scholarly journals Co-designing a Mobile Gamified Attention Bias Modification Intervention for Substance Use Disorders: Participatory Research Study

10.2196/15871 ◽  
2019 ◽  
Vol 7 (10) ◽  
pp. e15871 ◽  
Author(s):  
Melvyn Zhang ◽  
Sandor Heng ◽  
Guo Song ◽  
Daniel SS Fung ◽  
Helen E Smith
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Health Care Professionals ◽  
Attention Bias ◽  
Second Phase ◽  
Attention Bias Modification ◽  
The Impact ◽  
Bias Modification ◽  
Modification Intervention

Background Advances in experimental psychology have highlighted the need to modify underlying automatic cognitive biases, such as attentional biases. The effectiveness of bias modification has been well studied for substance use disorders. With recent advances in technology, it is now possible to work outside the laboratory with Web-based and mobile-based attention bias interventions. Gamification technologies might also help diminish the repetitiveness of the task and increase the intrinsic motivation to train. The inconsistent findings of the impact of gaming on the effectiveness of mobile interventions call for further work to better understand the needs of patients (users) and health care professionals. Objective The aim of this study was to involve patients, together with health care professionals, in the design of a gamified mobile attention bias modification intervention for substance use disorders. Methods The participatory design research method adopted is that of a user-oriented design approach in the form of a future workshop. In the first phase of the workshop, participants shared their critique of an attention bias modification intervention. In the second phase of the workshop, participants were asked to brainstorm features. Participants were also shown gamification approaches and asked to consider if gaming elements could enhance the existing app. In the last phase, participants were asked to sketch a new prototype. Results Three co-design workshops were conducted with health care professionals, inpatients, and outpatients. There were 20 participants, consisting of 10 health care professionals and 10 patients. When asked to identify the limitations in the existing app, common issues identified were those of the design, visual probe task, and the included images. Outpatients were also concerned with the safety of administration of the intervention. In the brainstorming sessions, health care professionals made recommendations as to how the stimulus, the mechanism of responding, and the presentation of the scores could be enhanced. Inpatient participants recommended the addition of functionalities, such as information on the harms associated with the substance use, and for there to be enhancements in the design, images, and task. Outpatient participants perceived a need to improve the images and presentation of the results and recommended the inclusion of gaming features. There were differences in opinion on the inclusion of gaming features, as only health care professionals endorsed their inclusion. In the last phase of the workshop, participants were tasked with the conceptualization of prototypes, and the commonality in the design was for a gradual shortening of the interval for stimulus/image presentation. Conclusions The results from this research will guide the development of an app that meets the specific needs of patients and is still based on a pre-existing validated task paradigm.  

scholarly journals A Smartphone Attention Bias Intervention for Individuals With Addictive Disorders: Protocol for a Feasibility Study (Preprint)

2018 ◽  
Author(s):  
Melvyn Zhang ◽  
Jiangbo Ying ◽  
Syidda B Amron ◽  
Zaakira Mahreen ◽  
Guo Song ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Feasibility Study ◽  
Attention Bias ◽  
Mobile Technologies ◽  
Attentional Biases ◽  
Attention Bias Modification ◽  
Addictive Disorders ◽  
Bias Modification ◽  
Modification Intervention

