Reilly Rachel, McKetin Rebecca, Barzi Federica, Degan Tayla, Ezard Nadine, Conigrave Katherine, Butt Julia, Roe Yvette, Wand Handan, Quinn Brendan, Longbottom Wade, Treloar Carla, Dunlop Adrian, Ward James
Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, Australia.
School of Psychology, University of Adelaide, Adelaide, Australia.
J Med Internet Res. 2025 Feb 28;27:e58341. doi: 10.2196/58341.
Digital interventions can help to overcome barriers to care, including stigma, geographical distance, and a lack of culturally appropriate treatment options. "We Can Do This" is a web-based app that was designed with input from cultural advisors and end users to support Aboriginal and Torres Strait Islander people seeking to stop or reduce their use of methamphetamine and increase psychosocial well-being.
This study aimed to evaluate the effectiveness of the "We Can Do This" web-based app as a psychosocial treatment for Aboriginal and Torres Strait Islander people who use methamphetamine.
The web app was evaluated using a randomized waitlist controlled parallel group trial. Participants were Aboriginal and Torres Strait Islander people aged 16 years or older who self-identified as having used methamphetamine at least weekly for the past 3 months. Participants were randomized on a 1:1 ratio to receive either access to the web-based app for 6 weeks or a waitlist control group. Both groups received access to a website with harm minimization information. The primary outcome was days of methamphetamine use in the past 4 weeks assessed at 1, 2, and 3 months post randomization. Secondary outcomes included severity of methamphetamine dependence (Severity of Dependence Scale [SDS]), psychological distress (Kessler 10 [K10]), help-seeking behavior, and days spent out of role due to methamphetamine use.
Participants (N=210) were randomized to receive either access to the web-based app (n=115) or the waitlist control condition (n=95). Follow-up was 63% at 1 month, 57% at 2 months, and 54% at 3 months. There were no significant group differences in days of methamphetamine use in the past 4 weeks at 1 the month (mean difference 0.2 days, 95% CI -1.5 to -2), 2 months (mean difference 0.6 days, 95% CI -1 to 2.4 days) or 3 months (mean difference 1.4 days, 95% CI -0.3 to 3.3 days) follow-up. There were no significant group differences in K10 scores, SDS scores, days out of role, or help-seeking at any of the 3 follow-up timepoints. There was poor adherence to the web-based app, only 20% of participants in the intervention group returned to the web-based app after their initial log-in. Participants cited personal issues and forgetting about the web-based app as the most common reasons for nonadherence.
We found poor engagement with this web-based app. The web-based app had no significant effects on methamphetamine use or psychosocial well-being. Poor adherence and low follow-up hindered our ability to accurately evaluate the effectiveness of the web-based app. Future web-based apps for this population need to consider methods to increase participant engagement.
Australian New Zealand Clinical Trials Registry ACTRN12619000134123p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376088.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/14084.
数字干预有助于克服医疗保健障碍，包括耻辱感、地理距离以及缺乏符合文化背景的治疗选择。“我们能做到”是一款基于网络的应用程序，在文化顾问和最终用户的参与下设计而成，旨在支持寻求停止或减少甲基苯丙胺使用并提高心理社会幸福感的原住民和托雷斯海峡岛民。
本研究旨在评估“我们能做到”这款基于网络的应用程序作为针对使用甲基苯丙胺的原住民和托雷斯海峡岛民的心理社会治疗方法的有效性。
使用随机候补名单对照平行组试验对该网络应用程序进行评估。参与者为16岁及以上的原住民和托雷斯海峡岛民，他们自我认定在过去3个月中至少每周使用一次甲基苯丙胺。参与者按1:1的比例随机分组，一组可使用该基于网络的应用程序6周，另一组为候补名单对照组。两组均可访问提供危害最小化信息的网站。主要结局是在随机分组后1、2和3个月时评估的过去4周内甲基苯丙胺使用天数。次要结局包括甲基苯丙胺依赖严重程度（依赖严重程度量表[SDS]）、心理困扰（凯斯勒10项量表[K10]）、寻求帮助行为以及因使用甲基苯丙胺而无法履行正常职责的天数。
参与者（N = 210）被随机分配接受访问基于网络的应用程序（n = 115）或候补名单对照条件（n = 95）。1个月时随访率为63%，2个月时为57%，3个月时为54%。在1个月（平均差异0.2天，95%CI -1.5至-2）、2个月（平均差异0.6天，95%CI -1至2.4天）或3个月（平均差异1.4天，95%CI -0.3至3.3天）随访时，两组在过去4周内甲基苯丙胺使用天数方面无显著差异。在3个随访时间点中的任何一个时间点，两组在K10得分、SDS得分、无法履行正常职责的天数或寻求帮助方面均无显著差异。对基于网络的应用程序的依从性较差，干预组中只有20%的参与者在首次登录后返回该基于网络的应用程序。参与者提到个人问题和忘记该基于网络的应用程序是不依从的最常见原因。
我们发现对这款基于网络的应用程序的参与度较低。该基于网络的应用程序对甲基苯丙胺使用或心理社会幸福感没有显著影响。依从性差和随访率低阻碍了我们准确评估该基于网络的应用程序有效性的能力。未来针对该人群的基于网络的应用程序需要考虑提高参与者参与度的方法。
澳大利亚新西兰临床试验注册中心ACTRN12619000134123p；https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376088。
国际注册报告识别号（IRRID）：RR2 - 10.2196/14084。
