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Tag: feasibility

A Randomized Controlled Study of Remote Computerized Cognitive, Neurofeedback, and Combined Training in the Treatment of Children with Attention-Deficit/Hyperactivity Disorder

Luo X, Guo X, Zhao Q, Zhu Y, Chen Y, Zhang D, Jiang H, Wang Y, Johnstone S, Sun L. A randomized controlled study of remote computerized cognitive, neurofeedback, and combined training in the treatment of children with attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 2023;32(8):1475-1486. doi:10.1007/s00787-022-01956-1

While medication remains the primary method for improving attention-deficit/hyperactivity disorder (ADHD) symptoms, the development of home-based training tools provides promising support for the future of non-pharmacological care. In this randomized clinical trial three home-based training programs were tested. The first training program was electroencephalogram (EEG) neurofeedback training (NFT) used to adjust brain activity enough to improve attention and daily function. The second training program focused on computerized cognitive training (CCT). In CCT repetitive practice and reinforcement improves specific symptoms for patients. The third training program included training modules from both NFT and CCT programs. Children (84% male, Ages 7-12) were randomly assigned one of these programs NFT (n = 25), CCT (n = 27), or NFT/CCT (n = 28). All training was conducted at home using the Focus Pocus (Neurocognitive Solutions Pty Ltd.) training program. Following baseline assessment training was completed at home for three months (3-5 sessions/week, 14 mini-games/session). Portable Bluetooth devices recorded EEG during each session. In the NFT and NFT/CCT groups the EEG devices provided real-time feedback during high-attention activities. In the CCT program, EEG was recorded but only used to monitor attention levels to accurately provide rewards for high focus. All training programs decreased ADHD symptom severity (measured by AD/HD-RS; p < 0.001). None of the training programs improved symptoms more effectively than the other programs (all p > 0.05). At-home training, regardless of program type, also improved impulsiveness and short-term focus scores (impulsiveness: p = 0.001, short-term focus: p = 0.00). This data provides novel insight into the benefits of home-based NFT and CCT programs.


The Feasibility, Acceptability, and Initial Efficacy of a Remotely Delivered, Financial-Incentive Intervention to Initiate Vaping Abstinence in Young Adults

Raiff BR, Newman ST, Upton CR & Burrows CA. (2022). The feasibility, acceptability, and initial efficacy of a remotely delivered, financial-incentive intervention to initiate vaping abstinence in young adults. Experimental and Clinical Psychopharmacology, 30(5), 632–641.

This study investigated the feasibility, acceptability, and preliminary efficacy of a remotely delivered intervention with financial incentives to promote vaping abstinence among young adults. Participants were recruited via a university email listserv and were between 18-35 years old, reported current vaping, and a desire to quit vaping. Eight participants were enrolled, given home cotinine saliva test kits (NicAlert and iScreen), and asked to abstain from vaping for 14 days. Live video meetings were scheduled every other day and provided the opportunity for participants to share their quitting process and receive support and guidance. All participants earned financial rewards for submission of their cotinine tests and escalating bonus rewards (increasing by $5 for each subsequent negative sample) for each cotinine negative sample at baseline and during the 14-day study. At the end of the study, participants completed exit survey questions on vaping behavior change and acceptability of study procedures. All participants completed 100% of video calls and were abstinent from vaping during the 2-week treatment period. Participants reported high favorability scores for the intervention (9.75-10 out of 10) related to convenience, effectiveness to help quit vaping, and fairness, and would recommend the intervention to someone else. Results also showed that cotinine levels decreased as financial bonuses for negative tests increased. This study provides a promising, acceptable, and safe approach to helping people stop vaping for 2 weeks. Future research should focus on exploring strategies for long-term sustainability of incentive-based interventions for vaping abstinence.


Augmenting project ECHO for opioid use disorder with data‑informed quality improvement

Murray OB, Doyle M, McLeman BM, Marsch LA, Saunders EC, Cox KM, Watts D, Ryder J. Augmenting project ECHO for opioid use disorder with data-informed quality improvement. Addict Sci Clin Pract 18, 24 (2023).

Learning collaboratives can address barriers to medication for opioid use disorder availability by training clinic staff on best-practice performance data collection and quality improvement (QI). Project ECHO is an evidence-based method using teleconferencing to link experts with community-based providers to enhance opioid use disorder (OUD) care. This study examined the feasibility of training of 18 clinics in New Hampshire using an additional component, ECHO-AMPLIFI, to collect and review performance data and develop QI initiatives for best practice of OUD care. Feasibility was assessed descriptively through each clinic’s participation in training sessions, data collection, and QI initiatives. At the end of the project, clinic staff completed surveys on their perspectives of usability and acceptability of the project. Five of the 18 clinics joined the ECHO-AMPLIFI project for 8 months and met the minimum engagement requirements (completed at least one training session, at least one month of performance data, and at least one QI initiative). Results from staff surveys showed the training and data collection was useful. However, there were several problems identified with data collection, including lack of staff time and lack of standardization of documentation in electronic health records. Findings indicate that implementing performance data-informed QI as a supplement to Project ECHO has potential to inform best practices, but challenges to collecting consistent performance data must be addressed. Future assessments could provide further information on the utility of performance data in helping clinics.


