Use of a Smartphone Recovery Tool for Latinos with Co-Occurring Alcohol and Other Drug Disorders and Mental Disorders

ABSTRACT

Objective: Addressing alcohol and other drug disorders and other mental disorders among adult Hispanics/Latinos is of critical concern, as they are one of the fastest-growing ethnic groups with a disproportionate rate of disease, mental disorders, and poverty. Although improvement in outcomes is associated with sustained participation in ongoing treatment for co-occurring alcohol and other drug disorders/mental disorders, continuing care is rare for these chronic conditions, especially for Latinos with more limited access to culturally and linguistically competent services. Methods: The evidence-based smartphone recovery application Addiction–Comprehensive Health Enhancement Support System (A-CHESS) was translated and adapted for Spanish-speaking Latinos with alcohol and other drug disorders/mental disorders, thus developing CASA-CHESS to address a high level of need for services, high rates of relapse, and lack of existing culturally competent services for Latinos. Results: Of the 79 Latino clients who completed residential treatment and received a smartphone equipped with CASA-CHESS, 26.6% discontinued using CASA-CHESS and 73.4% remained active for four or more months. CASA-CHESS usage was sustained over the four months across all three tenets of self-determination theory (competence, relatedness, and autonomy), with the most commonly utilized services being relevant to relatedness (e.g., messaging, discussion boards). CASA-CHESS clients demonstrated a similar pattern of usage to A-CHESS clients. Conclusions: Findings illustrate that Spanish-speaking Latinos with alcohol and other drug disorders/mental disorders will use a smartphone application to assist with their recovery, continuing their access to resources, case management, and quality information after leaving residential treatment. Consistent with previous findings, our results also emphasize the importance of social support during the four months post-discharge. Such evidence-based, theory-driven digital interventions may extend access to culturally and linguistically competent services.

KEYWORDS:

• Dual diagnosis
• Latinos
• relapse prevention
• self-determination theory
• smartphones
• mobile health

Acknowledgements

We express our sincere gratitude to the CASA-CHESS clients and staff (Monica Sanchez), research assistants (Christina Rios, Catherine Medina-Perez, Alicia Norton, Helen Tanchez, Christina Korin, Laura Heller, and Rachel Bowers-Sword), and additional CHESS staff (Susan Dinauer, Haile Berhe, and Amy Atwood). We would also like to thank Anthony Chamberas for his support with Tableau.

Preliminary data from this paper were presented at the Addiction Health Services Research 2014 Conference, Boston, Massachusetts, October 15–17, 2014, and the 19th Annual Conference of the Society for Social Work and Research, New Orleans, Louisiana, January 14–18, 2015.

Disclosures

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.

Funding

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