Journal of substance use and addiction treatment · 2026
A relational agent for treating substance use in adults: A randomized controlled trial with a psychoeducational comparator.
СтатьяРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Prochaska Judith J, Wang Maggie, Chieng Amy, Moore Jessie, Vogel Erin A, Baiocchi Michael, Pajarito Sarah, Pirner Maddison C, Bullard Lauren, Darcy Alison, Robinson Athena
Аннотация
BACKGROUND: Highly accessible and scalable, digital mental health interventions can reduce barriers associated with traditional treatment. Woebot for Substance Use Disorders (W-SUD) is a smartphone application in development that uses Woebot, a guided self-help relational agent intended to offer support to track and reduce problematic substance use. Two formative studies supported W-SUD's feasibility, acceptability, and efficacy to reduce substance use at end-of-treatment (EOT).
OBJECTIVES: In a randomized trial with a 1-month post-treatment follow-up, we aimed to evaluate W-SUD's efficacy in reducing substance use occasions relative to a psychoeducational control.
METHODS: U.S. adults (N = 258) with problematic substance use (CAGE-AID≥2) were recruited online and randomized to W-SUD or an email-delivered psychoeducational control. Primary and secondary outcomes were change in past-month substance use occasions from baseline to 8-weeks EOT and baseline to 1-month follow-up, respectively.
RESULTS: The analytic sample (N = 202; 107 = W-SUD; 95 = psychoeducation) averaged 38.3 years of age (SD = 10.4) and was 53.5% (108/202) female and 71.3% (144/202) White. At baseline, participants averaged 33.1 (SD = 18.3) past-month substance use occasions with problematic substance use reported as alcohol (73.3%, 148/202), cannabis (30.7%, 62/202), stimulants (17.3%, 35/202), and cocaine (12.4%, 25/202). Anxiety (32.7%, 66/202) or depression (23.3%, 47/202) co-occurred. W-SUD participants sent a median of 322.5 (interquartile range: 59.8, 924.0) in-app messages during the intervention. There was no significant treatment effect on the primary (beta = -0.675, p = 0.741; 95%CI = -4.96-3.49) or secondary outcomes. Baseline to EOT within-group change in past-month substance use occasions were -13.6 (SD = 15.4, d = -0.879) and -12.9 (SD = 15.3, d = -0.847) for the W-SUD and psychoeducation conditions, respectively, indicating moderate to large changes in both, which was sustained at 1-month follow-up. Decreases in substance use occasions significantly correlated with decreases in anxiety and depression and with greater treatment satisfaction in both groups. There were no serious adverse events.
CONCLUSIONS: Participants in both conditions reported significant improvements in primary and secondary outcomes at EOT and 1-month post-treatment, with no statistically significant difference in improvement between conditions.
CLINICALTRIALS: GOV (POSTED 2021-06-14): NCT04925570, https://clinicaltrials.gov/study/NCT04925570.
OBJECTIVES: In a randomized trial with a 1-month post-treatment follow-up, we aimed to evaluate W-SUD's efficacy in reducing substance use occasions relative to a psychoeducational control.
METHODS: U.S. adults (N = 258) with problematic substance use (CAGE-AID≥2) were recruited online and randomized to W-SUD or an email-delivered psychoeducational control. Primary and secondary outcomes were change in past-month substance use occasions from baseline to 8-weeks EOT and baseline to 1-month follow-up, respectively.
RESULTS: The analytic sample (N = 202; 107 = W-SUD; 95 = psychoeducation) averaged 38.3 years of age (SD = 10.4) and was 53.5% (108/202) female and 71.3% (144/202) White. At baseline, participants averaged 33.1 (SD = 18.3) past-month substance use occasions with problematic substance use reported as alcohol (73.3%, 148/202), cannabis (30.7%, 62/202), stimulants (17.3%, 35/202), and cocaine (12.4%, 25/202). Anxiety (32.7%, 66/202) or depression (23.3%, 47/202) co-occurred. W-SUD participants sent a median of 322.5 (interquartile range: 59.8, 924.0) in-app messages during the intervention. There was no significant treatment effect on the primary (beta = -0.675, p = 0.741; 95%CI = -4.96-3.49) or secondary outcomes. Baseline to EOT within-group change in past-month substance use occasions were -13.6 (SD = 15.4, d = -0.879) and -12.9 (SD = 15.3, d = -0.847) for the W-SUD and psychoeducation conditions, respectively, indicating moderate to large changes in both, which was sustained at 1-month follow-up. Decreases in substance use occasions significantly correlated with decreases in anxiety and depression and with greater treatment satisfaction in both groups. There were no serious adverse events.
CONCLUSIONS: Participants in both conditions reported significant improvements in primary and secondary outcomes at EOT and 1-month post-treatment, with no statistically significant difference in improvement between conditions.
CLINICALTRIALS: GOV (POSTED 2021-06-14): NCT04925570, https://clinicaltrials.gov/study/NCT04925570.