Cutting Edge Literature: Stay Up to Date with Evidence for Technology-Based Approaches

The Eye on Innovation section of the CTBH website contains a compilation of references and synopses of current empirical literature related to technology-based behavioral health care approaches.

The compendium is updated biweekly by our research staff and contains up-to-date literature related to emerging technologies and state-of-the-science care approaches to mental health and substance use issues.  Synopses are tagged for easy filtering by particular topics or technologies.  You can access the Cutting Edge Literature collection here.

CTBH Research Spotlight: Web-based Prescription Opioid Abuse Prevention for Adolescents

Under the leadership of CTBH Director Dr. Marsch, CTBH is partnering on a new NIDA-funded project to develop and evaluate a mobile-friendly, web-based program designed to prevent abuse of prescription opioids among adolescents.

Recreational use of prescription opioids among adolescents is a significant and growing public health concern and has been referred to as an emerging epidemic in the U.S. Although a number of science-based, interactive, drug-abuse prevention programs focus on preventing use of non-prescription drugs among youth, to our knowledge, no science-based, interactive program focused on the prevention of prescription opioid abuse among youth exists. Given that adolescents' views about the recreational use of prescription opioids differ in systematic ways from use of illegal, non-prescription drugs, developing an effective prevention program for youth targeted specifically at prescription opioid abuse is critical.

In this project, we are developing an interactive, web-based program for youth ages 11-14 focused on the prevention of prescription opioid abuse. This program will be grounded in a scientific understanding of risk factors for prescription opioid abuse among youth, employ informational technologies which are effective in promoting relevant knowledge and skills, and present program content using strategies which have been shown to be highly appealing to adolescents. Once development is completed, we will conduct a randomized, controlled trial with youth (ages 11-14 years) to evaluate the effectiveness of the web-based prevention intervention in increasing knowledge about key issues relevant to prescription opioid abuse among youth, skills acquisition relevant to preventing their misuse, negative attitudes about prescription opioid misuse, and perceived risk associated with their misuse. We will also assess the program’s effectiveness in reducing intentions to misuse prescription opioids as well as actual rates of such use. If effective, this scalable prevention program could enable widespread reach to youth in tackling the urgent public health issues of opioid misuse among adolescents.

CTBH Research Spotlight: Integrating Evidence-Based Behavioral Health Technologies into Primary Care

Funded by the Community Engagement Core of Dartmouth’s SYNERGY Program (Dartmouth’s NIH-funded Clinical Translational Science Award), Lisa Marsch, PhD, Sarah Lord, PhD, and Robert Drake, MD, PhD lead a CTBH team on this innovative project engaging community and academic partners in understanding needs and priorities among rural community health care systems around shifting health care systems – with a particular focus on integrating behavioral health and medical care in rural settings.

Behavioral health problems (addictions and mental health disorders, such as depression) are highly prevalent, especially in poor and disenfranchised populations. The great majority of these people (over 90%) receive no treatment. Behavioral health problems also complicate diagnosis, treatment, and outcomes for many chronic conditions, such as diabetes, obesity, heart failure, and cancer.  A sufficient workforce to address these problems does not exist - especially in rural communities.

Incorporating new health technologies could be a cost-effective solution. New technology tools could be used in primary care to improve access, self-care, and outcomes, and to reduce costs and health disparities. Yet, successful implementation and sustainability of any new intervention process, including a technology-based care approach, is strengthened by attention to pre-implementation readiness of the primary care community agencies and constituent stakeholders to adopt a technology treatment innovation in their system of care. 

This two-year, 2-phased project includes mixed-methods formative research in year 1 to assess community priorities and readiness for technology-based behavioral health tools in primary care settings, followed by a demonstration implementation project of a technology-based behavioral health intervention within rural primary care settings in year 2. This work will inform strategies for optimizing implementation outcomes when embedding technology-based behavioral health tools in rural primary care settings, supported by appropriate training/technical assistance.    

CTBH Research Spotlight: Increasing HIV Testing in Urban Emergency Departments using Mobile Technology

CTBH affiliate Ian David Aronson, PhD has received a grant from the National Institute on Drug Abuse to develop a mobile video-based intervention to increase HIV testing among patients in a high volume urban emergency department (ED) who initially decline HIV tests offered by hospital staff. The three-year study will randomize patients into four groups, which will each see a different onscreen presentation about the importance of HIV testing. Pre-post intervention data collection instruments will measure the effectiveness of each presentation in terms of HIV test rates, change in self-efficacy to test for HIV and deal with the results, and changes in HIV-related knowledge.

Because people with undiagnosed HIV will not receive treatment and may unknowingly infect others, the CDC recommends routine HIV testing in healthcare settings, including EDs. Unfortunately, those most at risk frequently decline HIV tests offered by triage staff, and in the New York ED where data will be collected for the current study, far more patients decline tests compared to those who accept.

This new study builds upon findings from a 2012 NIDA-funded trial, in which approximately one third of ED patients who initially declined HIV testing agreed to an HIV test after completing a similar computer-based intervention. The current study also builds upon findings from Dr. Aronson’s CTBH-funded pilot to integrate a qualitative protocol into the 2012 trial to understand why patients did or did not test after watching a video, how the intervention could be improved, and why they initially declined a test upon arrival in the ED. Based on the combined findings of both studies, the current project will develop a new set of videos, a new set of measures, and a new technology-based intervention. Resulting data may provide valuable new information about optimal strategies to leverage mobile technology to promote HIV testing behavior.

CTBH Presents Keynotes at SAMHSA Regional Summits and ATTC National Summit on Health Information Technology and Recovery

CTBH leadership gave the Keynote Addresses at a series of three regional summits organized by The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) to promote the use of health information technology in recovery.

The SAMHSA summits, organized as part of the Bringing Recover Supports to Scale Technical Assistance Center Strategy (BRSS TACS), brought together developers of technology-based approaches with providers and recovery specialists for a two-day meeting to explore how different technologies are being used to deliver evidence-base care across the care continuum, discuss the challenges and opportunities of technology based approaches, and dialogue together about how to promote use of technology to support person-centered, recovery-oriented care delivery. The summits included demonstrations of an array of technology-based recovery products, including video and teleconferencing platforms, social media support groups, decision support systems, and mobile recovery support tools. Workshops focused on issues related to privacy and ethics with the use of technologies, advancing the reach of peer workforces through health information technology, the role of social media in recovery, and strategies for facilitating implementation of technology-based care approaches.

Sarah Lord, CTBH Director of Dissemination and Implementation, presented the Keynote at the first summit, held in Atlanta, GA. Aimee Campbell, Ph.D., of New York State Psychiatric Institute presented the Keynote at the summit in Reno, NV, and CTBH Director Lisa Marsch closed the series by delivering the Keynote at the final summit in Kansas City, MO.

CTBH additionally led a similar Keynote Address for the National Frontier and Rural (NFAR) Addiction Technology Transfer Center Network (ATTC) for their annual Addiction Treatment Technology Summit in Chicago, IL. A downloadable video of this presentation is available at the ATTC Network’s website.