JMIR Publications

ABSTRACT

Background:

Mutual support groups are an important source of long-term help for people with addictive behaviour(s), but routine outcome monitoring (ROM) and feedback are yet to be implemented in these settings. Trained facilitators lead all SMART Recovery groups, providing an opportunity to implement ROM.

Objective:

This stage one pilot study was designed to explore the feasibility, acceptability and preliminary outcomes of a novel, purpose-built mobile health (mHealth) ROM and Feedback app (“Smart Track”) in mutual support groups co-ordinated by SMART Recovery Australia (SRAU) over 8 weeks.

Methods:

Smart Track was developed during phase one of this study using participatory design methods and an iterative development process. During the second phase, N=72 SRAU group participants were recruited to a non-randomised, prospective, single-arm trial of the Smart Track app. Four modes of data collection were employed: (i) ROM data directly entered by participants into the app using a range of outcome measures; (ii) app data analytics captured by Amplitude Analytics; (iii) baseline, 2- and 8- week follow-up assessments conducted via telephone by AKB; and (iv) qualitative interviews with a subsample of SRAU study participants (n=20) and facilitators (n=8) conducted over the telephone by RG.

Results:

94% of study participants created a Smart Track account and 88% used Smart Track at least once. Over half of participants (58%) used Smart Track for 5+ weeks. During week one, 83% of participants (n=60) entered ROM data for one or more outcomes, decreasing to 31% (n=22) by 8 weeks. Qualitative feedback from participants and facilitators support the acceptability of Smart Track. Facilitators played a key role in uptake and supporting implementation. Participants reported significant reductions between baseline and 8 week scores on the Severity of Dependence Scale (Mean Difference=1.93, SD=3.02, 95% CI=1.12 to 2.73) and Kessler-10 (Mean Difference=3.96, SD=8.31, 95% CI=1.75 to 6.17), but no change on the Substance Use Recovery Evaluator (Mean Difference=0.11, SD=7.97, 95% CI = -2.02 to 2.24).

Conclusions:

Qualitative and quantitative findings support the feasibility and acceptability of Smart Track and lend insight into avenues for enhancing sustained engagement. SMART Recovery participants were willing to use Smart Track, demonstrated repeated use across the 8-week follow-up interval, engaged most with the two main progress screens and reported Smart Track as useful and consistent with SMART Recovery principles and strategies. Smart Track would be improved by minor changes to app functionality and improved attention to implementation strategies (e.g. facilitator resources, training and support). Clinical Trial: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000686101