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      Feasibility Study of Using Mobile Phone-Based Experience Sampling to Assess Drug Checking by Opioid Street Drug Users

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          Abstract

          Background:

          To date, evaluations of take-home fentanyl (and/or benzodiazepine) test strip use – the most common form of drug checking services – and potential effects on overdose risk have relied on retrospective accounts for some preceding time period, usually a week to several months. Such accounts, however, are subject to recall and memory biases. This pilot study assessed the feasibility of using experiential sampling to collect daily information in situ on drug checking and associated overdose risk reduction – the primary outcomes - among a sample of street opioid users and compared the results to retrospective reports.

          Methods:

          We recruited 12 participants from a Chicago-based syringe services program. Participants were 18 years of age or older, reported using opioids purchased on the street 3+ times per week in the past month, and had an available Android mobile phone. A phone-based app was programmed to collect daily drug checking information and provided to each participant along with a supply of fentanyl and benzodiazepine test strips and instructions for use over 21 days. Comparable retrospective data were collected via follow-up in-person surveys at the conclusion of daily report collection.

          Results:

          We found a reasonably high rate of daily reporting (63.5%) with participants submitting reports on 160 “person-days” out of 252 possible days. Participants submitted daily reports an average of 13 of 21 days. Reports of test strip use frequency varied between the retrospective and daily reports with a relatively higher percentage of days/time using test strips obtained from the daily reports. We also found higher proportions reporting overdose risk reduction behaviors on the daily reports compared with the retrospective reviews.

          Conclusions:

          We believe the results support using daily experience sampling to collect information on drug checking behaviors among street drug users. Although resource intensive in comparison to retrospective reports, daily reporting potentially provides more detailed information on test strip use and its association with overdose risk reduction and, ultimately, fewer overdoses. Needed are larger trials and validation studies of daily experience sampling to identify the optimum protocol for collecting accurate information on drug checking and overdose risk reduction behavior.

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          Most cited references50

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          The REDCap consortium: Building an international community of software platform partners

          The Research Electronic Data Capture (REDCap) data management platform was developed in 2004 to address an institutional need at Vanderbilt University, then shared with a limited number of adopting sites beginning in 2006. Given bi-directional benefit in early sharing experiments, we created a broader consortium sharing and support model for any academic, non-profit, or government partner wishing to adopt the software. Our sharing framework and consortium-based support model have evolved over time along with the size of the consortium (currently more than 3200 REDCap partners across 128 countries). While the "REDCap Consortium" model represents only one example of how to build and disseminate a software platform, lessons learned from our approach may assist other research institutions seeking to build and disseminate innovative technologies.
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            Ecological Momentary Assessment

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              Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative.

              Data are reported on the background and performance of the K6 screening scale for serious mental illness (SMI) in the World Health Organization (WHO) World Mental Health (WMH) surveys. The K6 is a six-item scale developed to provide a brief valid screen for Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) SMI based on the criteria in the US ADAMHA Reorganization Act. Although methodological studies have documented good K6 validity in a number of countries, optimal scoring rules have never been proposed. Such rules are presented here based on analysis of K6 data in nationally or regionally representative WMH surveys in 14 countries (combined N = 41,770 respondents). Twelve-month prevalence of DSM-IV SMI was assessed with the fully-structured WHO Composite International Diagnostic Interview. Nested logistic regression analysis was used to generate estimates of the predicted probability of SMI for each respondent from K6 scores, taking into consideration the possibility of variable concordance as a function of respondent age, gender, education, and country. Concordance, assessed by calculating the area under the receiver operating characteristic curve, was generally substantial (median 0.83; range 0.76-0.89; inter-quartile range 0.81-0.85). Based on this result, optimal scaling rules are presented for use by investigators working with the K6 scale in the countries studied.
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                Author and article information

                Journal
                Res Sq
                ResearchSquare
                Research Square
                American Journal Experts
                13 January 2023
                : rs.3.rs-2472117
                Affiliations
                [1 ]Jane Addams College of Social Work, University of Illinois Chicago
                [2 ]Community Health Sciences, School of Public Health, University of Illinois Chicago
                [3 ]Chestnut Health Systems, Chicago, Illinois
                Author notes

                Authors’ contributions. All authors read and approved the final manuscript. JAS contributed to the conceptualization; methodology; resources; project administration; investigation; data collection and curation; formal analysis; visualization; writing, reviewing, and editing. ADM oversaw data collection operations at SSP clinics and advised on participant recruitment. MEMA reviewed and edited successive preliminary drafts. She also designed and programmed the experience sampling application. LTR and EP were responsible for all data collection and project logistics within the outreach offices and advised on the accuracy of this part of the manuscript.

                All correspondence regarding this article should be sent to: James A. Swartz, Jane Addams College of Social Work, University of Illinois Chicago, 1040 W. Harrison Street, (MC 309), Chicago, IL 60607, jaswartz@ 123456uic.edu
                Author information
                http://orcid.org/0000-0003-2206-7962
                Article
                10.21203/rs.3.rs-2472117
                10.21203/rs.3.rs-2472117/v1
                9882685
                36711637
                ed4cb5a3-dbb2-4753-9ef9-52977878ae4f

                This work is licensed under a Creative Commons Attribution 4.0 International License, which allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use.

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                Categories
                Article

                drug checking,ecological momentary assessment,mobile ecological momentary assessment,opioid overdose prevention,experience sampling,fentanyl test strips,m-ema

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