JMIR Publications

ABSTRACT

Background:

Non-medical use of prescription opioids (NMUPO) in young adults in the US is concerning and is robustly influenced by many psychosocial factors. Given the advantages of flexibility, wide coverage, and real-time responses and assessment, social media appears to be promising and innovative approach to deliver psychosocial intervention to young adults. However, scant theory-based social media interventions are available for NMUPO targeting this at-risk population. Guided by the information-motivation-behavioral-skill (IMB) model, the proposed research addresses the critical gaps by theoretically exploring psychosocial contents associated with NMUPO among young adults via the formative assessment. These findings will then be utilized to develop and evaluate feasibility and preliminary efficacy of a peer-led social media intervention to reduce NMUPO among young adults.

Objective:

The proposed study has three specific aims. Aim 1 is to conduct a formative study to inform a theory-based social media intervention for NMUPO among young adults in the US. Aim 2 is to develop a theory-based social intervention to reduce NMUPO among young adults. The intervention will be developed upon findings from the formative study. Aim 3 is to test feasibility and preliminary efficacy of the theory-based social media intervention with a randomized controlled design for NMUPO among young adults.

Methods:

The proposed study will comprise serial research activities. First, formative research will be conducted through semi-structured interviews among 30 young adults engaged in NMUPO. Qualitative data will be synthesized using a pragmatic approach for identifying psychosocial contents associated with NMUPO. Second, qualitative findings will be used for developing a peer-led social media intervention to reduce NMUPO among young adults by integrating promising psychotherapy principles and incorporating with well-trained recovery coaches. Third, the social media intervention will be evaluated through a 12-week randomized controlled trial among 70 young adults (35 in the intervention group or control group) engaged in NMUPO via mixed methods, including pre- and post-intervention surveys, social media Paradata (e.g., time-series reactions to posts) collection, and ecological momentary assessment during the intervention. The control group will not receive an intervention but complete the pre- and post-intervention surveys. The primary outcomes will be feasibility, useability, and acceptability, while the secondary outcomes will be psychosocial and behavioral measures, such as past-three-month NMUPO, intention, psychological distress, self-efficacy, resilience, and coping strategies.

Results:

N/A.

Conclusions:

The proposed study will be the one of the first efforts to develop and deliver a theory-based peer-led intervention on social media, incorporating empirical findings on psychosocial mechanism of NMUPO. Findings of the proposed study will provide valuable insights into opioid risk reduction for young adults through an innovative approach. If the trial is tested feasible, the proposed study will contribute to future scaled-up and fully powered psychosocial interventions among young adults and other key population at risk for NMUPO. Clinical Trial: This trial is registered at ClincialTrials.gov, registration number: NCT06469749, registered on June 25, 2024