Testing mediational processes of substance use relapse among youth who participated in a mobile texting aftercare project

Abstract

Background

The goal of this paper is to advance the understanding of mechanisms of action involved in behavioral-driven aftercare interventions for substance use disorders (SUDs) among youth populations. This paper reports data from a study that measured the impact of an aftercare intervention on primary substance use relapse among youth who completed treatment in Los Angeles County for SUDs. The aftercare intervention, Project ESQYIR-Educating and Supporting inQuisitive Youth In Recovery, utilized text messaging to monitor relapse and recovery processes, provide feedback, reminders, support, and education among youth from SUD specialty settings during the initial 3-month period following treatment completion.

Method: Mediational modeling informed by Baron and Kenny was used to examine the extent to which select recovery processes including participation in extracurricular activities and self-help, were impacted by the texting intervention, and if such processes helped sustain recovery and prevent primary substance use relapse. The data come from a two-group randomized controlled pilot study testing the initial efficacy of a mobile health texting aftercare intervention among 80 youth (M_age= 20.7, SD = 3.5, range: 14–26 years) who volunteered to participate after completing SUD treatment between 2012 and 2013.

Results: Among the two recovery processes examined in the mediational modeling, only involvement in extracurricular activities mediated the effects of the texting aftercare intervention on reductions in primary substance use relapse; not self-help participation.

Conclusion: Findings from this pilot study offer greater understanding about potential recovery-related mechanisms of action of mobile aftercare interventions. Mobile texting was found to promote increased engagement in recovery-related behaviors such as participation in extracurricular activities, which mediated the effects of the mobile aftercare intervention on decreasing primary substance use relapse. Findings suggest mobile approaches may be effective for increasing adherence to a wide-array of recovery behavioral regiments among youth populations challenged by complex behavioral issues.

Keywords:

• Aftercare
• text messaging
• mental health recovery
• substance-related disorders
• recurrence
• adolescent

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content of this paper.

Author contributions

Rachel Gonzales-Castaneda, PhD, MPH conceived and designed the analysis, collected the data, contributed to the data or analysis tools, performed the analysis, interpreted the results and was the primary author writing the text. James R. McKay, PhD, Jane Steinberg, PhD, MPH, Ken C. Winters, PhD, Irene C. Valdovinos, LCSW, MPH, Janna M. Casillas, MA, and Kyle C. McCarthy, BA interpreted the results and contributed to the written text. Chong Ho (Alex) Yu, PhD contributed to the data or analysis tools and performed the analysis.

Additional information

Funding

This study was supported by grant K01DA027754 from the National Institute on Drug Abuse (NIDA).