Ava A Jones
University of Houston
Co-Authors: Pamella Nizio1, Tzuan A Chen1, Julia D Buckner2, Brooke Y Redmond1, Michael S Businelle3, Marshall K Cheney3, Ezemenari M Obasi4, Michael J Zvolensky1, Lorra Garey1
1University of Houston, 2Louisiana State University, 3University of Oklahoma, 4Wayne State University
Background: African American/Black (hereafter referred to as Black) adults face significant cannabis-related health disparities, including more frequent cannabis use and higher rates of Cannabis Use Disorder (CUD) relative to non-Hispanic/Latinx White adults. There is a need for interventions that are accessible, culturally tailored, and capable of addressing the unique needs of Black adults with CUD.
Objective: The current study aimed to evaluate the feasibility, utilization, acceptability, and initial efficacy of a culturally tailored mobile intervention (Culturally Tailored-Mobile Integrated Cannabis and Anxiety Reduction Treatment [CT-MICART]), integrating false safety behavior (FSB) reduction or elimination skills for cannabis use reduction or cessation among Black adults with probable CUD.
Methods: Participants (N= 50, 50.0% female, Mage= 42.9 years, SD= 10.7) were randomized to 1) CT-MICART+ ecological momentary assessments (EMAs) or 2) EMA-only for 6-weeks. Feasibility outcomes included enrollment, retention, and EMA completion rates, and utilization was assessed via app feature engagement. Acceptability was evaluated via self-reported app satisfaction, and preliminary efficacy was examined by testing whether CT-MICART was associated with greater reductions in cannabis use.
Results: Results demonstrated strong feasibility, with an EMA completion rate of 75.64% in the CT-MICART+EMA condition vs. 65.80% in the EMA-only condition and a follow-up assessment completion rate of 80% (44% in the CT-MICART+EMA condition vs. 36% in the EMA-only). App engagement and utilization were high, as participants in the CT-MICART+EMA condition accessed on-demand features 3,351 times. Additionally, acceptability was positive, with a System Usability Scale (SUS) mean of 74.06 (SD= 18.02) among the 40 participants who completed the follow-up assessment. There was a statistically significantly higher SUS acceptability in the CT-MICART+EMA condition (M= 80.11, SD= 15.36) compared to EMA-only (M= 66.67, SD= 18.65; t(38)= 2.50, p= .001, Cohen’s d= 0.80). Preliminary efficacy analyses indicated statistically significant lower cannabis use frequency rates (γ= -2.07, SE= 0.22, p< .001, R2= .18) and less time spent under the influence of cannabis (γ= -.56, SE= 0.10, p< .001, R2= .18) in the CT-MICART+EMA condition compared to the EMA-only condition.
Conclusions: Findings provide initial evidence for the feasibility, acceptability, and efficacy of CT-MICART+EMA for cannabis use frequency and quantity among Black adults with probable CUD. Larger scale studies are necessary to test whether CT-MICART, via targeting FSBs and integrating culturally relevant intervention components, holds potential as a scalable solution to support cannabis use goals for this underserved population.