Accepted for/Published in: JMIR Human Factors
Date Submitted: Feb 16, 2022
Date Accepted: Jan 24, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Text Message Exchanged Between Individuals with Opioid Use Disorder and their mHealth E-Coaches: A Content Analysis Study
ABSTRACT
Background:
Opioid Use Disorder (OUD) has affected 2.2 million people in the United States. About 7.2 million people reported using illicit drugs in 2019, which contributed to over 70,000 overdose deaths. Text message interventions have been shown to be effective in OUD recovery. However, the interpersonal communication between individuals in OUD treatment and a support team on digital platforms has not been well-examined.
Objective:
The current study aims to understand the communication between participants undergoing OUD recovery and their e-coaches by examining the text messages exchanged from the lens of social support, and the issues related to OUD treatment.
Methods:
A content analysis of messages exchanged between individuals recovering from OUD and members of a support team was conducted. Participants were enrolled in a mHealth intervention titled “uMAT-R”, a primary feature of which is the ability for patients to instantly connect with a recovery support staff or an “e-coach” via in-app messaging. Our team analyzed dyadic text-based messages of over 12 months. 71 participants’ messages and 1,531 unique messages were analyzed using a social support framework and OUD recovery topics.
Results:
Out of 71 participants, 63.4% were between ages of 31-50 years, 47% females, 59.2% Caucasian, and 60.6% reported living in unstable housing conditions. An average of 21.5 (SD=41.1) messages were exchanged between each participant and their e-coach. Out of 1,531 messages, 59% (n=918) messages were sent by e-coaches and 40% (n=613) by participants. Messages of emotional support occurred the most, with 238 occurrences [(0.65%, n =10) and e-coaches (14.9%, n =228)]. Messages of material support had 125 occurrences [participants (0.59%, n = 9) and e-coaches (7.51%, n = 115)]. With OUD recovery topics, opioid use risk factors appeared the most [118 total occurrences (patient = 6.14%, n = 94; e-coach = 0.39, n = 6)], followed by message of avoidance of drug-use 7.12% (n =109), which occurred mainly from participants. Depression was correlated with messages of social support (r = .27, p <.05).
Conclusions:
Individuals with OUD who had mental health needs tended to engage in instant messaging with the recovery support staff. Patients who are engaged in messaging often engage in conversations around risk factors and avoidance of drug-use. Instant messaging services can be instrumental in providing social and education support needs of individuals recovering from OUD.
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