Digital Media & Communication Technologies in Adolescent Drug Abuse Treatment

United States

Meeting Purpose:

• A number of effective treatments exist for adolescent substance use disorders. Unfortunately, they are not reaching those in need due to significant barriers (e.g., cost and burden of implementation, rejection of traditional models of care by youth).
• In April 2010, NIDA held a meeting "Digital Media & Communication Technologies in Adolescent Drug Abuse Treatment" to explore technology as one way to overcome some of these barriers.

Objectives:

• Build research partnerships between technology experts and scientists developing effective treatments for adolescent drug abuse
• Generate research recommendations for integrating technologies into treatments for adolescent drug abuse
• Increase the volume of research grant applications that integrate technologies into adolescent drug abuse treatments

Topics Presented:

• Emerging Research on the Application of Technologies to Behavior Change Interventions
• Selecting a Technology, Working with a Developer, and Making Research Affordable
• Exploring New Directions for Technology in Existing Evidence-Based Behavioral Treatments
• Opportunities and Challenges in Integrating Technology into Adolescent Drug Abuse Treatment Research
• Considerations for Future Research

Summary of Discussion:

• As technologies evolve, they become less expensive, more accessible, and more popular with youth. There is tremendous potential in the use of technology to reach and engage youth who may not otherwise enter, or remain engaged in, traditional models of care.
• Technologies can be considered (e.g., games, virtual environments, social networks, handheld devices) as stand-alone treatments, or used as adjuncts to behavioral interventions. They could be used to deliver intervention components, reinforce behavioral principles learned in treatment, and provide opportunities to practice new skills and build social networks.
• To optimize the use of technology to impact behavior change, it is imperative to identify and target hypothesized or proven mechanisms of action or active ingredients of an intervention.
• Working with technology experts throughout application development will facilitate the process, and help manage realistic expectations regarding technology capabilities, costs, and time-lines prior to application development.
• Research should include participation from the end-user, who should provide input iteratively through development of the intervention.
• Realism vs. Naturalism in Graphic Design: The use of high end technology and realism may not be necessary for better outcomes. Naturalism seems to be more important (e.g., cartoon character makes life-like motions, mapped from human movement).
• Research with technology does not always require development of new innovations. Designing an intervention based on technology that is accessible and used by a target population may increase generalizability and sustainability.
• It is critical to understand the mechanisms of change, or how and why a technology works. Technologies of the moment are always changing, yet the mechanisms may be constant. Some technologies are more expensive to produce than others, and knowing if the mechanism of change is specific to an expensive technology, or whether you can get a similar effect size with a lower cost technology is of benefit. And finally, this information is necessary for replication of research findings.
• Security and privacy are concerns for all technologies, including video games if they are used to collect any data. Two potential solutions include: (1) encryption and the use of industry standards with electronic communication; and (2) using one's own programs and servers, rather than those of 3rd party vendors.

Future Directions:

• Research is needed to integrate technology-based assessments, data collection and analytic tools, and technology-based interventions into adolescent drug abuse treatments.
• Research should address unique benefits and opportunities allowed by technologies. Examples of research questions include: To what extent does technology have potential to access non-traditional treatment seekers and those who do not have access to traditional treatments? How should passive participation ("lurking") vs. active participation in on-line social networks be measured for the purpose of considering dose-response? Does an adolescent on-line social network increase or decrease the risk of iatrogenic group effects (e.g., using substances together)? How much can real-time intervention, facilitated by GPS warning systems programmed to identify triggers, impact effect-size? How is losing or failing in a game different from real-life events, and how does this affect the learning process?
• Research is needed on the process through which behaviors within games and virtual environments translate into real-world situations.
• Dissemination and implementation, as well as cost-effectiveness analyses are important aspects of this research and should be considered in study development.