Combined Laboratory and Field Test of a Smartphone Breath Alcohol Device and Blood Alcohol Concentration Estimator to Facilitate Moderate Drinking Among Young Adults

Leeman RF, Berey BL, Frohe T, Rowland BHP, Martens MP, Fucito LM, Stellefson M, Nixon SJ, & O’Malley SS. (2022). A combined laboratory and field test of a smartphone breath alcohol device and blood alcohol concentration estimator to facilitate moderate drinking among young adults. Psychology of Addictive Behaviors, 36(6), 710–723.

This paper evaluated feasibility, usability, acceptability, and efficacy of blood alcohol content (BAC) related moderate drinking technology during a laboratory alcohol self-administration session and follow-up field test in real-world situations. Participants were randomly assigned to 1 of 3 technologies to use during a laboratory alcohol drinking session: (1) breathalyzer alcohol device connected to an app, (2) BAC estimator app where participants make entries about drinking behavior, and (3) a self-texting control condition where participants send a text after each alcoholic drink consumed. All participants completed a laboratory alcohol-drinking session while using the assigned technology procedure. After this session, participants were instructed to use all three forms of technologies for two weeks. At the end of the field-testing period, acceptability, usability, and perspectives on all three technologies were The breathalyzer and BAC estimator app both had favorable acceptability and usability ratings. Participants used at least one form of technology on 67% of drinking days. Based on self-reported data, as also significantly lower during the field-test period than at baseline. Overall, combining lab and field methods to test drinking technologies was feasible among young adults. Results support the potential of mobile interventions to help young adults in motivating behavior change given their willingness to use apps.


Implementation fidelity of the Promoting First Relationships intervention program in a Native community

Booth-LaForce C, Oxford ML, O’Leary R, Rees J, Petras A, Buchwald DS. Implementation fidelity of the Promoting First Relationships intervention program in a Native community. Transl Behav Med. 2023 Jan 20;13(1):34-41. doi: 10.1093/tbm/ibac060. PMID: 36227860; PMCID: PMC9853091.

An evidence-based parenting intervention called Promoting First Relationship (PFR) was evaluated for implementation fidelity in a Northern Plains Native community. PFR is a preventive program for primary caregivers and their young children based on attachment theory. Ten sessions are delivered weekly for an hour through home visits conducted by trained providers who are tribal members living on the reservation with at least a relevant bachelor’s degree. Each week has a specific theme and includes a check-in, reflection time, observation of video recordings, and handouts on the child’s behaviors, feelings, and needs. This study analyzed data from a randomized controlled trial of 162 primary caregivers and their children (10-30 months old) who were assigned to the PFR intervention or the control condition (referral to local resources). PFR providers were trained in a two-day in-person workshop and then, online intensive training and pilot sessions. All trainees were required to pass fidelity checks with three families to be certified. Researchers measured implementation fidelity using a checklist on adherence to content, scoring quality of delivery in video-recorded sessions, number of PFR sessions completed, and participant satisfaction. On average, adherence to PFR content was very high (mean=0.99 out of 1.00; SD=0.02) and quality of delivery exceeded established criteria. Despite high attrition which occurred before intervention delivery (28.40%, N=23), the remaining participants completed all 10 intervention sessions. Additionally, participants reported high satisfaction with the program (mean=3.90 out of 4, SD=0.19). Overall, high implementation fidelity of the PFR intervention was achieved in a Native community using in-person and remote online training and video feedback.


A WeChat-based smoking cessation intervention for Chinese smokers: a feasibility study

Luo T, Li MS, Williams D, Fritz J, Beiter K, Phillippi S, Yu Q, Kantrow S, Chen L, Chen Y, & Tseng TS. (2022). A WeChat-based smoking cessation intervention for Chinese smokers: a feasibility study. Translational Behavioral Medicine, 12(10), 1018–1027.

This paper reported the development and feasibility findings of a WeChat-based smoking cessation intervention for smokers in China. A total of 403 participants who currently smoked and used WeChat, the most widely used social media platform in China, were recruited and randomized to three study arms: Standard Intervention (N=136), Enhanced Intervention (N=135), and waitlist control (N=132). The Standard intervention consisted of 20 smoking cessation messages for 2 weeks and the Enhanced intervention included 20 smoking cessation messages for 2 weeks and 6 oral health-related messages for another week. Intervention content was informed by the Transtheoretical Model framework and targeted self-efficacy, stimulus control, coping skills, consciousness raising, and oral health. Researchers assessed feasibility by measuring program reach, recruitment rate, cost per person, attrition rate, intervention exposure, engagement, and satisfaction. Attrition from baseline to 4-week follow-up was 46% and program cost was estimated as $0.85 per person. In the Standard and Enhanced intervention arms, all participants read at least one message and on average engaged (sent a Like or comment) with 57% of the messages. A majority of participants were very or somewhat satisfied with the intervention (96%), engaged (72%) and would recommend to others (95%). Overall, findings support feasibility of both the Standard and Enhanced intervention. Given the feasibility and low cost of the WeChat-based program, this has the potential to be scaled up for larger population sizes to deliver smoking cessation treatment at low costs.


