Abstract
BackgroundThe rates of cannabis use continue to increase among adolescents and the current interventions have modest effects and high rates of relapse following treatment. There is increasing evidence for the efficacy of mobile technology–based interventions for adults with substance use disorders, but there is limited study of this technology in adolescents who use cannabis.ObjectiveThe goal of our study was to elucidate elements of an app-based adjunctive intervention for cannabis cessation that resonate with adolescents who use cannabis.MethodsAdolescents, aged between 14 and 17 years, who used cannabis were recruited from San Diego County high schools. Semistructured focus groups (6 total; N=37) were conducted to examine the ways in which participants used smartphones, including the use of any health behavior change apps, as well as to elicit opinions about elements that would promote engagement with an app-based intervention for adolescent cannabis cessation. An iterative coding structure was used with first cycle structural coding, followed by pattern coding.ResultsThemes that emerged from the analysis included (1) youth valued rewards to incentivize the progressive reduction of cannabis use, which included both nontangible rewards that mimic those obtained on social media platforms and prosocial activity-related rewards, (2) having the ability to self-monitor progression, (3) peer social support, (4) privacy and confidentiality discrete logo and name and usernames within the app, and (5) individualizing frequency and content of notifications and reminders.ConclusionsIntegrating content, language, interfaces, delivery systems, and rewards with which adolescents who use cannabis are familiar, engage with on a day-to-day basis, and identify as relevant, may increase treatment engagement and retention for adolescents in substance use treatment. We may increase treatment effectiveness by adapting and individualizing current evidence-based interventions, so that they target the needs of adolescents and are more easily incorporated into their everyday routines.
Highlights
Cannabis is the most prevalent drug of abuse among adolescents, with nearly 50% of 12th graders, 30% of 10th graders, and 15% of 8th graders reporting lifetime use [1]
Adolescent cannabis use initiation is linked to negative long-term health effects [38,39], with likely greater impact because of rising delta-9-tetrahydrocannabinol concentrations [40,41]
Technology-based substance use interventions appear promising in adult and college-aged populations, but few are adapted for youth, and none targeted for adolescents with cannabis use disorder (CUD)
Summary
Cannabis is the most prevalent drug of abuse among adolescents, with nearly 50% of 12th graders, 30% of 10th graders, and 15% of 8th graders reporting lifetime use [1]. The likelihood of developing cannabis dependence is linearly associated with the frequency of use and inversely associated with age, such that early onset users are the most susceptible for later dependence [3]. This is of concern as adolescents’ brains are developing and more susceptible to perturbations because of substance exposure. The rates of cannabis use continue to increase among adolescents and the current interventions have modest effects and high rates of relapse following treatment. There is increasing evidence for the efficacy of mobile technology–based interventions for adults with substance use disorders, but there is limited study of this technology in adolescents who use cannabis. We may increase treatment effectiveness by adapting and individualizing current evidence-based interventions, so that they target the needs of adolescents and are more incorporated into their everyday routines
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