Graduate School of Medicine, Department of Psychiatric Nursing, The University of Tokyo, Tokyo, Japan.
JMIR Ment Health. 2016 Jan 6;3(1):e1. doi: 10.2196/mental.4875.
Although drug abuse has been a serious public health concern, there have been problems with implementation of treatment for drug users in Japan because of poor accessibility to treatment, concerns about stigma and confidentiality, and costs. Therapeutic interventions using the Internet and computer technologies could improve this situation and provide more feasible and acceptable approaches.
The objective of the study was to show how we developed a pilot version of a new Web-based cognitive behavioral relapse prevention program with tailored feedback to assist people with drug problems and assessed its acceptance and usability.
We developed the pilot program based on existing face-to-face relapse prevention approaches using an open source Web application to build an e-learning website, including relapse prevention sessions with videos, exercises, a diary function, and self-monitoring. When users submitted exercise answers and their diary, researchers provided them with personalized feedback comments using motivational interviewing skills. People diagnosed with drug dependence were recruited in this pilot study from a psychiatric outpatient ward and nonprofit rehabilitation facilities and usability was evaluated using Internet questionnaires. Overall, website usability was assessed by the Web Usability Scale. The adequacy of procedures in the program, ease of use, helpfulness of content, and adverse effects, for example, drug craving, mental distress, were assessed by original structured questionnaires and descriptive form questions.
In total, 10 people participated in the study and completed the baseline assessment, 60% completed all relapse prevention sessions within the expected period. The time needed to complete one session was about 60 minutes and most of the participants took 2 days to complete the session. Overall website usability was good, with reasonable scores on subscales of the Web Usability Scale. The participants felt that the relapse prevention sessions were easy to use and helpful, but that the length of the videos was too long. The participant who until recently used drugs was satisfied with the self-monitoring, but others that had already maintained abstinence for more than a year felt this activity was unhelpful and were bored tracking and recording information on daily drug use. Feedback comments from researchers enhanced participants' motivation and further insight into the disease. Serious adverse effects caused by the intervention were not observed. Some possible improvements to the program were suggested.
The Web-based relapse prevention program was easy to use and acceptable to drug users in this study. This program will be helpful for drug users who do not receive behavioral therapy. After the pilot program is revised, further large-scale research is needed to assess its efficacy among drug users who have recently used drugs.
尽管药物滥用一直是一个严重的公共卫生问题，但由于治疗药物使用者的可及性差、对污名和保密性的担忧以及成本问题，日本在实施药物治疗方面一直存在问题。使用互联网和计算机技术的治疗干预措施可以改善这种情况，并提供更可行和更可接受的方法。
本研究的目的是展示我们如何开发一种新的基于网络的认知行为复发预防计划的试点版本，该计划具有定制的反馈功能，以帮助有药物问题的人，并评估其接受度和可用性。
我们基于现有的面对面复发预防方法，使用开源网络应用程序构建了一个电子学习网站，包括带有视频、练习、日记功能和自我监测的复发预防课程。当用户提交练习答案和日记时，研究人员使用动机访谈技巧为他们提供个性化的反馈意见。这项试点研究从精神科门诊病房和非营利性康复机构招募了被诊断为药物依赖的人，并使用网络问卷评估了可用性。总体而言，网站可用性通过网络可用性量表进行评估。程序的适当性、易用性、内容的有用性以及药物渴望、精神困扰等不良反应通过原始结构问卷和描述性问题进行评估。
共有 10 人参加了这项研究并完成了基线评估，其中 60%的人在预期时间内完成了所有的复发预防课程。完成一个课程大约需要 60 分钟，大多数参与者需要 2 天时间完成该课程。总体而言，网站的可用性良好，网络可用性量表的子量表得分合理。参与者认为复发预防课程易于使用且有帮助，但视频的长度太长。最近仍在使用药物的参与者对自我监测感到满意，但其他已经保持戒断状态一年以上的参与者认为该活动没有帮助，并且在跟踪和记录每日药物使用信息时感到无聊。研究人员的反馈意见增强了参与者的动机，并进一步深入了解了疾病。没有观察到干预措施引起的严重不良反应。有人提出了一些对该计划的改进建议。
在这项研究中，基于网络的复发预防计划易于使用且被药物使用者接受。该计划将有助于那些未接受行为治疗的药物使用者。在试点计划修订后，需要进一步进行大规模研究，以评估其在近期使用药物的药物使用者中的疗效。
