A Smartphone Application Supporting Recovery from Heroin Addiction: Perspectives of Patients and Providers in China, Taiwan, and the USA
- 644 Downloads
Smartphone-based interventions are increasingly used to support self-monitoring, self-management, and treatment and medication compliance in order to improve overall functioning and well-being. In attempting to develop a smartphone application (S-Health) that assists heroin-dependent patients in recovery, a series of focus groups (72 patients, 22 providers) were conducted in China, Taiwan, and the USA to obtain their perspectives on its acceptance and potential adoption. Data were analyzed according to the Diffusion of Innovation (DOI) theory of characteristics important to the adoption of innovation. Important to Relative Advantage, USA participants cited S-Health’s potential ability to overcome logistical barriers, while those in China and Taiwan valued its potential to supplement currently limited services. In terms of Compatibility, participants across sites reported recovery needs and goals that such an application could be helpful in supporting; however, its utility during strong craving was questioned in China and Taiwan. Important factors relevant to Complexity included concerns about smartphone access and familiarity, individualization of content, and particularly in China and Taiwan, participants wanted assurance of privacy and security. The study results suggest a general acceptance, but also indicate cultural variations in access to therapeutic and other social support systems, legal repercussions of substance use, societal perceptions of addiction, and the role of family and other social support in recovery. Taking these factors into consideration is likely to increase diffusion as well as effectiveness of these smartphone-based interventions.
KeywordsSmartphone application Recovery from heroin addiction Diffusion of innovation theory S-Health
Compliance with Ethical Standards
This study was funded by the National Institute on Drug Abuse (P30DA016383, R21DA033285, & R13 DA035084; PI:Hser).
Conflict of Interest
All authors declare no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Charmaz K (2012) The power and potential of grounded theory. Medical Sociology Online 6(3):2–15Google Scholar
- Charmaz K (2014) Constructing grounded theory. SageGoogle Scholar
- Duan S, Han J, Tang RH, Yang YC, Xiang LF, Ye RH, Yang SS, Yang YB, Long YC, Li GQ, Yin MS, Pang L, Rou KM, Wu ZY, He N (2013) Study on the incidence and risk factors of HCV infection among heroin addicts who were on methadone maintenance treatment in Dehong prefecture, Yunnan province. Zhonghua Liu Xing Bing Xue Za Zhi 34(6):552–556PubMedGoogle Scholar
- eMarketer (2014) 2 Billion consumers Worldwide to get Smart(Phones) by 2016. http://www.emarketer.com/Article/2-Billion-Consumers-Worldwide-Smartphones-by-2016/1011694#sthash.DZVjChdO.dpuf http://www.emarketer.com/Article/2-Billion-Consumers-Worldwide-Smartphones-by-2016/1011694
- Fjeldsoe BS, Marshall AL, Miller YD (2009) Behavior change interventions delivered by mobile telephone short-message service. Am J Prev Med 36(2):165–173Google Scholar
- Gao P, Pan S (2014) Permanent mechanism for community-based drug addiction treatment. Journal of Shanxi Normal University (Social Science Edition) 41(3):59–64Google Scholar
- Gustafson DH, McTavish, FM, Chih MY et al. (2014) A Smartphone Application to Support Recovery From Alcoholism. JAMA Psych 71(5):566–572Google Scholar
- Heron KE, Smyth JM (2010) Ecological momentary interventions: Incorporating mobile technology into psychosocial and health behavior treatments. Brit J H Psych. 15(1):1–39Google Scholar
