Impact

Publications & Posters

• Cannabis use is legal for recreational use in more states each year, with a rapidly growing landscape of cannabis products (vapes, flower, edibles) available. Our team developed a novel tool to look at different policy environments, such as increasing tax rates, capping THC potency of products, to understand prospectively the impact of legal cannabis policies on consumer purchase and use behaviors.

• Less than 5% of people with a cannabis use disorder receive any treatment. Our team developed a telehealth-delivered intervention that is aiming to engage and provide care to those who are not currently receiving any cannabis use disorder care. This new treatment focuses on promoting wellness by increasing cannabis-free activities based on each person’s own preferences and goals.

• Dr. Walton published a protocol paper describing a study testing digital health interventions to prevent involvement with risky drinking and violence. The study uses an innovative design called a sequential, multiple assignment, randomized trial (SMART), which using a precision health lens, adjusts intervention dose and content based on response. Specifically, youth (ages 14-20) in the emergency department who self-report recent risky drinking and violent behaviors will be randomly assigned to a telehealth session called SafERteens, with 4-weeks of boosters: 1) Text Messaging (TM), or 2) Remote Health Coach calls (HC). After 4 weeks, intervention response/non-response is determined (e.g., binge drinking or violent behaviors).  Responders are re-randomized to continued intervention condition (e.g., maintenance) or minimized condition (e.g., stepped down). Non-responders are re-randomized to continued condition (e.g., maintenance), or intensified condition (e.g., stepped up). Outcomes are measured at 4 and 8 months. Data analyses are ongoing, with findings informing the content and timing booster interventions to alter risk behavior trajectories and improve health.

• Dr. Walton presented a poster at the Addiction Health Services Research Conference in New York which focused on collaborative work with Drs. Coughlin (PI) and Bonar, as well as Dr. Nahum-Shani affiliated with the Data-science for Dynamic Decision Making (d3C) at ISR, and colleagues from Harvard such as Dr. Murphy. The focus on the poster was describing a newly developed mobile health intervention, which is focused on reducing cannabis use and improving health among emerging adults who are regularly using cannabis. This just-in-time adaptive intervention (JITAI) employs a reinforcement learning algorithm (RL) — an adaptive intervention approach that continually interacts with the participant in real-time to learn to make decisions (e.g., about intervention delivery) to maximize proximal benefits. The study uses an innovative design, called a micro-randomized trial to randomize emerging adults, twice daily (morning and evening), to receive either a mobile-based intervention message or no message. At each of these decision points, an RL algorithm will adjust the probability of delivering a message using prior data to maximize proximal engagement with the mobile intervention. Over 30 days, participants will be prompted to complete twice daily surveys, with assessments weekly, post-intervention, and 2 months post-enrollment. Primary outcomes concern feasibility and acceptability, with findings advancing the field of mobile health to inform future studies.

• Stimulant-involved overdose deaths are increasing in the US. At the same time, stimulant use disorder treatment was increasing prior to the pandemic, but precipitously dropped off at the start of the pandemic. Concerningly, stimulant use disorder treatment has not returned to pre-pandemic levels, pointing to a need to targeted efforts to bring stimulant use disorder treatment to people who could benefit from care.

In press...link to come!

• Preoperative risky alcohol use is one of the most common surgical risk factors. Accurate and early identification of risky alcohol use could enhance surgical safety. Artificial Intelligence-based approaches, such as natural language processing (NLP), provide an innovative method to identify alcohol-related risks from patients' electronic health records (EHR) before surgery. 

• Drs. Lin and Bonar along with their team have published a new paper in Contemporary Clinical Trials describing the innovative protocol for an ongoing randomized controlled trial. Taking a patient-first approach, the team uses electronic health record data and proactive outreach approaches to engage primary care patients living with alcohol use disorders into telehealth treatment. 

• Drs. Walton & Bonar will be presenting their poster titled "Exploring Individual Factors Associated with Risk Levels for Opioid Misuse and Opioid Use Disorder Among Adolescents and Young Adults in the Emergency Department" at the College on Problems of Drug Dependence (CPDD) 86th Annual Scientific Meeting.

Ongoing Projects