Social Media Antismoking Intervention: Delivery, Tracking, and Engagement Systems on a Smartphone-Accessed Facebook Group

Funding Source: National Institute on Drug Abuse – Center for Technology and Behavioral Health Pilot Core

Project Period: October 2014 – September 2015

Principal Investigator: Sunny J. Kim, PhD

Other Project Staff: Lisa A. Marsch, PhD; Jesse Dallery, PhD; Jeffrey T. Hancock, PhD; Haiyi Xie, PhD; Benjamin S. Crosier, PhD


Project Summary:

Tobacco use is the primary cause of premature death in the U.S., responsible for more than 443,000 preventable deaths per year.  A total of approximately 8.4 billion dollars was spent in 2011 for marketing cigarettes, which was far greater than the $175 million that the Centers for Disease Control and Prevention and the states have invested in tobacco prevention and control programs. Media-based antismoking communication approaches are considered to be the most effective intervention strategy in countering this aggressive cigarette marketing while promoting quitting and preventing cigarette-smoking.


Social media, such as Facebook, provide promising interfaces that can substantially enhance the delivery system of targeted messages with high frequency, reach, and duration - which are three key factors for successful health campaigns. Facebook features, such as Facebook Groups, provide multi-directional, non-linear communication platforms connecting geographically distant audiences, and enhance users’ engagement with shared messages and interactions with other users. 


This study is designed to promote effective delivery, tracking, and engagement/interaction systems via a smartphone-accessed Facebook Group in order to facilitate antismoking attitudes and smoking reduction/cessation behavior. We will adopt existing antismoking ads and campaigns, and utilize the smartphone-accessed Facebook Group as a communication platform to deliver antismoking content. This pilot study has the following specific aims. First, we aim to evaluate the feasibility of delivering antismoking content via our smartphone-accessed Facebook Group as well as acceptability/usability of our antismoking intervention. Second, we aim to evaluate the feasibility of fostering engagement and interaction on the smartphone-accessed Facebook Group that can lead to positive intervention outcomes (e.g., antismoking attitudes and smoking reduction).


The project seeks to advance new knowledge about how the technology features afforded by social media can promote antismoking attitudes and behaviors through active engagement with the intervention and via interaction among group users.

Computer-based Prescription Opioid Abuse Prevention for Adolescents

Funding Source: National Institute on Drug Abuse

Funding Period: 2014 - 2016

Principal Investigator: Lisa A. Marsch, PhD 

Other Project Staff: Sarah K. Moore, PhD (Project Co-Investigator; Site Principal Investigator, Capital Health Medical Center), Sarah Lord, PhD (Project Co-Investigator), Michael Grabinski (Lead Developer)

Project Summary: 
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.   In our completed Phase 1 of this project, we developed and demonstrated the scientific, technical and commercial merit and feasibility of a prototype of a web-based, prescription opioid abuse prevention program for youth.  Phase I results demonstrated the high acceptability and potential utility of the prototype of this program to the target audience.   Participants’ rated the program very positively, and their knowledge related to prescription opioid abuse prevention markedly increased from low baseline levels to perfect or near perfect levels after completing the program prototype.   In this Phase 2 project, we will complete the development of all components of the multimedia, prescription opioid abuse prevention program and 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.  

This program will be developed as a mobile-friendly website which can be accessed via a variety of platforms online (e.g., desktop interface, mobile device) to enable flexible use in a variety of settings.  If this tool is shown to be effective in this project, we plan to embed it in a suite of science-based, technology-delivered tools focused on the prevention and treatment of substance use disorders that have been developed and deployed in a wide array of settings by our group. 

Public Health Significance: 
This program may provide an innovative, engaging, effective and potentially cost-effective tool for promoting the widespread delivery of science-based prevention of prescription opioid abuse among adolescents. 

Breathe Free: Smartphone Videogame-based Incentives for Smoking Cessation

Funding Source: National Institute on Drug Abuse (Small Business Innovation Research); R44DA036252

Project Period: 2014-2016

Principal Investigators: Bethany Raiff, PhD; Multi-PI Darion Rapoza, PhD

Other Project Staff: Nicholas Fortungno (Playmatics, Inc); Madeline Carrig (Duke University); Daniel Scherlis (Entertainment Science)

Project Summary:
Cigarette smoking remains the number one cause of preventable morbidity and mortality in the U.S. Each year, one third to one half of smokers attempt to quit at least once; however, approximately 94% of quit attempts fail. A number of interventions have been developed to help smokers initiate and maintain abstinence. Unfortunately, even though most smokers express a desire to quit, relapse is the most likely outcome. Thus, it is not only critically important that more effective interventions be developed to reduce relapse, but it isalso a primary public health goal to ensure that evidence-based smoking cessation interventions be made widely available, and at a low cost, to smokers. One of the most powerful, evidence-based behavioral interventions for smoking cessation is contingency management (CM). CM for smoking cessation consists of delivering incentives (typically money) contingent on objectiveevidence of smoking abstinence (e.g., carbon monoxide [CO] levels in the exhaled breath). However, the cost of providing incentives, the time it takes to administer the program, and the distance that must be traveled to participate in supervised monitoring procedures are often cited as barriers to CM. This SBIR Fast-Track project seeks to develop a mobile videogame-basedcontingency management intervention for smoking cessation. The goals of the present project are to markedly decrease costs, improve sustainability, and further increase accessibility of CM interventions for smoking cessation. To increase access, all aspects of the intervention will be available via Android or iOS smartphones used in conjunction with a matchbox-sized peripheral device for monitoring breath CO. To decrease costs and improve sustainability, themobile game we will develop will allow us to replace the monetary incentives typically used in CM interventions with in-game "virtual rewards" that can immediately be used to help players meet game objectives, as well as with social reinforcement, prompted and incentivized in the context of the game. In Phase I, an iterative design and formative evaluation process will be used to create a game design and storyboard for the mobile game to be developed in Phase II, the CO data collection software will be produced and integrated with the CO Monitor, and a demo of the videogame will be developed. The demo created will be presented to 20 treatment-seeking smokers owning the targetplatform devices, who will then complete a survey & prospective evaluation of the planned intervention. In Phase II the development of the videogame, capable of supporting 7 weeks of play, will be completed, and a 7 week randomized control trial outcome evaluation will be conducted with 114 subjects to assess the feasibility, acceptability, appeal, and efficacy of the smoking cessation intervention.

