Correctional Service of Canada Pilot Trial of Digital Substance Use Disorder Interventions (PROCESS)

Condition(s) studied

Investigational drug(s) / intervention(s)

Breaking Free Online (BFO): BFO is a digital intervention for substance use problems and commonly co-occurring disorders, such as depression and anxiety. Its structure is based on cognitive behavioural therapy (CBT) and mindfulness techniques. It is self-directed by the individual and can be done on a smartphone, tablet, or online. BFO provides techniques for cognitive restructuring (i.e., reshaping how we view certain situations) and managing and planning for high-risk situations (e.g., minimizing relapse in the face of certain triggers).

Computer-Based Training for Cognitive Behavioural Therapy (CBT4CBT): CBT4CBT is a digital intervention used for substance use problems through the application of CBT techniques. The program involves various video modules, educational games, quizzes, interactive videos, and more. The modules are self-paced and can be done online. Modules will focus on teaching users core skills to avoid substance use and ways of effectively communicating. It discusses various situations where potential triggers could arise, and homework done afterwards allows the user to identify their own personal triggers and individualize how they can minimize these risks.

Study summary

Problems with substance use are common in prisoners. Since most substances are still illegal in Canada, substance use problems can increase the risk for re-incarceration. Although research suggests that treatment may reduce these risks, they are still rarely used in correctional settings. This pilot study will examine the feasibility and usefulness of two digital treatments for substance use problems in individuals recently released from prison. The investigators will compare engagement across both treatments over a 6-month period, and assess the rates of substance use relapse and re-incarceration.

Eligibility

Primary outcome measure(s)

• Feasibility of Digital Treatment Interventions — End of enrollment (~6 months)
  Number of enrolled pilot trial participants, overall and by intervention.
• Overall Substance Use Treatment Engagement — End of enrollment (~6 months)
  The number and percentage of modules, and homework modules, completed.
• Perceived Treatment Utility — End of enrollment (~6 months)
  Mean module and overall treatment rating using a 4-question "Module Utility" scale created by the research team. This is an 11-point Likert scale (0-10) rating the importance, relevance, usefulness, and likeliness to recommend treatment, with higher scores indicating better utility.
• Efficacy of Treatment Module Content — End of enrollment (~6 months)
  Treatment modules include quizzes with several true or false questions (5-10 questions per module) that assess individuals' understanding of the content learned. Overall performance on intervention quizzes in treatment modules will be examined using the total number of questions answered correctly, with higher scores indicating a better understanding of the treatment modules.
• Efficacy of Digital Treatment Interventions for Substance Use — Study follow-up (~3 months post-treatment completion)
  Substance use relapse documented by the CSC staff.
• Efficacy of Digital Treatment Interventions for Recidivism — Study follow-up (~3 months post-treatment completion)
  Institutional readmission documented by the CSC staff.

Trial sites (4)

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