Alexander K, Scialanca M. The Development of a Patient-Centered Digital Health Care Technology for Young Adults in Opioid Use Disorder Treatment: Qualitative Study. JMIR Form Res. 2025;9:e67401. doi:10.2196/67401
This pilot proof-of-concept study examined the development and initial use of AWARE (Awareness and Response to the Environment), a patient-centered digital health technology designed to help address treatment dropout risk factors among young adults receiving treatment for opioid use disorder (OUD). A convenience sample of 8 participants was recruited from an opioid treatment program: 3 young adult patient-counselor dyads and 2 clinic leaders. Participants were interviewed about barriers to treatment and what elements of daily self-monitoring could identify stressors to support discussions between young adults and their treatment counselors, as well as the potential utility of AWARE. The three patient-counselor dyads then piloted AWARE for 28 days and responded to daily surveys about the technology’s usefulness. Overall survey completion was 53%, and 2 participants completed the study. All 3 counselors received weekly summaries of the reported stressors. Young adults most frequently reported stress related to family-related obligations (10 responses), having to do things without help (9 responses), and being organized (9 responses). Stressors involving the health of a family member, physical care, and medical abilities each received 8 responses. Treatment center staff reported similar perspectives on stressors and barriers to treatment engagement and linked difficulties staying away from drug use to participants’ living and social environments. Staff also identified a lack of positive relationships as contributing to limited motivation to remain in treatment. Patient participants and their counselors considered AWARE relevant, acceptable, and feasible over 4 weeks, although completion rates varied. These initial findings suggest that daily surveys and weekly counselor summaries are possible and relevant tools for supporting treatment engagement, and future research refining AWARE may prove a beneficial addition to the field.