Lydia A Shrier1,2, Pamela J Burke1,3, Meredith Kells1, Emily A Scherer1,2,4, Vishnudas Sarda1, Cassandra Jonestrask1, Ziming Xuan5, Sion Kim Harris1,2. 1. Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA. 2. Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA. 3. School of Nursing, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA. 4. Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, NH, USA. 5. Department of Community Health Sciences, Boston University School of Public Health, Boston, USA.
Abstract
BACKGROUND: 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] vs. No-messages (MET/momentary assessment) vs. MET-only. In MOMENT, two MET sessions were followed by 2 weeks of momentary assessment of marijuana use and factors related to use, with motivational messaging displayed after report of marijuana triggers, desire, use, and effort to avoid use. We evaluated study feasibility (recruitment, retention, and response rates; feedback survey responses) and explored intervention effects on marijuana desire and use at three months with linear mixed effects modeling. RESULTS: Seventy youth [mean (M) =20.7 years, 60% female] were assigned to MOMENT (n=27), No-messages (n=15; assignment suspended to enrich other arms), or MET-only (n=28). Most attrition occurred during baseline, before MET. Of those completing MET session 1, 82% completed their assigned treatment and 79% provided 3-month data. Participants highly rated acceptability; comments reflected changing motivation and behavior. Across arms, participants reported significantly lower marijuana use, desire, and problems at follow-up vs. baseline. Momentary marijuana desire declined more in MOMENT vs. MET-only. Marijuana use following a targeted context or behavior was less likely in MOMENT and No-messages, vs. MET-only. CONCLUSIONS: The MOMENT intervention is feasible to deliver, acceptable, and potentially efficacious in reducing marijuana desire and use among adolescent and young adults in primary care. A larger randomized trial to evaluate efficacy is warranted.
BACKGROUND: 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] vs. No-messages (MET/momentary assessment) vs. MET-only. In MOMENT, two MET sessions were followed by 2 weeks of momentary assessment of marijuana use and factors related to use, with motivational messaging displayed after report of marijuana triggers, desire, use, and effort to avoid use. We evaluated study feasibility (recruitment, retention, and response rates; feedback survey responses) and explored intervention effects on marijuana desire and use at three months with linear mixed effects modeling. RESULTS: Seventy youth [mean (M) =20.7 years, 60% female] were assigned to MOMENT (n=27), No-messages (n=15; assignment suspended to enrich other arms), or MET-only (n=28). Most attrition occurred during baseline, before MET. Of those completing MET session 1, 82% completed their assigned treatment and 79% provided 3-month data. Participants highly rated acceptability; comments reflected changing motivation and behavior. Across arms, participants reported significantly lower marijuana use, desire, and problems at follow-up vs. baseline. Momentary marijuana desire declined more in MOMENT vs. MET-only. Marijuana use following a targeted context or behavior was less likely in MOMENT and No-messages, vs. MET-only. CONCLUSIONS: The MOMENT intervention is feasible to deliver, acceptable, and potentially efficacious in reducing marijuana desire and use among adolescent and young adults in primary care. A larger randomized trial to evaluate efficacy is warranted.
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