by the EMA, urine testing, and a life experience timeline (LET) assessment.MethodsA total of 75 participants dependent on heroin or amphetamine-type stimulant (ATS) in Shanghai were recruited to participate in a 4-week pilot study. Of the participants, 50 (67% [50/75]) were randomly assigned to the experimental group and 25 (33% [25/75]) were assigned to the control group. The experimental group used mobile health (mHealth) based EMA technology to assess their daily drug use in natural environments and received 2 short health messages each day, whereas the control group only received 2 short health messages each day from the app. Urine tests and LET assessments were conducted each week and a post-intervention survey was administered to both groups. The correlations among the EMA, the LET assessment, and the urine test were investigated.ResultsThe mean age of the participants was 41.6 (SD 8.0) years, and 71% (53/75) were male. During the 4 weeks of observation, 690 daily EMA survey data were recorded, with a response rate of 49.29% (690/1400). With respect to drug use, the percent of agreement between the EMA and the LET was 66.7%, 79.2%, 72.4%, and 85.8%, respectively, for each of the 4 weeks, whereas the percent of agreement between the EMA and the urine test was 51.2%, 65.1%, 61.9%, and 71.5%, respectively. The post-intervention survey indicated that 46% (32/70) of the participants preferred face-to-face interviews rather than the mHealth app.ConclusionsThis study demonstrated poor agreement between the EMA data and the LET and found that the acceptance of mHealth among individuals with SUDs in China was not positive. Hence, greater efforts are needed to improve the feasibility of mHealth in China.

Current reporting of usability and impact of mHealth interventions for substance use disorder: A systematic review

“…The remaining nineteen articles consisted of nine feasibility articles, seven non-randomized trials, two qualitative articles, and one mixed methods study. The majority of included articles were academic/clinically based, while two were industry based (Attwood et al, 2017;Glass et al, 2017) and four were other or not specified (Dulin and Gonzalez, 2017;Gonzales et al, 2014;Gonzales et al, 2016;Han et al, 2018). The SUDs represented were alcohol (N =20), cannabis (N=3), opioids (N =2), and general or polysubstance use (N =7).…”

“…Half of the articles specified participant education on the study app/device as part of their protocol (Aharonovich et al, 2017;Barnett et al, 2017;Beckham et al, 2018;Glass et al, 2017;Gonzalez and Dulin, 2015;Guarino et al, 2016;Gustafson et al, 2014;Han et al, 2018;Leonard et al, 2017;Muench et al, 2017;Muroff et al, 2017;Shrier et al, 2018;Suffoletto et al, 2016;Witkiewitz et al, 2014;Wright et al, 2018;You et al, 2017). This typically consisted of a tutorial and training of how the technology worked, with a focus on aspects that were needed for the study.…”

Digital mental health in China: a systematic review

“…One focus group study (Schulte et al, 2016 ) reported that receiving support via the app helped people avoid feeling ashamed of sharing personal information with others compared to attending services in-person. However, another study indicated limited acceptance; 46% of participants preferred in-person services instead of using the app (Han et al, 2018 ). In summary, the feasibility of app-based interventions for perinatal depression was limited, and contradictory results were found for smartphone app-based programmes for SUD; some participants felt the app was acceptable, while others preferred in-person services.…”

PSIXPORT: Mobile App for Ecological Momentary Assessment of Psychological Dimensions in Sport Injury

“…For instance, Mulvaney et al ( 2012 ), assessing diabetes adherence patterns in adolescents, got 59% EMA's response rate for a 10-day calling period, and Könen et al ( 2015 , 2016 ) assessing sleeping behaviors consequences on childhood, founded similar surveys' compliance ratios depending on the daytime where surveys were prompt, ranging from 57% (afternoon) to 66% (morning). Han et al ( 2018 ) reported a 49.29% response rate for the mHealth app designed to gather information about drug use through daily assessments during a 4-week assessment period. Therefore, we can consider Psixport's user engagement in line with what similar apps have obtained in previous studies.…”