BACKGROUND Substance use disorders are highly prevalent globally. Relapse rates following conventional psychological interventions for substance use disorders remain high. Recent reviews have highlighted attentional and approach or avoidance biases to be responsible for multiple relapses. Other studies have reported the efficacy of interventions to modify biases. With advances in technologies, there are now mobile versions of conventional bias modification interventions. However, to date, no study has evaluated bias modification in a substance-using, non-Western sample. Existing evaluations of mobile technologies for the delivery of bias interventions are also limited to alcohol or tobacco use disorders. OBJECTIVE This study aims to examine the feasibility of mobile-based attention bias modification intervention among treatment-seeking individuals with substance use and alcohol use disorders. METHODS This is a feasibility study, in which inpatients who are in their rehabilitation phase of clinical management will be recruited. On each day that they are in the study, they will be required to complete a craving visual analogue scale and undertake both a visual probe-based assessment and and modification task in a smartphone app . Reaction time data will be collated for the computation of baseline attentional biases and to determine whether there is a reduction of attentional bias across the interventions. Feasibility will be determined by the number of participants recruited and participants’ adherence to the planned interventions up until the completion of their rehabilitation program and by the ability of the app in detecting baseline biases and changes in biases. Acceptability of the intervention will be assessed by a short questionnaire of users’ perceptions of the intervention. Statistical analyses will be performed using SPSS version 22.0, while qualitative analysis of the perspectives will be performed using NVivo version 10.0. RESULTS This study was approved by the National Healthcare Group Domain Specific Research Board, with approval number (2018/00316). Results will be disseminated by means of conferences and publications.Currently, we are in the process of recruitment for this study. CONCLUSIONS To the best of our knowledge, this is the first study to evaluate the feasibility and acceptability of a mobile attention bias modification intervention for individuals with substance use disorders. The data pertaining to the feasibility and acceptability are undoubtedly crucial because they imply the potential use of mobile technologies in retraining attentional biases among inpatients admitted for medical-assisted detoxification and rehabilitation. Participants’ feedback pertaining to the ease of use, interactivity, and motivation to continue using the app is crucial because it will determine whether a codesign approach might be warranted to design an app that is acceptable for participants and that participants themselves would be motivated to use. INTERNATIONAL REGISTERED REPOR PRR1-10.2196/11822

scholarly journals Codesigning a mobile gamified attention bias modification intervention: research protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031897
Author(s):  
Melvyn WB Zhang ◽  
Sandor Heng ◽  
Guo Song ◽  
Daniel Shuen Sheng Fung ◽  
Helen Smith
Keyword(s):  
Participatory Design ◽  
Design Research ◽  
Healthcare Professionals ◽  
Cognitive Biases ◽  
Attention Bias ◽  
Second Phase ◽  
Attention Bias Modification ◽  
Ethical Approval ◽  
Bias Modification ◽  
Modification Intervention

IntroductionAdvances in experimental psychology has highlighted the need to modify underlying automatic cognitive biases, such as attentional biases. While prior research has documented the effectiveness of cognitive bias modification, such interventions tend to be highly repetitive and individuals lack motivation to train over time. Participatory action research methods have been more widely applied in psychiatry to help design interventions that are of relevant to key stakeholders and end users. This study aimed to involve both healthcare professionals and patients in the joint codesign of a gamified mobile attention bias modification intervention.Methods and analysisThe participatory design research method adopted is that of a use-oriented design approach, in the form of a future workshop. 20 participants, comprising 10 healthcare professionals, 5 inpatients and 5 outpatients will be recruited to participate in three separate codesign workshops. In the first phase of the workshop, the participants share their critique of an attention bias modification intervention. In the second phase of the workshop, participants are asked to brainstorm features. The participants are also shown gamification approaches and are asked to consider if gaming elements could enhance the existing application. In the last phase, the participants are asked to sketch a new prototype.Ethics and disseminationEthical approval has been obtained from the National Healthcare Group’s Domain Specific Research Board (approval number 2018/01363). The findings arising from this study will be disseminated by means of conferences and publications.

Lessons Learnt from the conduct of a Pilot Study of a Codesigned Mobile Attention Bias Modification Intervention during the COVID-19 Pandemic (Preprint)

2020 ◽  
Author(s):  
Melvyn Zhang ◽  
Syidda Amron ◽  
Zaakira Mahreen ◽  
Song Guo ◽  
Daniel SS Fung ◽  
...  
Keyword(s):  
Substance Use ◽  
Pilot Study ◽  
Substance Use Disorders ◽  
Randomised Trial ◽  
Attention Bias ◽  
Small Sample ◽  
Attentional Biases ◽  
Management Service ◽  
Attention Bias Modification ◽  
Bias Modification

