Table 2.

Studies of Technology-based Interventions for High-risk Drug Users, January 2016 – March 2017

Study Authors/Intervention Name	Study population	Intervention Technologies & Component(s)	Primary Intervention Target	Study Design and N	Intervention Acceptability & Outcomes
Westergaard et al. (2017) [19] mPeer2Peer	HIV-positive adult patients at a HIV clinic, with VL > 1000 copies/mL, 0 clinic visits in the past 6 months, and who were willing to attend a care visit after enrollment; The original criteria of having a substance use disorder was dropped mid-study due to recruitment difficulty.	Mobile application; Based on the IMB model, and consisting of 2 main components: 1) a mobile app with HIV medical care appointments and adherence reminders, laboratory results, clinic contact information, and twice-daily EMA surveys; and 2) supportive peer navigators who communicated with participants in-person and by telephone and text messaging.	Improve HIV healthcare engagement	RCT of 19 patients to receive either mPeer2Peer or SOC; 12 participants participated in follow up qualitative interviews reported in this study.	Only intervention acceptability reported; Participants reported that the mobile app was easy or very easy to use, noting that the frequent medication and appointment reminders, as well as the EMA surveys, helped them to prioritize their healthcare even during chaotic or stressful times.
Guarino et al. (2016) [20]; Check-in Program	Methadone Maintenance Therapy (MMT) Clients in New York City, NY, USA	Mobile application; Functional Analysis and Self-Management Modules	Skills acquisition; illicit drug use	Single arm study of 25 men, who received a reduced SOC treatment + web-based Therapeutic Education System (TES) + Check-in Program. Results compared to prior collected data on MMT SOC.	92% accessed the app at least once; 36% required additional training on how to use the mobile device; High levels of module completion; moderate to high acceptability ratings; higher mean weeks opioid abstinent by urine toxicology (Check-in Program = 4.88 weeks vs MMT SOC = 2.72 weeks)
Himelhoch et al. (2017) [23]; Heart2HAART	HIV-positive adults (18–64) who attend an adherence program in Baltimore, MD, USA with a lifetime history of alcohol or drug use with adherence difficulties	Mobile application to assist with ART adherence among HIV-positive substance users also receiving directly observed treatment; participants responded to randomly selected daily messages about their medication regimen and side effects, as well as answered a weekly mood questionnaire	Unannounced pill count via telephone call.	RCT of 28 participants to receive Heart2HAART (+ DOT + adherence counseling; n=19) or DOT + adherence counseling alone (n=9)	63% reported no difficulty using the intervention; 94% reported reminders did not interfere with daily activities; no group differences in ART adherence at 3-month follow-up.
Gustafson et al. (2016) [33]; A-CHESS	Patients at 3 clinics (1 in Massachusetts and 1 in Wisconsin, USA) who meet the criteria for opioid use disorder of at least moderate severity and taking methadone, injectable naltrexone, or buprenorphine	Mobile application; Based on Self-Determination Theory; Functionality includes a list of preapproved supporters to call, CBT skills, self-monitoring, location tracker alerting participant to high-risk locations, just in time coping supports, counselor dashboard, and HIV/HCV screening	% days using illicit opioids over 24 months	RCT of 440 methadone maintenance therapy patients to medication-assisted treatment (MAT) or MAT + A-CHESS	In Progress
Glasner-Edwards et al. (2016) [34]; TXT-CBT	HIV-positive adults with co-morbid substance use disorders residing in Los Angeles, CA, USA	Text messaging; 12-week CBT intervention targeting ART adherence, risk behaviors, and drug use; messages include medication reminders, CBT skills for drug relapse prevention, HIV risk behavior messages, ART adherence promotion messages, messages to manage cravings in real time, and on-call clinician telephone call when requested through SMS	Unannounced pill count and chart review documentation of VL; urine screen and Timeline Followback for substance use; HIV risk behavior	RCT of 50 participants to receive TXT-CBT or SOC for HIV medical management.	In Progress
Festinger et al. (2016) [35]; CJ-CARE	Adults (of all sero-status) residing in Philadelphia, PA, USA charged with a non-violent felony offence and in need of treatment for drug abuse or dependence.	Three 20-minute computer-based sessions that included a brief risk assessment, review of identified risks, skills building videos, and the development of a risk prevention action plan.	Self-reported HIV testing at 6-, 12- and 18-week post-intervention; number of condoms taken (out of 30) after each intervention session; High risk drug and sexual behavior.	RCT of 200 participants randomized to receive a modified version of the Computer Assessment and Risk Reduction Education (CARE), CJ-CARE, or an attention control.	89% completed all three intervention sessions; significantly higher HIV testing among the CJ-CARE group; mixed findings for condom procurement by group; significant time effect for sex risk scores, but no group effect.
Jongbloed et al. (2016) [36]; Cedar Project WelTel mHealth intervention	HIV-negative young Indigenous people who use illicit drugs in two Canadian cities and are enrolled in the Cedar Project cohort study.	Weekly text messaging to participants, with telephone follow-up from case managers for participants who have a specific problem or need	HIV infection (assessed by a HIV propensity score) at 6 months	RCT of 200 participants randomized to the Cedar Project WelTel mHealth intervention or control (the Cedar Project cohort)	In Progress
Cordova et al. [37] Storytelling 4 Empowerment (S4E)	Adolescents (13–22 years old; 53% binge drinking ≤90 days;47% lifetime drug use) recruited in a clinic waiting room in Southeast Michigan in the US.	Mobile application; Technology-based adaptation of the face-to-face Storytelling for Empowerment (SFE) intervention to be delivered in primary care settings prior to a provider visit; S4E consisted of 2 modules: 1) HIV/STI module; 2) Risk Assessment, Alcohol and Drugs module	Reduce condomless sex, increases HIV testing, and increase skills to resist drug use	Single arm study of 30 adolescent youth who received the S4E intervention and participated in a focus group or an individual interview	Only intervention acceptability reported. Adolescents found the content and format (e.g., videos) of the modules engaging, and stated that receiving the intervention while they wait for their appointment was ideal; however, they noted that the intervention must be brief and protect their confidentiality.