Public Health Relevance: 
We plan to develop and evaluate a mobile videogame-based smoking cessation intervention that will overcome barriers to treatment using such as cost, sustainability, participation time and travel burdens, and program appeal. This videogame will be the first of its kind, is based on an evidence-based intervention shown to promote smoking abstinence, and we anticipate it will be highly effective for helping smokers who wish to quitstop smoking. The findings from this research will be of great public health significance because of the unprecedented reach and relatively low cost, aswell as the potential for similar interventions to be developed for other health problems, such as alcohol or drug abuse and medication adherence forchronic illnesses.

WorkingWell: Developing a Mobile Employment Support Tool  for Individuals with Psychiatric Disabilities

Funding Source: National Institute on Disability and Rehabilitation Research (H133G140089)

Project Period: 2014 - 2017

Principal Investigator: Joanne Nicholson, Ph.D.

Other Project Staff: Sarah E. Lord, Ph.D. (Co-Investigator), Justin Tauscher, M.S., LADC, LCMHC

Project Summary: 

In this intervention development project we examine the feasibility and acceptability of WorkingWell, an innovative mobile employment support tool for individuals with severe psychiatric disabilities, who constitute a large and underserved population in need of vocational rehabilitation services. WorkingWell will be based on the Individual Placement and Support (IPS) model of supported employment. Despite strong evidence that IPS successfully connects individuals to competitive employment, studies suggest that individuals may benefit from additional follow-up support to sustain employment. Mobile communication devices and cloud computing may be the most effective, least expensive, and most non-stigmatizing way to provide follow-up support to the broadest group of individuals in the work place.

WorkingWell will target three key autonomy-supportive constructs derived from Self-Determination Theory and previous research to help people succeed in employment: engage (identifying personal motivation to work), manage (setting goals, assessing progress, and building self-efficacy), and connect (linking to social supports). The specific aims of the WorkingWell project include: (1) to develop the information architecture, functionality, technical specifications and general design for the WorkingWell prototype via iterative, user-centered design including focus groups of users and employment specialists, and expert review; (2) to develop the fully functional WorkingWell prototype using state-of-the-art processes informed by iterative, formative testing of the usability, accessibility and acceptability of prototype components; and (3) to test the acceptance and feasibility of WorkingWell through (a) a 6-month pretest-posttest demonstration field test with individuals receiving IPS, (b) usage metrics, and (b) post-implementation feedback interviews with a purposive sample of users and employment specialists. We hypothesize that use of the WorkingWell tool, by focusing on engaging, managing, and connecting in the workplace, will contribute to positive changes in motivation, self-efficacy, and social support, and will enhance job tenure.

WorkingWell will offer users an innovative, easy-to-access, self-directed and individualized employment support tool available where and when the user needs it, for as long as he or she needs it. Our goal is to create a validated application that can be easily installed onto a mobile phone, facilitating wide-scale and far-reaching dissemination of IPS and follow-up support for the target population of individuals with severe psychiatric disabilities.

Jacob Borodovsky, BA

PhD Student, Dartmouth Psychiatric Research Center

Buprenorphine; Opioid, Behavioral Health Technology; Co-Occurring Disorders

borodovsky smallJacob Borodovsky is currently a Health Policy and Clinical Practice PhD student at The Dartmouth Institute in the Geisel School of Medicine. He graduated from Tufts University with a B.A. in Clinical Psychology. Before coming to the Center for Technology and Behavioral Health he worked as a research coordinator for WestBridge Community Services and Cambridge Health Alliance in Boston. Jacob’s research is focused primarily on exploring the role that technological interventions can play in enhancing behavioral health and the treatment of Co-Occurring disorders. Jacob is particularly interested in developing technologically based models of buprenorphine treatment that may help increase rates of medication adherence and reduce diversion. He is currently conducting this research under the supervision of Dr. Lisa Marsch and Dr. Alan Budney. In his spare time he enjoys rock climbing.

Selected Publications:

Schuman-Olivier, Z., Weiss, R. D., Hoeppner, B. B., Borodovsky, J., & Albanese, M. J. (2014). Emerging adult age status predicts poor buprenorphine treatment retention. Journal of Substance Abuse Treatment, 47(3), 202-212. doi: 10.1016/j.jsat.2014.04.006

Schuman-Olivier, Z., Hoeppner, B. B., Weiss, R. D., Borodovsky, J., Shaffer, H. J., & Albanese, M. J. (2013). Benzodiazepine use during buprenorphine treatment for opioid dependence: Clinical and safety outcomes. Drug Alcohol Depend, 132(3), 580-586.

Schuman-Olivier, Z., Connery, H., Griffin, M. L., Wyatt, S. A., Wartenberg, A. A., Borodovsky, J., . . . Weiss, R. D. (2013). Clinician beliefs and attitudes about buprenorphine/naloxone diversion. Am J Addict, 22(6), 574-580.