BACKGROUND Substance use disorders are prevalent globally, that of opioid use disorders. Conventional treatment involves a combination of both pharmacological and psychological approaches. With advances in experimental psychology, there is now a better understanding of attentional biases in substance use disorders. Prior meta-analytical review has highlighted the existence of robust attentional biases amongst opioid using individuals. To date, there remains limited evaluation of bias modification amongst an Asian cohort of participants. Whilst there has been attempts to better the conventional methods of assessment through co-design, such co-designed application has yet to be evaluated. OBJECTIVE The primary objective of this pilot randomised trial was to refine the intended processes of the definitive study (i.e. the recruitment of participants, the process of randomisation into two separate intervention arms, and the administration of the intervention). METHODS The study design was that of a non-blinded randomised controlled trial. Participants were allocated to receiving either the conventional attention bias modification task or the newly designed co-designed task by means of simple randomisation. The study was conducted on the inpatient unit at the National Addictions Management Service, Institute of Mental Health Singapore. Convenience sampling was used to recruit participants over a period of 12 months, with all participants being screened for the presence of baseline biases. On each day of the intervention, participants must undertake both a bias assessment and modification task. RESULTS Over a period of 4 months, a total of 12 participants were invited to participate, of which 4 declined, thus leaving 8 participants who consented to participate. The study was terminated early because of the COVID-19 Pandemic. Of these 8 potential participants, only 3 screened positive. There was a 66.7% attrition rate as two of the 3 participants completed the planned interventions. CONCLUSIONS Our pilot study has provided preliminary evidence of the feasibility of the planned methods, despite the small sample size. Several findings arising from this current pilot (such as there being an absence of baseline biases in some participants) have resultant implications when planning the definitive randomised trial.

Attitude of Health Care Professionals Toward Patients With Substance Use Disorders

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Dalia A.M. Mahmoud, ◽  
Mona M. El Shiekh, ◽  
Amira R. Kirolos, ◽  
Yomna A. El Hawary
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Health Care Professionals

scholarly journals Substance use Treatment and Harm Reduction Services for Migrants and Refugees in the COVID-19 Pandemic: Findings from a Global Survey

2020 ◽  
Author(s):  
Cornelis De Jong ◽  
Ali Farhoudian ◽  
Mehrnoosh Vahidi ◽  
Mohsen Ebrahimi ◽  
Hamed Ekhtiari ◽  
...  
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Substance Use Disorders ◽  
Mental Health Problems ◽  
World Health ◽  
Substance Use Treatment ◽  
Second Phase ◽  
Addiction Medicine ◽  
Global Survey ◽  
The Impact

Abstract Migrants and refugees are considered vulnerable to mental health problems and substance use disorders; and may be particularly affected by service disruptions associated with the COVID-19 pandemic The International Society of Addiction Medicine (ISAM) ran a multi-phased global survey among clinicians and health professional that are actively working in the field of addiction medicine to investigate the impact of the COVID-19 pandemic on substance use and related services. In March 2020, the first month after the announcement of the pandemic by the World Health Organization, 177 informants from 77 countries took part in the global survey, and only 12.9% of them reported their countries’ substance use treatment and harm reduction services for the migrants and refugees with substance use disorders continued as usual. In May 2020, 11.7% of respondents of the second phase reported that the services for refugees and migrants improved in comparison to March 2020; 11.7% reported that these services in their country discontinued. Results suggest that refugee and migrants access to treatment and harm reduction services has been reduced as a result of COVID-19. It can be concluded that it is crucial to improve the visibility of migrants’ needs and exploit appropriate interventions for those with substance use disorders.

