The purpose of this study is to further develop and test the Momentary Self-Monitoring and Feedback + Motivational Enhancement Therapy (MOMENT) intervention, a real-time, contextual intervention to reduce marijuana use among primary care patients.
This study proposes a pilot randomized trial to further develop and test the Momentary Self-Monitoring and Feedback + Motivational Enhancement Therapy (MOMENT) intervention, a real-time, contextual intervention to reduce marijuana use over three months in 15-to-24-year-old primary care patients who use frequently. We will randomize youth to one of two arms (goal 30 per arm completing 3-month follow-up): 1) MOMENT (MET + momentary self-monitoring + context-dependent feedback), or 2) MET-only. The two study arms will permit evaluation of the contributions of the self-monitoring and feedback components of the intervention above-and-beyond the MET and directly test the influence of the intervention on the link between momentary context and marijuana-related outcomes. The specific aims of the study are Specific Aim 1: Continued Feasibility Evaluation. In our preliminary work, we demonstrated that 1) youth perceive MOMENT to be easy to understand, comfortable, motivating, and helpful in reducing their marijuana use, 2) we can recruit 4 participants/month (minimum rate for the proposed study), and 3) we can successfully implement a MOMENT intervention study in the proposed recruitment sites. Based on this work, we have identified additional areas of feasibility on which to focus in the proposed study. Specifically, we aim to achieve: 1a. A signal response rate of at least 70% during each of three periods of momentary data collection - baseline, intervention, and 3-month follow-up. 1b. A diary response rate of at least 70% during each momentary data collection period 1. c. A retention rate of at least 80% of participants at the 3-month follow-up. Specific Aim 2. Early-Stage Efficacy Exploration. Our preliminary work showed that both momentary and individual-level outcomes improved from baseline to three months post-intervention. The primary momentary outcomes are desire to use marijuana when in a triggering context and likelihood of use following exposure to a triggering context. The primary individual-level outcomes are number of use events/week, 30-day percent of days abstinent, dose/use event, and measures of motivation (importance of, readiness for, and confidence about reducing use). Based on the preliminary findings, we will explore these early-stage efficacy questions: 2. a. Will improvements in momentary outcomes be observed with MOMENT, but not MET-only? (1) The association between exposure to self-identified trigger contexts and momentary desire to use marijuana will be attenuated at three months, compared to pre-intervention. (2) The likelihood of marijuana use following exposure to a trigger context will be reduced at three months. 2b. Will improvements in individual-level outcomes be greater with MOMENT vs. MET-only? 1. The reduction in marijuana use frequency (events/week and 30-day percent of days abstinent) and dose (per use event) will be greater at three months. 2. The increase in motivation to reduce or discontinue use will be greater at three months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
70
Motivational Enhancement Therapy only
The full MOMENT intervention: Motivational Enhancement Therapy + momentary and daily mobile self-monitoring + motivational feedback messages prompting participants to consider their individualized coping strategies to avoid using marijuana
Boston Children's Hospital Adolescent/Young Adult Medical Clinic
Boston, Massachusetts, United States
Martha Eliot Health Center Adolescent Clinic
Jamaica Plain, Massachusetts, United States
Marijuana desire
Desire to use marijuana when in top-3 trigger context
Time frame: 3 months
Marijuana use following trigger exposure
Marijuana use following exposure to top-3 trigger context
Time frame: 3 months
Frequency of marijuana use
Marijuana use events/day
Time frame: 3 months
Percent days abstinent
30-day percent days abstinent from marijuana use
Time frame: 3 months
Motivation to reduce marijuana use
Daily score on 3 scales - readiness to reduce marijuana use, importance of reducing use, and confidence in ability to reduce use
Time frame: 3 months
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