An Outcome Study of the CASA-CHESS Smartphone Relapse Prevention Tool for Latinx Spanish-Speakers with Substance Use Disorders

Abstract

Background: Hispanic/Latinx persons with alcohol and other drug disorders (AOD) have limited access to culturally competent continuity of care. To address this, the evidence-based smartphone recovery application Addiction-Comprehensive Health Enhancement Support System (A-CHESS) was translated and adapted for Latinx Spanish-speakers with AOD, developing CASA-CHESS. Objectives: This study examined the AOD and mental health outcomes for Latinx Spanish-speaking clients using the CASA-CHESS smartphone tool over a 6-month period, post-residential treatment. This single group, pre-post study design included seventy-nine male and female Spanish-speaking Latinx clients, equipped with CASA-CHESS as they completed residential AOD treatment. Primary outcome measures at baseline and 6-month follow-up included substance use and other mental health symptoms. Results: While over 70% of the sample reported past heroin use and alcohol use, clients had low baseline rates of substance use, depression and anxiety and elevated social support scores as they graduated from residential treatment. Overall participants maintained their relatively low baseline rates during the 6-month post-residential period while using the CASA-CHESS relapse prevention tool. Those who discontinued using CASA-CHESS within the first 4 months after leaving residential treatment reported higher rates of substance use as well as anxiety and depression symptoms than those using it for 4 or more months, suggesting that continued use of CASA-CHESS may contribute to maintenance of successes gained in treatment. Conclusions/Importance: CASA-CHESS may reduce the risk of relapse for Latinx Spanish-speakers following residential services and extend needed access to culturally and linguistically competent aftercare services for those with AOD.

Keywords:

• Substance use
• Latinx
• relapse prevention
• smartphones
• mobile health

Acknowledgments

We express our sincere gratitude to the CASA-CHESS clients and staff , research assistants (Christina Rios, Erika Gaitan, Catherine Medina-Perez, Alicia Norton, Helen Tanchez, Christina Korin, Laura Heller, Rachel Bowers-Sword), and additional CHESS staff (Susan Dinauer, Haile Berhe).

Disclosure statement

This article was supported by SAMHSA-CSAT Grant No. TI 024733 awarded to Dr. Muroff.

Additional information

Funding

Author Gustafson has a shareholder interest in CHESS Mobile Health, a small business that develops web-based health care technology for patients and family members. This relationship is extensively managed by the authors and the University of Wisconsin. All other authors declare that they have no competing interests.