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Pilot Randomized Trial of MOMENT, a Motivational Counseling-Plus-Ecological Momentary Intervention to Reduce Marijuana Use in Youth

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Pilot Randomized Trial of MOMENT, a Motivational Counseling-Plus-Ecological Momentary Intervention to Reduce Marijuana Use in Youth

Lydia A Shrier et al. Mhealth.

Abstract

Background: Ecological momentary interventions (EMIs) influence behavior in real time, in real life. We evaluated trial feasibility and preliminary efficacy of MOMENT, a counseling-plus-EMI to reduce frequent marijuana use in youth in primary care.

Methods: Primary care patients age 15-24 years using marijuana at least 3 times/week were randomized to MOMENT [motivational enhancement therapy (MET)/smartphone-based momentary assessment/responsive motivational messaging] vs. No-messages (MET/momentary assessment) vs. MET-only. In MOMENT, two MET sessions were followed by 2 weeks of momentary assessment of marijuana use and factors related to use, with motivational messaging displayed after report of marijuana triggers, desire, use, and effort to avoid use. We evaluated study feasibility (recruitment, retention, and response rates; feedback survey responses) and explored intervention effects on marijuana desire and use at three months with linear mixed effects modeling.

Results: Seventy youth [mean (M) =20.7 years, 60% female] were assigned to MOMENT (n=27), No-messages (n=15; assignment suspended to enrich other arms), or MET-only (n=28). Most attrition occurred during baseline, before MET. Of those completing MET session 1, 82% completed their assigned treatment and 79% provided 3-month data. Participants highly rated acceptability; comments reflected changing motivation and behavior. Across arms, participants reported significantly lower marijuana use, desire, and problems at follow-up vs. baseline. Momentary marijuana desire declined more in MOMENT vs. MET-only. Marijuana use following a targeted context or behavior was less likely in MOMENT and No-messages, vs. MET-only.

Conclusions: The MOMENT intervention is feasible to deliver, acceptable, and potentially efficacious in reducing marijuana desire and use among adolescent and young adults in primary care. A larger randomized trial to evaluate efficacy is warranted.

Keywords: Marijuana; adolescents; ecological momentary intervention (EMI); motivational intervention; primary care.

Conflict of interest statement

Conflicts of Interest: Findings were presented in part at the Society for Adolescent Health and Medicine annual meeting, March 2016, Washington, D.C. and the Association of Medical Education and Research in Substance Abuse annual meeting, November 2016, Washington, D.C.

Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
Momentary marijuana desire in each study phase, by study arm.
Figure 3
Figure 3
Proportion of reports of marijuana use within 6 hours after desire, trigger, or report of use or avoiding use in each study phase, by study arm.

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