Mobile Health (mHealth) Assessment of Illicit Drug Use Among Community Dwelling Drug Users in Baltimore, MD

mHealth;Illicit Drug Use;HIV;Ecological Momentary Assessment;not listed

Linas, Beth SydneyLatkin, Carl A. ;

Johns Hopkins University

关键词: mHealth;    Illicit Drug Use;    HIV;    Ecological Momentary Assessment;    not listed;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/37966/Full_dissertation_BLv6.docx?sequence=2&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Background: Substance abuse is a chronic disease often characterized by multiple attempts at abstinence, frequent relapse and is associated with a range of morbidities and mortality. This dissertation utilizes a mobile health (mHealth) data collection method known as Ecological Momentary Assessment (EMA) to capture the dynamic process that drug use represents. The goals of this dissertation were to examine the accuracy of real-time mHealth methods in assessing drug use, examine individual drug using patterns to identify those at risk for poor engagement in care and to examine the real-time environments of drug using and craving. Methods: Exposure Assessment in Current Time (EXACT) study participants were recruited from the AIDS Linked to the IntraVenous Experience (ALIVE) study, an on-going, community-recruited, observational cohort of persons with a history of injecting drugs in Baltimore, MD. The EXACT study included four successive trials, planned to follow 30 participants each for 30 days and was conducted from November 2008 through May 2013. Participants were asked to self-initiate a survey and self-report through a hand-held device each time they either craved (but refrained from using) or used heroin or cocaine (or both) in any manner (smoked, snorted or injected). At the end of each week, sweat patch samples (PharmCheck®) were collected for measurement of illicit substances and participants answered an audio-computer assisted self -interview (ACASI) questionnaire concerning activities, behaviors and drug using events during the prior week. Results: 109 EXACT participants were a median of 48.5 years old, 90% African American, 52% male and 59% HIV-infected. EMA methods demonstrated moderate percent agreement of reported drug use when compared to ACASI methods but less agreement when compared to sweat patch methods. Real-time collection of drug use identified three distinct classes of drug users. The most risky class included individuals engaging consistently in high-intensity drug using behavior, which was associated with poor engagement in care. Lastly, drug-related activities provided the strongest cues for real-time drug use, while craving was associated with being in more structured environments.Conclusion: Interactive mHealth methods are capable of assessing and describing the drug-using environment and can provide the framework for developing context-sensitive interventions (ecological momentary interventions) that can be tailored to prevent relapse and support cessation of illicit drug use.