JMIR Publications

ABSTRACT

Background:

More than 5 million young adults in the United States. meet criteria for cannabis use disorder (CUD), placing them at risk for adverse physical, psychiatric, and social outcomes. Most young adults with CUD do not receive treatment due to numerous barriers, including motivation, stigma, limited availability and accessibility of developmentally appropriate services, and competing demands for time and finances. We have developed a novel digital health intervention, MOMENT-V, that combines telehealth motivational enhancement therapy (MET) with mobile health (mHealth) ecological momentary intervention (EMI) to provide a fully remote brief intervention for CUD among young adults being seen in primary care.

Objective:

We describe the protocol for a parallel, 2-arm, pilot randomized controlled trial of MOMENT-V vs. enhanced usual care (EUC) to evaluate intervention and trial feasibility in young adults with CUD recruited from primary care clinics.

Methods:

We are inviting 18-26-year-old primary care patients to self-screen through posters with a QR code in clinics, invitations from clinicians, and via patient portal messages. Eligible patients (e.g., Cannabis Use Disorders Identification Test-Revised score ≥12, cannabis use >3 days/week, smartphone ownership; N=60) will be randomly assigned 1:1 to receive MOMENT-V or EUC. MOMENT-V will include two weekly sessions of Motivational Enhancement Therapy via telehealth, then two weeks of mHealth EMI – mobile self-monitoring with messages after report of personal triggers for use. EUC will include a brief meeting with a counselor to review cannabis use problems and provide substance use and mental health resources. Participants will be assessed via survey and timeline follow-back calendar interview at baseline, 3 weeks, 3 months, and 6 months, and by interview at 6 months. Primary outcomes will include completion, EMI engagement, and acceptability for intervention feasibility and screening, eligibility, enrollment, and retention rates for trial feasibility. Primary outcomes will be evaluated against a priori benchmarks. Secondary outcomes will include counselor adherence to motivational interviewing principles, therapeutic alliance, duration of study activities, barriers, facilitators, CUD symptoms, amount of delta-9-tetrahydrocannabinol used in standard units, motivation to change use, psychological distress, cognitive function, and quality of life. We will also examine cannabis use frequency and problems from cannabis use. For the quantitative analyses, we will use descriptive statistics, logistic regression, and generalized linear mixed effects modeling. For the qualitative analyses, we will use immersion/crystallization, template organizing style, and thematic analysis.

Results:

Recruitment began in August 2025 and is anticipated to end in January 2027. Data collection is projected to be completed in July 2027. We plan to submit a manuscript describing the main outcomes in early 2028.

Conclusions:

This study will provide data regarding the MOMENT-V digital health intervention and trial feasibility in anticipation of a fully powered efficacy trial in young adults with CUD being seen in primary care. Clinical Trial: ClinicalTrials.gov ID NCT06661031 (registration date: 10/22/2024)