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• W4237334294 abstract "<sec> <title>BACKGROUND</title> Misuse of substances is common, can be serious and costly to society, and often goes untreated due to barriers to accessing care. Woebot is a mental health digital solution informed by cognitive behavioral therapy and built upon an artificial intelligence–driven platform to deliver tailored content to users. In a previous 2-week randomized controlled trial, Woebot alleviated depressive symptoms. </sec> <sec> <title>OBJECTIVE</title> This study aims to adapt Woebot for the treatment of substance use disorders (W-SUDs) and examine its feasibility, acceptability, and preliminary efficacy. </sec> <sec> <title>METHODS</title> American adults (aged 18-65 years) who screened positive for substance misuse without major health contraindications were recruited from online sources and flyers and enrolled between March 27 and May 6, 2020. In a single-group pre/postdesign, all participants received W-SUDs for 8 weeks. W-SUDs provided mood, craving, and pain tracking and modules (psychoeducational lessons and psychotherapeutic tools) using elements of dialectical behavior therapy and motivational interviewing. Paired samples t tests and McNemar nonparametric tests were used to examine within-subject changes from pre- to posttreatment on measures of substance use, confidence, cravings, mood, and pain. </sec> <sec> <title>RESULTS</title> The sample (N=101) had a mean age of 36.8 years (SD 10.0), and 75.2% (76/101) of the participants were female, 78.2% (79/101) were non-Hispanic White, and 72.3% (73/101) were employed. Participants’ W-SUDs use averaged 15.7 (SD 14.2) days, 12.1 (SD 8.3) modules, and 600.7 (SD 556.5) sent messages. About 94% (562/598) of all completed psychoeducational lessons were rated positively. From treatment start to end, in-app craving ratings were reduced by half (87/101, 86.1% reporting cravings in the app; odds ratio 0.48, 95% CI 0.32-0.73). Posttreatment assessment completion was 50.5% (51/101), with better retention among those who initially screened higher on substance misuse. From pre- to posttreatment, confidence to resist urges to use substances significantly increased (mean score change +16.9, SD 21.4; <i>P</i>&lt;.001), whereas past month substance use occasions (mean change −9.3, SD 14.1; <i>P</i>&lt;.001) and scores on the Alcohol Use Disorders Identification Test-Concise (mean change −1.3, SD 2.6; <i>P</i>&lt;.001), 10-item Drug Abuse Screening Test (mean change −1.2, SD 2.0; <i>P</i>&lt;.001), Patient Health Questionnaire-8 item (mean change 2.1, SD 5.2; <i>P</i>=.005), Generalized Anxiety Disorder-7 (mean change −2.3, SD 4.7; <i>P</i>=.001), and cravings scale (68.6% vs 47.1% moderate to extreme; <i>P</i>=.01) significantly decreased. Most participants would recommend W-SUDs to a friend (39/51, 76%) and reported receiving the service they desired (41/51, 80%). Fewer felt W-SUDs met most or all of their needs (22/51, 43%). </sec> <sec> <title>CONCLUSIONS</title> W-SUDs was feasible to deliver, engaging, and acceptable and was associated with significant improvements in substance use, confidence, cravings, depression, and anxiety. Study attrition was high. Future research will evaluate W-SUDs in a randomized controlled trial with a more diverse sample and with the use of greater study retention strategies. </sec> <sec> <title>CLINICALTRIAL</title> ClinicalTrials.gov NCT04096001; http://clinicaltrials.gov/ct2/show/NCT04096001. </sec>" @default.
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• W4237334294 date "2020-10-07" @default.
• W4237334294 modified "2023-09-24" @default.
• W4237334294 title "A Therapeutic Relational Agent for Reducing Problematic Substance Use (Woebot): Development and Usability Study (Preprint)" @default.
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• W4237334294 doi "https://doi.org/10.2196/preprints.24850" @default.
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