Ramón de la Fuente Muñiz, National Institute of Psychiatry, Department of Social Sciences in Health, Direction of Epidemiological and Psychosocial Research, Mexico City, Mexico.
JMIR Ment Health. 2016 Sep 29;3(3):e47. doi: 10.2196/mental.6001.
The development of Web-based interventions for substance abuse in Latin America is a new field of interest with great potential for expansion to other Spanish-speaking countries.
This paper describes a project aimed to develop and evaluate the usability of the Web-based Help Program for Drug Abuse and Depression (Programa de Ayuda para Abuso de Drogas y Depresión, PAADD, in Spanish) and also to construct a systematic frame of reference for the development of future Web-based programs.
The PAADD aims to reduce substance use and depressive symptoms with cognitive behavioral techniques translated into Web applications, aided by the participation of a counselor to provide support and guidance. This Web-based intervention includes 4 steps: (1) My Starting Point, (2) Where Do I Want to Be? (3) Strategies for Change, and (4) Maintaining Change. The development of the program was an interactive multistage process. The first stage defined the core structure and contents, which were validated in stage 2 by a group of 8 experts in addiction treatment. Programming of the applications took place in stage 3, taking into account 3 types of end users: administrators, counselors, and substance users. Stage 4 consisted of functionality testing. In stage 5, a total of 9 health professionals and 20 drug users currently in treatment voluntarily interacted with the program in a usability test, providing feedback about adjustments needed to improve users' experience.
The main finding of stage 2 was the consensus of the health professionals about the cognitive behavioral strategies and techniques included in PAADD being appropriate for changing substance use behaviors. In stage 5, the health professionals found the functionalities easy to learn; their suggestions were related to the page layout, inclusion of confirmation messages at the end of activities, avoiding "read more" links, and providing feedback about every activity. On the other hand, the users said the information presented within the modules was easy to follow and suggested more dynamic features with concrete instructions and feedback.
The resulting Web-based program may have advantages over traditional face-to-face therapies owing to its low cost, wide accessibility, anonymity, and independence of time and distance factors. The detailed description of the process of designing a Web-based program is an important contribution to others interested in this field. The potential benefits must be verified in specific studies.
International Standard Randomized Controlled Trial Number (ISRCTN): 25429892; http://www.controlled-trials.com/ISRCTN25429892 (Archived by WebCite at http://www.webcitation.org/6ko1Fsvym).
在拉丁美洲，开发基于网络的物质滥用干预措施是一个新的研究领域，具有向其他西班牙语国家扩展的巨大潜力。
本文描述了一个旨在开发和评估基于网络的药物滥用和抑郁帮助计划（Programa de Ayuda para Abuso de Drogas y Depresión，PAADD）的可用性的项目，并为未来基于网络的计划的开发构建了一个系统的参考框架。
PAADD 旨在通过翻译为 Web 应用程序的认知行为技术来减少物质使用和抑郁症状，并由辅导员提供支持和指导。这个基于网络的干预措施包括 4 个步骤：（1）我的起点，（2）我想去哪里？（3）改变策略，和（4）维持改变。该程序的开发是一个互动的多阶段过程。第一阶段定义了核心结构和内容，第二阶段由 8 名成瘾治疗专家组成的小组对其进行了验证。应用程序的编程在第三阶段进行，考虑了 3 种类型的最终用户：管理员、辅导员和物质使用者。第四阶段包括功能测试。第五阶段，共有 9 名卫生专业人员和 20 名正在接受治疗的药物使用者自愿参与了该程序的可用性测试，提供了有关改善用户体验所需的调整的反馈。
第二阶段的主要发现是卫生专业人员对包括在 PAADD 中的认知行为策略和技术适合改变物质使用行为达成了共识。在第五阶段，卫生专业人员发现功能易于学习；他们的建议涉及页面布局、在活动结束时添加确认消息、避免“阅读更多”链接，以及提供关于每个活动的反馈。另一方面，用户表示模块内呈现的信息易于遵循，并建议更具动态性的功能，提供具体的说明和反馈。
由于其低成本、广泛的可及性、匿名性以及时间和距离因素的独立性，基于网络的程序可能比传统的面对面治疗具有优势。设计基于网络的程序过程的详细描述是对该领域感兴趣的人的重要贡献。潜在的好处必须在具体研究中得到验证。
国际标准随机对照试验编号（ISRCTN）：69134104；http://www.controlled-trials.com/ISRCTN69134104（由 WebCite 存档于 http://www.webcitation.org/6ko1Fsvym）。
