Developing a Telehealth + mHealth Cannabis Use Intervention for Young Adults

[Aim 1] Percent of participants assigned to the intervention arm completing the intervention (defined as both MET sessions and any EMI surveys). Benchmark: ≥80%

[Aim 1] Percent of days on which participant responded to at least one survey during the 14 days of EMI. Benchmark: Median of ≥80% across intervention participants

[Aim 1] Satisfaction with intervention measured on the Client Satisfaction Questionnaire-8, an 8-item 4-point scale on which scores range from 8-32, with higher scores indicating greater satisfaction.

Benchmark: ≥80% of participants with a scale score ≥24 (mean item score of ≥3 out 4)

[Aim 1] Measure of acceptability (usability, likability, perceived effect, burden) for each intervention component (2 MET sessions and EMI). Components assessed with an 11- or 12-item 5-point Likert-type scales (1, Strongly Disagree to 5, Strongly Agree) developed for the study. Higher scores indicate greater acceptability.

Benchmark for each scale: ≥80% of participants with mean item score ≥4 out of 5

[Aim 2] Number of patients self-screening per month. Benchmark: ≥13 per month

[Aim 2] Number of patients eligible per month. Benchmark: ≥6 per month

[Aim 2] Number of patients enrolled per month. Benchmark: ≥3 per month

[Aim 2] Percent of participants retained at each assessment time point (3 weeks, 3 months, 6 months, by assigned condition.

Benchmark: ≥80% at each time point

[Aim 3] Number of cannabis use days measured on Timeline Follow-Back (TLFB) calendar

[Aim 3] Number of cannabis use times measured on TLFB calendar

[Aim 3] Number of negative consequences (problems) measured on the 19-item Marijuana Problems Scale

[Aim 1] Working Alliance Inventory - Short Form, 12-items, 5-point Likert-type scale, total scale score and subscale scores (affective bond, perceived agreement on tasks, perceived agreement on goals; 4 items each), participant ("client") and observer versions reported separately and tested for agreement.

Benchmark: ≥80% of participants with total score ≥48 (mean item score ≥4), participant version

[Aim 1] Measure of counselor adherence to MI principles in each MET session, as reported by participant. Sessions assessed with 7- to 9-item 5-point Likert-type scales (Strongly Disagree to Strongly Agree) developed for the study.

Benchmark for each scale: ≥80% of participants with mean item score ≥4 out of 5

[Aim 2] Duration of each study activity (in minutes)

[Aim 3] Symptom count measured by the Composite International Diagnostic Interview - Substance Abuse Module (CIDI-SAM)

[Aim 3] Number of standard THC units (1 unit = 5 mg THC) derived from number of familiar units (joints, vapes, gummies, etc.) x amount per unit (grams, milligrams, or milliliters) x estimated potency (% THC), measured on TLFB calendar.

If unable to calculate standard THC units: Number of familiar units (joints, vapes, gummies, etc.)

[Aim 3] One item each assessing readiness to, importance of, and confidence to change cannabis use, developed and used in our prior research, 11-point Likert-type scale for each. On follow-up, modified items about maintaining behavior if participant reports having started to change behavior but not having achieved change goals, or having changed behavior and achieved goals.

[Aim 3] Kessler Psychological Scale-6 (K6), assessing frequency of experiencing 6 symptoms in the past month on a 5-point Likert-type scale, with coding such that high scores indicate greater psychological distress.

[Aim 3] PROMIS Cognitive Function v.2.0 - Short Form 6a, 6 items, 5-point Likert-type response, measures participant-perceived cognitive deficits in the past 7 days. Age- and gender-weighted T scores, higher T-scores indicating better cognitive function.

[Aim 3] PROMIS Global Health v1.2, a 10-item, 5-point Likert-type response (except pain item 0-10), participant-reported measure of physical, mental, and social health, in general except for past 7 days for emotional problems, fatigue, and pain. Age- and gender-weighted T scores, higher T-scores indicating better quality of life.

[Exploratory Aim] Measure of acceptability (usability, likability, burden), 5 items, 5-point Likert-type scale (1, Strongly Disagree to 5, Strongly Agree), with higher scores indicating greater acceptability

[Exploratory Aim] Number and percent of videos of self-testing completed out of those expected, per participant Number and percent of observations of self-testing during study visit out of those expected, per participant

[Exploratory Aim] Agreement between oral fluid test results (positive/negative) and cannabis use reported on TLFB calendar for the day of testing or the day before testing (use/no use on either day)

[Exploratory Aim] Oral fluid test results for delta-9-tetrahydrocannabinol on 4 consecutive days (all negative = nonuse over 5 days/any positive = use within the 5 days)