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Rural and Urban Variation in Mobile Health Substance Use Disorder Treatment Mechanisms and Efficacy.

Jeremy Mennis1, J Douglas Coatsworth2, Michael Russell3

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Mobile health (mHealth) effectively treats cannabis use disorder (CUD) in young adults by improving protective behaviors and readiness to change. This approach shows similar efficacy in rural and urban settings, addressing key treatment barriers.

Keywords:
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Area of Science:

  • Behavioral Science
  • Public Health
  • Digital Health

Background:

  • Rural residents face significant substance use disorder (SUD) treatment barriers, including limited access and stigma.
  • Mobile health (mHealth) offers accessible, private SUD treatment, but its rural vs. urban efficacy is unclear.
  • Peer Network Counseling-txt (PNC-txt) is an mHealth intervention for cannabis use disorder (CUD).

Purpose of the Study:

  • To investigate rural vs. urban differences in mHealth SUD treatment efficacy.
  • To examine treatment mechanisms: protective behavioral strategies, readiness to change, and peer network health.
  • To test if PNC-txt impacts these mechanisms differently in rural and urban young adults with CUD.

Main Methods:

  • A randomized clinical trial of PNC-txt for CUD in young adults (18-25).
  • Compared efficacy and treatment mechanisms between rural and urban participants.
  • Analyzed changes in protective behavioral strategies, readiness to change, and peer network health.

Main Results:

  • PNC-txt reduced past 30-day cannabis use at 6 months.
  • Treatment effects were mediated by increases in protective behavioral strategies and readiness to change at 1 month.
  • These indirect effects did not significantly differ between rural and urban residents.

Conclusions:

  • mHealth SUD treatment is effective for young adults with CUD, regardless of geographic location.
  • Protective behavioral strategies and readiness to change are key targets for reducing cannabis use.
  • mHealth interventions can effectively address rural SUD treatment barriers.