Accepted for/Published in: JMIR Formative Research
Date Submitted: Sep 17, 2023
Date Accepted: Nov 28, 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Warning: This is an author submission that is not peer-reviewed or edited.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.
Development and Usability Testing of an mHealth Tool for Trauma-Informed Prevention for Substance Use, HIV Acquisition, and Risky Sexual Behaviors among Adolescents: A Mixed Method Study
ABSTRACT
Background:
Youth who experience traumatic events are at substantially higher risk for engagement in substance use and sexual risk behaviors and problems (e.g., HIV acquisition) than their non-trauma-exposed counterparts. Evidence-based substance use and risky sexual behavior prevention may reduce risk for these outcomes. Trauma-focused mental health treatment provides a window of opportunity for the implementation of such prevention work with these youth. However, overburdened clinicians face challenges in adding prevention content while implementing evidence-based treatments; mHealth tools can help reduce such burden in delivering prevention curricula. Trauma Informed Prevention for Substance use and risky Sexual behavior (TIPS) is an mHealth application that was developed to aid Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) clinicians in the implementation of evidence-based risk behavior prevention curriculum.
Objective:
The goal of this paper is to describe the rationale for and development of the TIPS app and present results from a mixed method approach for initial evaluation of its usability.
Methods:
Participants included clinicians (n=11), adolescents (n=11), and caregivers (n=10) who completed qualitative interviews and an adapted version of the Website Analysis and MeasureMent Inventory (WAMMI).
Results:
Four overarching themes emerged from the participants’ answers to the qualitative interview questions, demonstrating a generally positive response to the app. Themes included: (1) strength in app content, (2) suggestions about app content, (3) aesthetics and usability, and (4) benefits to the patient and session implementation. Results from the WAMMI further illustrated the users’ favorable reaction to the TIPS app, with 100% clinicians and caregivers and the majority (64%) of adolescents selecting “strongly agree” or “somewhat agree” to the statement, “This app has much that is of interest to me.”
Conclusions:
The TIPS app shows promise as an mHealth tool for TF-CBT clinicians to integrate evidence-based substance use, risky sex, and HIV prevention during the course of treatment. Future research, including a randomized controlled trial comparing TF-CBT implementation with and without inclusion of the app, is necessary to evaluate the feasibility and efficacy of the app in reducing risk for substance use and risky sexual behavior among trauma-exposed adolescents. Clinical Trial: N/A
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