The Potential for Technology in Brief Interventions for Substance Use, and During-Session Prediction of Computer-Delivered Brief Intervention Response

Abstract

We first provide an overview of the potential of technology in the area of brief interventions for substance use and describe recent projects from our lab that are illustrative of that potential. Second, we present data from a study of during-session predictors of brief intervention response. In a sample of postpartum women (N = 39), several variables showed promise as predictors of later drug use, and a brief index derived from them predicted abstinence with a sensitivity of .7 and a specificity of .89. This promising approach and initial study findings support the importance of future research in this area.

Keywords :

• pregnancy
• substance abuse
• motivational interviewing
• technology
• prediction
• efficacy

THE AUTHORS

Dr. Steven J. Ondersma is an Associate Professor in the Department of Psychiatry and Behavioral Neurosciences of the Wayne State University School of Medicine, and also in the Merrill Palmer Skillman Institute of Wayne State. His primary interest is in brief, computer-delivered interventions for substance abuse and other risk factors among high-risk parents, especially pregnant and postpartum women. He is the former Editor of the journal Child Maltreatment, and has been Principal Investigator of multiple research grants (NIDA, CDC) focusing on the development and validation of technology-based brief interventions.

Dr. Emily R. Grekin is an Assistant Professor in the Department of Psychology at Wayne State University. Her research involves identifying biological and dispositional factors that predict the development of substance dependence. In particular, she is interested in whether different personality traits predict distinct forms of substance dependence (e.g., alcohol, drug, and tobacco dependence). She is also interested in the degree to which personality traits interact with environmental factors to predict substance misuse. Some of her recent studies have examined whether heavy drinking “events” (e.g., turning 21 and going on spring break) elicit different degrees of alcohol use in people with different personality traits (e.g., impulsive versus constrained traits).

Dr. Dace Svikis is a Professor in the Department of Psychology and Director of Promoting Healthy Pregnancies in the Department of Obstetrics/ Gynecology at Virginia Commonwealth University (VCU). She is also Deputy Director of the VCU Institute for Women's Health. Dr. Svikis has been involved in multidisciplinary drug user treatment research from many years. From 1992 to 1999 she served as Director of the Center for Addiction and Pregnancy (CAP) at Johns Hopkins University School of Medicine. The CAP is a nationally recognized interdisciplinary program for pregnant drug-dependent women and their children. Dr. Svikis is committed to bridging the gap between research and clinical practice. She is currently principal investigator on 2 National Institute on Alcohol Abuse and Alcoholism (NIAAA) and NIDA grants that focus on treatment engagement and motivational and behavioral brief interventions for women with alcohol and other drug-use-related problems. In addition, she is Lead Investigator for a national multisite study and Director of Training for the Mid-Atlantic Node of the NIDA Clinical Trials Network. She is committed to student and faculty mentoring, serving as advisor for two National Research Service Award (NRSA) grants and mentor on 4 National Institutes of Health (NIH) K-series faculty training grants.

GLOSSARY

• Mann–Whitney U-test: A nonparametric equivalent to the t-test, appropriate for examining independence of two groups on an ordinal variable.

• Perinatal period: The period surrounding childbirth.

• Rank-biserial correlation: A measure of the strength of association of two variables, when one is dichotomous and the other is ordinal.

• State variable: A variable that reflects current emotional, intentional, or attitudinal functioning and is capable of fluctuating rapidly (as opposed to the more commonly measure trait variables, which are seen as stable characteristics).

• Tablet PC: A laptop computer with an integrated touch-screen; many are convertible, meaning that the screen can fold over the keyboard, thus allowing the user to interact only with the touch-screen.

Notes

2 The reader is reminded that the concepts and processes of “risk” and “protective” factors are often noted in the literature without helping the reader to adequately understand their dimensions (linear, non-linear), their “demands”, the critical necessary conditions (endogenously as well as exogenously; from a micro to a macro level) which are necessary for either of them to operate (begin, continue, become anchored and integrate, change as de facto realities change, cease, etc.) or not to and whether their underpinnings are theory-driven, empirically-based, individual and/or systemic stake holder- bound, based upon “principles of faith”, historical observation or what. What is necessary –endogenously as well as exogenously for THIS to happen? This is necessary to clarify if the term is not to remain as yet another shibboleth in a field of many stereotypes.