WebBased Intervention for Cannabis Use Sally Rooke PhD

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Web-Based Intervention for Cannabis UseSally
Rooke (PhD) Jan Copeland (Prof)
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Overview

• What is NCPIC?
• Why a cannabis intervention?
• Rationale qualitative and meta-analytical
• Evaluation methodology
• Demonstration
• Pitfalls progress

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Consortium members

• The Centre is comprised of a consortium of
  organisations, with a wide range of expertise.
  These are as follows
• National Drug and Alcohol Research Centre (NDARC)
  as lead partner
• National Drug Research Institute (NDRI)
• Lifeline
• Australian Institute of Criminology (AIC)
• ORYGEN Research Centre (ORYGEN)
• Ted Noffs Foundation (TNF)
• National Centre for Education and Training on
  Addiction (NCETA)

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What does it do?

• Community cannabis information
• Workforce training on the delivery of evidence
  based interventions
• Development of clinical resources and innovative
  interventions

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• Why a cannabis intervention?

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Lifetime Illicit Drug Use 14 years 2007
National Drug Household Survey

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Changes in recent drug use over time 2007
National Drug Household Survey

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Cannabis use across age groups2007 National Drug
Household Survey

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Indicators of problem use among daily smokers

• Difficulty controlling use Use
  10 cones/day

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Rationale

• Most individuals with cannabis use disorders do
  not seek help
• Face-to-face therapy has limited accessibility
  due to factors such as cost, inconvenience, and
  stigmatisation concerns
• Self-help strategies offer a promising solution
  to the difficulties associated with face-to-face
  treatment, and the Internet provides an excellent
  delivery mode for such strategies

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Rationale

• A 2004 qualitative review of web-based SUD
  interventions (Copeland Martin) concluded that
  such an appropriate was promising but the
  evidence-base was extremely thin
• Initial RCTs for depression, panic, PTSD
  obesity were promising
• The web is frequently accessed for alcohol and
  other drug information in addition to e-therapy,
  blogs and discussion sites
• CBT interventions have the strongest evidence
  base and best suited to web delivery

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Rationale

• A meta-analysis examining the efficacy of
  web-based CBT for anxiety and depression found
  large treatment effects for studies with
  therapist support versus small effect sizes for
  those without therapist support (Spek et al.,
  2007)
• A small meta-analysis of 10 studies of computer
  delivered alcohol interventions among college
  students reported a small effect size with
  superior results with face to face component
  (Carey et al., (2007)
• A recent meta-analysis of 35 computer-delivered
  treatments (44 effect sizes with 10, 773
  participants) for alcohol and tobacco use found
  that the treatments had a small average effect
  size with alcohol interventions more effective
  than those for tobacco cessation (Rooke,
  Thorsteinsson, Karpin, Copeland, Allsop, 2009).
  

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Rationale and research objective

• No study has tested the effectiveness of a
  web-based treatment for cannabis use
• The current study aims to recruit 800 individuals
  who want to reduce their cannabis use and are
  willing to participate in an RCT
• Participants will be randomly assigned to
  receive a link to the intervention website or to
  an online factsheet
• The site has taken 8 months to develop and will
  be live by the end of the month

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Web-based intervention

• The intervention uses CBT and MI strategies. Its
  six core modules are
• (1) Feedback and Building Motivation
• (2) Managing Smoking Urges and Withdrawal
• (3) Changing Your Thinking
• (4) Coping Strategies and Skill Enhancement
• (5) Activities and Interpersonal Skills
• (6) Relapse Prevention and Lifestyle Changes

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Web-based intervention

• The website also contains
• a personalised folder for the participant
• blogs from former cannabis users
• quick assist links
• skill-building tasks
• automatically-generated encouragement emails
• several optional extras
• Individuals using the website have the option of
  reading its text or watching a video of an actor
  speaking the text.
• See http//reduce.ncpic.org.au

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Method

• Procedure
• Participants will contact the researcher via
  email and complete the consent form and screening
  questions.
• Eligible participants will be randomly assigned
  to receive a link to the intervention website or
  to an online factsheet.
• The participant will complete the
  pre-intervention assessment before s/he can move
  further into the website.
• Participants in the experimental group will
  receive automatically generated
  reminder/encouragement emails weekly.
• Automatically generated emails will prompt
  participants to complete the post-intervention
  assessment after six weeks, and a followup
  assessment after six months. Participants will
  receive a 25 Coles Myer voucher for completing
  each of these latter assessments.

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Web-based intervention
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Web-based intervention
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Web-based intervention

• Feedback on the individuals progress is provided
  throughout
• Cannabis Use (in Standard Cannabis Units) During
  the Program

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Web-based intervention
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Pitfalls problems

• Triple the development time! ( budget)
• Recruitment strategy requires thought
• Degree of personal contact?
• ???

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Contacts

• Dr Sally Rooke (S.Rooke_at_unsw.edu.au)
• Professor Jan Copeland (J.Copeland_at_unsw.edu.au)
• Website www.ncpic.org.au
• Helpline 1800 304050