“Counselor in Your Pocket”: Youth and Provider Perspectives on a Mobile Motivational Intervention for Marijuana Use

Abstract

Previous interventions for marijuana use have been administered out of the real-life contexts in which use occurs. In 2010, we interviewed youth aged 15–24 years who use marijuana frequently (n = 8) and providers who treat them (n = 6) on the acceptability and utility of a mobile intervention involving momentary self-monitoring of use-related contexts and responsive motivational messaging following clinic-based brief motivational enhancement therapy. Thematic analysis was used to examine youth and provider perspectives on the mobile intervention. Results suggest that mobile technology is a promising tool for brief interventions to reduce youth marijuana use and warrants further development.

Keywords :

• youth
• marijuana use
• motivational intervention
• mobile health
• momentary intervention

THE AUTHORS

Lydia A. Shrier, M.D., M.P.H., is a senior associate in medicine with the Division of Adolescent/Young Adult Medicine at Boston Children's Hospital and an associate professor of pediatrics at Harvard Medical School. Dr. Shrier's research is focused on the links between mental health and risk behavior in adolescents and young adults. In this work, she uses momentary sampling methods with electronic devices for frequent assessment of and intervention on emotional states, social contexts, and health behaviors in vivo.

Amanda M. Rhoads, B.S., is a graduate student at Vanderbilt University School of Nursing, pursing a Master of Science degree to become a Family Nurse Practitioner. Her research interests include child, adolescent, and family health promotion, as well as prevention of risk behavior within the community.

Meghan E. Fredette, M.D., is a pediatric intern at the Boston Combined Residency Program in Pediatrics (BCRP). While as a medical student at the University of Connecticut, she received a grant from the American Pediatric Society/Society for Pediatric Research (APS/SPR) to assist with this work.

Pamela J. Burke, Ph.D., R.N., F.N.P., P.N.P., is an associate professor of nursing at Northeastern University's Bouvé College of Health Sciences, co-director of Nurse Training for the LEAH (Leadership Education in Adolescent Health) Program at Boston Children's Hospital, adjunct associate professor of social and behavioral sciences at Harvard School of Public Health, and a member of the Motivational Interviewing Network of Trainers (MINT). Her research is focused on risk reduction, and in adolescent reproductive health and substance use.

GLOSSARY

• Affect: Subjective experience of feeling, often qualified as positive or negative.

• Ecological momentary intervention: Treatment that is administered to individuals in real time and in their natural environment.

• Harm reduction: Approach to substance use treatment that focuses on reduction of substance-related harm, which does not necessarily included abstinence from substance use.

• Mobile device: Small, handheld computer, such as a personal digital assistant (PDA) or smartphone (mobile phone with advanced computing capabilities).

• Motivational enhancement therapy: Motivational interviewing treatment that includes assessment and feedback.

• Motivational intervention: Approach to behavior change that focuses on increasing readiness to change, generally using a motivational interviewing style of counseling.

• Motivational interviewing: Counseling style for facilitating behavior change that is (1) collaborative, directive, and person-centered, and (2) focused on eliciting and strengthening motivation for change through guiding individuals to explore and resolve their ambivalence.

• Thematic analysis: Identification and organization of themes and patterns in qualitative material (e.g., interviews), typically by using a coding scheme.