Optimizing a just-in-time adaptive intervention to increase uptake of chemsex harm reduction services in MSM: a micro-randomized trial

Active Project Grant Awarded Last action

Award ID
R01DA061661
Recipient
Awarding agency
Obligated
$5,220,457

Award facts

Assistance listing
93.279 Drug Use and Addiction Research Programs
Completion date 48% complete
Place of performance
Storrs, CT 06269, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
Chemsex, the use of psychoactive drugs before or during sexual activity, is a growing public health concern due to its association with increased HIV transmission and other harms, particularly among men who have SEX with men (MSM). Current estimates suggest that 9-26% of malaysian MSM participate in chemsex, contributing to recent increases in HIV prevalence. In the absence of evidence-based interventions for chemsex, harm reduction strategies remain the MOST impactful approach to mitigating chemsex-associated harms. However, getting harm reduction interventions to MSM who engage in chemsex is a major challenge due to the spontaneous and dynamic nature of chemsex risk. Just-in-time adaptive interventions (JITAIS) delivered via smartphones represent a powerful strategy to deliver support by deploying tailored intervention when needed. Specifically, apps that incorporate jitai can be more effective than traditional APP-based interventions by addressing the dynamic nature of chemsex risk and capitalizing on users' changing states of vulnerability (heightened chemsex risk behaviors) and receptivity (willingness to engage in intervention), while also minimizing user burden, disruption, and habituation. Although JITAIS are increasingly being used in domains such as addiction, mental health disorders, physical inactivity, and obesity, research on JITAIS to address chemsex harm reduction is non-existent. In response, we developed jomcare, a smartphone APP-based chemsex harm reduction jitai, that uses a machine learning algorithm to determine risk and deliver tailored support as needed. Jomcare includes several `pull' and `push' intervention components based on the information-motivation-behavioral skills (IMB) model, and has demonstrated high feasibility and utility in our recent pilot work. However, little is known to guide which intervention components should be delivered in specific contexts to achieve maximum benefit, thus indicating the need to optimize jomcare. Framed by the multiphase optimization strategy (MOST) and building on our formative work, we will optimize jomcare using a micro-randomized trial (MRT) to evaluate: I) which theory-driven intervention components are efficacious in reducing chemsex risk behaviors; and II) which contexts influence the efficacy of jomcare. Specifically, we will conduct a 90-day MRT of the jomcare jitai among 482 chemsex-involved malaysian MSM. Participants will be randomized twice daily via the APP to receive: I) no prompt; II) a generic engagement prompt; or III) one of three IMB model-based engagement prompts. The specific aims of this application include: I) evaluate the effects of any intervention (i.e., theory-driven or generic engagement prompts) versus no intervention on chemsex risk behaviors (proximal outcomes) at subsequent emas following randomization; II) compare the effects of theory-driven and generic engagement prompts on proximal outcomes; and III) examine contextual moderators of intervention on proximal outcomes.

Transactions

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Subawards

Subrecipient Amount Awarded
University Of Malaya Optimizing a Just-in-Time Adaptive Intervention to Increase Uptake of Chemsex Harm Reduction Services in MSM: A Micro-randomized Trial $69,846
Regents Of The University Of Michigan Dr. Nahum-Shani will collaborate with Dr. Shrestha at the University of Connecticut on developing and testing the proposed JomPrEP+ intervention - an… $95,196
Yale Univ Dr. Jeffrey Wickersham will serve as the principal investigator (Yale) on this MPI application. During the active period of this research, Dr. Wickersham will… $747,252
University Of Malaya Optimizing a Just-in-Time Adaptive Intervention to Increase Uptake of Chemsex Harm Reduction Services in MSM: A Micro-randomized Trial $67,093
The Ohio State University $61,782
The University Of Texas Health Science Center At Tyler responsible for developing machine learning algorithms for the prediction of stimulant use, and use predictive modeling to analyze, visualize the data… $108,688

Quick answers

Who received award R01DA061661?

R01DA061661 was awarded to University Of Connecticut by National Institute on Drug Abuse (National Institutes of Health) on July 15, 2024.

How much is award R01DA061661 worth?

$5,220,457 has been obligated on R01DA061661.

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