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A Randomized Controlled Trial of an Online Relapse Prevention Program for Adolescents in Substance Abuse Treatment

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Abstract

Background

An Internet-based relapse prevention supplement to adolescent substance abuse treatment programming is a promising modality to reinforce treatment gains and enhance recovery; however, an evidence base is lacking.

Objective

To assess the efficacy of the online Navigating my Journey (NmJ) program.

Methods

129 adolescent-aged participants (ages 13–23) receiving substance abuse treatment participated in a randomized parallel group study comparing two conditions: experimental (NmJ) versus attention control (viewed wellness articles from the Nemours Foundation at their discretion). Participants in the experimental condition were asked to complete 12 core lessons over 3 months. Lesson content was developed to teach evidence-based relapse prevention skills. Data were collected at four time points: baseline, 1-month follow up, 3-month follow up, and 6-month follow up.

Results

We used a linear mixed modeling approach to test for differences between conditions on each outcome. Participants in the experimental condition reported a significantly greater increase in motivation to reduce or not misuse drugs from baseline to 3-month follow up and from baseline to 6-month follow up, compared to the control participants. Participants in the experimental condition also reported a greater decrease in drug use score from baseline to 3-month follow up, compared to the control participants. An analysis of age as a potential moderator suggested that the intervention may be more effective for older adolescents. Greater use of the program was associated with greater self-efficacy and lower self-reported substance use over time.

Conclusions

Relapse prevention treatment with adolescents may be facilitated by theory-based online interventions.

ClinicalTrials.gov Identifier

NCT02125539.

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Notes

  1. Three older participants screened in because they responded “YES” to the screener question “Are you between the ages of 18 and 21?” then reported an age that was 22 or 23. Based on input from consultants, these data were retained for analysis.

  2. An a priori power analysis was conducted to determine the target number of participants required to achieve 80% power assuming a small-to-moderate effect of the intervention. Further details are available upon request.

  3. Acquiescence bias is defined as agreeing or disagreeing to all items on a questionnaire or battery of questionnaires without considering the actual content of the items. The ways the authors identified acquiescent responding are consistent with the definition provided by Furr and Bacharach (2013).

  4. ES is the effect size defined by the difference between conditions in the change in means from one time point to another (e.g., baseline to 3-month follow-up).

  5. “Few” was defined as equal to or less the first 25% of the distribution (≤25th percentile).

  6. “Moderate” was defined as the middle 50% of the distribution (25th percentile through 75th percentile).

  7. “Many” was defined as the top 25% of the distribution (>75th percentile).

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Acknowledgements

The authors would like to thank their funder (NIDA SBIR Grant #2R44DA026645) and their Inflexion colleagues who contributed to the development of the intervention, NavigatingmyJourney.com: Ellen Patterson, Lisa Sawyer, Matt Solano, and Mila Pavek. We are also grateful to the editor and two anonymous reviewers for their very constructive feedback on the original draft. Lastly, thank you to Kelly Manser for her editorial review of this manuscript.

Research Funding

This work was supported by NIDA SBIR Grant #2R44DA026645. The funders had no part in designing the study, the collection of data and its analysis, or in the decision to complete or write this manuscript.

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Authors and Affiliations

  1. Inflexxion, Inc., Waltham, MA, USA

    Kimberlee J. Trudeau & Ryan A. Black

  2. Center for Behavioral Health Integration, LLC, Middlebury, VT, USA

    Jody L. Kamon

  3. University of Southern California, Los Angeles, CA, USA

    Steve Sussman

Authors
  1. Kimberlee J. Trudeau
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Corresponding author

Correspondence to Kimberlee J. Trudeau.

Ethics declarations

Conflict of interest

All authors were salaried employees or paid consultants of the organization that received the NIH SBIR grant to develop and test this program. KT and RB were employees of Inflexxion, Inc., Newton, MA during this project. JK and SS declare that they have no conflict of interest to report. We had a subcontract with Hazelden Publishing to draft content for the intervention program described and tested herein.

Ethical Approval

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

Informed consent was obtained from all individual participants included in the study.

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Trudeau, K.J., Black, R.A., Kamon, J.L. et al. A Randomized Controlled Trial of an Online Relapse Prevention Program for Adolescents in Substance Abuse Treatment. Child Youth Care Forum 46, 437–454 (2017). https://doi.org/10.1007/s10566-016-9387-5

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