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Reducing Cannabis Use in Young Adults With Psychosis Using iCanChange, a Mobile Health App: Protocol for a Pilot Randomized Controlled Trial (ReCAP-iCC)
Journal article   Open access   Peer reviewed

Reducing Cannabis Use in Young Adults With Psychosis Using iCanChange, a Mobile Health App: Protocol for a Pilot Randomized Controlled Trial (ReCAP-iCC)

Ovidiu Tatar, Amal Abdel-Baki, Anne Wittevrongel, Tania Lecomte, Jan Copeland, Pamela Lachance-Touchette, Stephanie Coronado-Montoya, José Côté, David Crockford, Simon Dubreucq, …
JMIR Research Protocols, Vol.11(11), pp.1-18
2022
DOI: https://doi.org/10.2196/40817
PMCID: PMC9736767
PMID: 36427227
Appears in  Thompson Institute Research Collection
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Reducing Cannabis Use in Young Adults With Psychosis Using iCanChange, a Mobile Health App Protocol for a Pilot Randomized Controlled Trial (ReCAP-iCC)462.41 kBDownloadView
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Abstract

psychological intervention behavioral intervention cannabis misuse cannabis use disorder drug use substance use cannabis marijuana young adult teenager psychosis schizophrenia mental health disorder dual diagnosis telemedicine mobile health mHealth digital health eHealth app smartphone mobile phone randomized controlled tria RCT cognitive behavioral therapy CBT motivational interviewing behavioral management self-management drug substance protocol Interview behavior outcome Other Collaborations Thompson Institute Special Collection UniSC Diversity Area - Disability and Inclusion UniSC Diversity Area - Life Stages
Background: Cannabis use is the most prevalent among adolescents and young adults; frequent consumption is associated with cannabis use disorder (CUD) and psychosis, with a high prevalence (up to 50%) of CUD in individuals with first episode psychosis (FEP). Early Intervention Services (EIS) for psychosis include face to face psychosocial interventions for CUD, because reducing or discontinuing cannabis use improves clinical and health care service use outcomes. However, multiple barriers (eg, staff availability and limited access to treatment) can hinder the implementation of these interventions. Mobile health (mHealth) interventions may help circumvent some of these barriers; however, to date, no study has evaluated the effects of mHealth psychological interventions for CUD in individuals with FEP. Objective: This study describes the protocol for a pilot randomized controlled trial using a novel mHealth psychological intervention (iCanChange [iCC]) to address CUD in young adults with FEP. iCC was developed based on clinical evidence showing that in individuals without psychosis, integrating the principles of cognitive behavioral therapy, motivational interviewing, and behavioral self management approaches are effective in improving cannabis use related outcomes. Methods: Consenting individuals (n=100) meeting the inclusion criteria (eg, aged 18 to 35 years with FEP and CUD) will be randomly allocated in a 1:1 ratio to the intervention (iCC+modified EIS) or control (EIS) group. The iCC is fully automatized and contains 21 modules that are completed over a 12 week period and 3 booster modules available during the 3 month follow up period. Validated self report measures will be taken via in person assessments at baseline and at 6, 12 (end point), and 24 weeks (end of trial); iCC use data will be collected directly from the mobile app. Primary outcomes are intervention completion and trial retention rates, and secondary outcomes are cannabis use quantity, participant satisfaction, app use, and trial recruiting parameters. Exploratory outcomes include severity of psychotic symptoms and CUD severity. For primary outcomes, we will use the chi square test using data collected at week 12. We will consider participation in iCC acceptable if ≥50% of the participants complete at least 11 out of 21 intervention modules and the trial feasible if attrition does not reach 50%. We will use analysis of covariance and mixed effects models for secondary outcomes and generalized estimating equation multivariable analyses for exploratory outcomes. Results: Recruitment began in July 2022, and data collection is anticipated to be completed in July 2024. The main results are expected to be submitted for publication in 2024. We will engage patient partners and other stakeholders in creating a multifaceted knowledge translation plan to reach a diverse audience. Conclusions: If feasible, this study will provide essential data for a larger scale efficacy trial of iCC on cannabis use outcomes in individuals with FEP and CUD.

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