Codesigned Gamified Attention Bias Modification for Individuals with Opioid Use Disorder: Study Protocol of a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Melvyn Zhang ◽  
Daniel SS Fung ◽  
Helen Elizabeth Smith
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Attention Bias ◽  
Attentional Biases ◽  
Opioid Use ◽  
Attention Bias Modification ◽  
Randomized Controlled ◽  
Opioid Use Disorders ◽  
Bias Modification ◽  
Modification Intervention

UNSTRUCTURED Introduction Substance use disorders are prevalent globally. In 2019, there has been a large increase in individuals abusing opioids; a 56% increment from previous estimates, and this led to the World Health Organization declaring there being an Opioid epidemic. Locally, in Singapore, Opioids are also highly abused. The recent advances in experimental psychology has led to there being better understanding of automatic, unconscious processes, such as that of attentional biases. Prior research has demonstrated there being robust attentional biases amongst individuals diagnosed with opioid use disorders; and even those who are maintained on methadone maintenance therapy. To date, there remains no prior studies that have evaluated the effectiveness of bias modification amongst Asian individuals, and amongst a cohort of participants with opioid use disorders. No prior evaluations have evaluated the effectiveness of a codesigned mobile attention bias modification intervention. Given this, this current study investigates the effectiveness of the codesigned intervention as compared to the conventional intervention in reducing the magnitude of the attentional biases, where effectiveness is defined as a substantial significant reduction in the magnitude of attentional biases (when comparing the magnitude at baseline and that at the end of the intervention). Methods and Analysis This proposed study is a non-blinded randomized controlled trial, comparing the codesigned attention bias modification intervention against the conventional intervention. Prior to randomization, all participants will be assessed to determine if they are eligible and if they have underlying positive baseline biases. This study uses a 2 (Intervention: codesigned versus conventional) x 2 (time: baseline, completion of intervention) design. Power computation reveals that 162 participants per arm are required, considering a 65% attrition rates (for participants without baseline biases). Participants enrolled into this trial are either randomized into receiving the conventional intervention or the codesigned intervention. Ethics and Dissemination We are in the process of seeking extramural funding. Once funding has been secured, we will apply for ethical approval from the National Healthcare Group’s Domain Specific Research Board. The results arising from the study will be disseminated by conferences and research publications.

Development of a co-designed gamified attention bias modification app for individuals with opioid use disorder

2020 ◽  
pp. 1-6
Author(s):  
Melvyn W.B. Zhang ◽  
Sandor Heng ◽  
Guo Song ◽  
Daniel S.S. Fung ◽  
Helen E. Smith
Keyword(s):  
Cognitive Bias ◽  
Therapeutic Option ◽  
Attention Bias ◽  
Cognitive Bias Modification ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Attention Bias Modification ◽  
Prior Review ◽  
Bias Modification ◽  
Modification Intervention

BACKGROUND: The advances in experimental psychology in the last decade have led to a greater understanding of cognitive bias, and the investigation of cognitive bias modifications as a therapeutic option. Whilst conventionally such interventions are delivered in a laboratory, technological advances are changing the potential modes of delivery of these interventions. Whereas mobile delivery of interventions might seem to increase accessibility and encourage compliance, this might not be the case for cognitive bias modification interventions. To reduce boredom, researchers have investigated whether gamification of the task could help reduce repetitiveness, and the diminished motivation that participants had over time. In a prior review of cognitive bias modification interventions, a collaboration between academics and developers was recommended to ensure that the developed product is evidence-based. With the increased recognition of the importance of participatory action research, participants could better help conventional intervention to meet their needs. OBJECTIVE: The aim of this article was to describe the iterative steps in the conceptualization of the co-designed gamified cognitive bias modification intervention for individuals with opioid use disorders. METHODS AND RESULTS: A multidisciplinary team worked through the differences in the perspectives offered by healthcare professionals and patient participants, and jointly worked with a developer to conceptualize a new co-designed gamified attention bias modification intervention. The methods shared in this article could be considered and applied to future conceptualization of co-designed interventions.

Substance Use Disorders in Health Care Professionals

2010 ◽  
pp. 1375-1398 ◽  
Author(s):  
George A. Kenna ◽  
Jeffrey N. Baldwin ◽  
Alison M. Trinkoff ◽  
David C. Lewis
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Health Care Professionals
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