JMIR Publications

ABSTRACT

Background:

There is a growing body of evidence on eHealth interventions that target substance use disorders. Development and funding decisions in this area have been challenging due to a lack of understanding of what parts of an intervention work in which context.

Objective:

We conducted a realist review on the literature of Electronic Health Cognitive-behavioural Therapy (eCBT) programs for substance use with the goal of answering the following realist question: “how do different eCBT interventions for substance use interact with different contexts to produce certain outcomes?”

Methods:

A literature search of published and gray literature eHealth programs targeting substance use was conducted. After data extraction, in order to conduct a feasible realist review in a timely manner, the scope had to be refined further and ultimately, only included literature focusing on eCBT programs targeting substance use. We synthesized the available evidence from the literature into Context-Mechanism-Outcome configurations in order to better understand when and how programs work.

Results:

A total of 54 papers studying 24 programs were reviewed. Our final results identified 8 Context-Mechanism-Outcome configurations from 5 unique programs that met criteria for relevance and rigor.

Conclusions:

5 strategies that may be applied in future eCBT programs for substance use are discussed and may contribute to a better understanding of mechanisms and ultimately help design more effective solutions in the future. Future research on eHealth CBT programs should try and understand mechanisms of program strategies and how they lead to outcomes in different contexts.