- Lee TS, Shen HC, Wu WH, Huang CW, Yen MY, Wang BE, Chuang P, Shih CY, Chou YC, Liu YL (2011) Clinical characteristics and risk behavior as a function of HIV status among heroin users enrolled in methadone treatment in northern Taiwan. Subst Abuse Treat Prev Policy 6:6CrossRefPubMedPubMedCentralGoogle Scholar
- Lewden C, Salmon D, Morlat P, Bevilacqua S, Jougla E, Bonnet F, Heripret L, Costagliola D, May T, Chene G (2005) Causes of death among human immunodeficiency virus (HIV)-infected adults in the era of potent antiretroviral therapy: emerging role of hepatitis and cancers, persistent role of AIDS. Int J Epidemiol 34:121–130CrossRefPubMedGoogle Scholar
- Li ES (2013) The new drug detoxification system in China: a misused tool for drug rehabilitation. E Asia L Rev 9:168–212Google Scholar
- McCann MJ, Rawson RA, Obert JL, Hasson A (1994) Treatment of opiate addiction using methadone: a counselor manual. Center for Substance Abuse Treatment, RockvilleGoogle Scholar
- Miller WR, Rollnick S (1991) Motivational interviewing: preparing people to change addictive behavior. J Community Appl Soc Psychol 2:299–300Google Scholar
- Narcotics Control Bureau of the Ministry of Public Security P. R. China (2014) Annual report on drug control in China. http://www.bjjdzx.org/157/2014-07-15/60020.htmhttp://www.bjjdzx.org/157/2014-07-15/60020.htm. Accessed 10 Sept 2015
- National Institute on Drug Abuse (2014) Drug facts: Heroin. http://www.drugabuse.gov/publications/drugfacts/heroin. Accessed 13 Sept 2015
- Reback CJ, Grant DL, Fletcher JB, Branson BM, Shoptaw S, Rhode Bowers J, Charania M, Mansergh G (2012) Text messaging reduces HIV risk behaviors among methamphetamine-using men who have sex with men. Aids and Beh. 16(7):1993–2002Google Scholar
- Substance Abuse and Mental Health Services Administration (2013) National Survey of Substance Abuse Treatment Services Report: Trends in the Use of Methadone and Buprenorphine at Substance Abuse Treatment Facilities: 2003 to 2011 http://www.samhsa.gov/data/sites/default/files/N-SSATS%20Rprt%20Trnds%20Use%20Methadone%20&%20Buprenorphine%20at%20SA%20Trmt%20Facs%20%2003-11/N-SSATS%20Rprt%20Trnds%20Use%20Methadone%20&%20Buprenorphine%20at%20SA%20Trmt%20Facs%20%2003-11/sr107-NSSATS-Buprenorph.htm. Accessed 10 Dec 2015
- Substance Abuse and Mental Health Services Administration (2015) Behavioral Health Treatment Services Locator. https://findtreatment.samhsa.gov/. Accessed 10 Dec 2015s
- Taiwan Ministry of Health and Welfare (2015) 2014 Anti-drug report http://www.moj.gov.tw/public/Attachment/410291426435.pdf. Accessed 13 Dec 2015
- United Nations Office on Drug and Crime (2013) World Drug Refport. Vienna: UNODC, 2013Google Scholar
- White W (2009) Long-term strategies to reduce the stigma attached to addiction, treatment, and recovery within the City of Philadelphia (with particular reference to medication-assisted treatment/recovery). Philadelphia, PA: Department of Behavioral Health and Intellectual Disability Services. http://dbhids.org/technical-papers-on-recoverytransformation/. 15 September 2015
- White WL (2011) Narcotics Anonymous and the pharmacotherapeutic treatment of opioid addiction. Great Lakes Addiction Technology Transfer Center and Philadelphia Department of Behavioral Health and Intellectual Disability Services, ChicagoGoogle Scholar
- World Health Organization (2014) Reducing harm, preventing HIV, saving lives: China’s vast methadone maintenance treatment program marks successes even as it addresses key challenges ahead. http://www.wpro.who.int/china/mediacentre/releases/2014/2014112702/en/. 13 September 2015.
- World Health Organization (2015) Injecting drug use: HIV/AIDS. http://www.who.int/hiv/topics/idu/about/en/. 14 September 2015