Feasibility and acceptability of using smartphone-based EMA to assess patterns of prescription opioid and medical cannabis use among individuals with chronic pain

Anderson Goodell EM, Nordeck C, Finan PH, Vandrey R, Dunn KE, & Thrul J. (2021). Feasibility and acceptability of using smartphone-based EMA to assess patterns of prescription opioid and medical cannabis use among individuals with chronic pain. Internet Interventions: the Application of Information Technology in Mental and Behavioural Health, 26, 100460–100460.

This paper described the feasibility and acceptability of a smartphone-based Ecological Momentary Assessment (EMA) data collection tool among people who use multiple substances and suffer from chronic pain. Forty-six participants were recruited through targeted Facebook and Instagram advertisements and completed screening via the link in the ads. Eligible participants had an opioid medication prescription, current opioid use, a pain disorder, and a referral for medical cannabis. Participants completed prompted EMA surveys on a mobile app for 30 days. Surveys included questions about opioid medication use, medical cannabis use, and pain symptoms. Participants were prompted to respond to four randomly timed surveys (assessing the past hour) and one daily diary per day. A subsample of 10 participants completed qualitative interviews. On average, participants responded to 70% of past-hour surveys and 92% of daily diaries. During qualitative interviews, participants reported an overall positive experience, but identified some issues related to smartphone notifications, redundant questions, or being prompted to complete assessments when they do not feel well. Findings demonstrate the feasibility and general acceptability of using this methodology for examining patterns of medical cannabis and prescription opioid medication use among individuals with chronic pain. Engagement with the digital tool over the 30-day duration was comparable to previous work. This study has implications for informing larger-scale epidemiology studies, interventions, and assessments on a wider geographic scale.


Mobile App–Based Self-Report Questionnaires for the Assessment and Monitoring of Bipolar Disorder: Systematic Review

Chan E, Sun Y, Aitchison K, Sivapalan S. Mobile App–Based Self-Report Questionnaires for the Assessment and Monitoring of Bipolar Disorder: Systematic Review. JMIR Form Res 2021;5(1):e13770 DOI: 10.2196/13770

to determine the state of evidence for feasibility and validity of mobile app-based self-report questionnaires as tools for monitoring of bipolar symptoms. All papers published in English that assessed adherence to and validity of mobile app-based self-report surveys for monitoring patients with bipolar disorder were included. A total of 13 articles were identified. Four studies assessed the concurrent validity of mobile self-report tools and all 4 found a statistically significant association between mood ratings collected via mobile app self-report and clinical assessment using the Hamilton Depression Rating Scale or Montgomery-Asberg Depression Rating Scale. . Two studies observed statistically significant associations between data collected via mobile app self-report tools and instruments assessing clinically- related factors. Satisfactory adherence rates (at least 70%) were observed in all but 1 study that used a once-daily assessment. There was a wide range of adherence rates in studies using twice-daily assessments (42-95%). Overall, the review demonstrated that mobile app-based self-report instruments are valid relative to established assessment methods for measuring symptoms of mania and depression in patients with bipolar disorder. Future research is needed to evaluate feasibility of mobile self-report methods for identifying acute episodes and to inform insights into differences between patients with bipolar disorder and those without lived experience of this condition.


A gamified app for supporting undergraduate students’ mental health: A feasibility and usability study

Nicolaidou I, Aristeidis L, Lambrinos L. A gamified app for supporting undergraduate students’ mental health: A feasibility and usability study. Digit Health. 2022;8:20552076221109059. Published 2022 Jun 21. doi:10.1177/20552076221109059

This study aimed to address the mental health impact of the COVID-19 pandemic on undergraduate students by designing and testing feasibility, acceptability, and usability of Student Stress Resilience, a gamified mobile app that provides personalized data and focuses on enhancing students’ resilience. The app design is based on a theory of nine behavioral change techniques: action planning, feedback on outcomes, self-monitoring of behavior, social support, social comparison, prompts/cues, achievements, and incentives. The app includes a daily goal setting component for studying, exercising, or socializing. The app also tracks progress by using data from the smartphone accelerometer and sound sensor and from self-reported anxiety measurements and reflection on performance. App users receive points and badges for completing challenges. Social interaction is facilitated by allowing users to share their progress with others and the inclusion of a leaderboard. Adult undergraduate students (N=74) evaluated the prototype for Student Stress Resilience and completed an online survey on feasibility for supporting resilience and usability. Overall, participants gave positive feedback (3.76 out of 5 rating, on average) on all app functions for improving psychological resilience. Usability was satisfactory and 93% said they would be interested in continuing to use the app once it is fully developed. Student Stress Resilience is a promising mobile app to support mental health for the general student non-clinical population. Following the development of a fully functioning app, future research should evaluate Student Stress Resilience in a randomized controlled trial.