A Peer-Led, Narrative-Based, and Mobile-Supported Intervention in Opioid Use Disorder: Multiphase Qualitative and...

Area of Science:

• Digital Health
• Substance Use Disorders
• Health Communication

Background:

• The opioid epidemic increases emergency department visits and hospitalizations, presenting opportunities for treatment linkage.
• Effective interventions are needed to connect individuals with opioid use disorder (OUD) to medication for opioid use disorder (MOUD) treatment post-hospitalization.

Purpose of the Study:

• To develop and evaluate mTools4life, a peer-led mobile health (mHealth) intervention.
• To integrate narrative-based health communication into an mHealth app.
• To enhance post-hospitalization engagement in MOUD and reduce substance use among individuals with OUD.

Main Methods:

• Formative phase: interviews with individuals with OUD and clinicians to inform app content.
• Intervention development based on Information-Motivation-Behavioral Skills, Transportation, and Transtheoretical models.
• Pilot phase: evaluated acceptability and usability of the mHealth app in individuals with OUD recruited from an emergency department.

Main Results:

• Twenty individuals with OUD piloted the intervention; 80% completed the 3-month follow-up.
• Opioid use significantly decreased from baseline (100%) to follow-up (56.3%; P=.001).
• Mean acceptability (4.5/5) and appropriateness (4.3/5) scores were high; 68.8% used the app, and 62.5% engaged with peer navigators.

Conclusions:

• The study demonstrates the feasibility of developing and deploying a narrative-based mHealth intervention for OUD care.
• Preliminary data support the intervention's acceptability, appropriateness, and effectiveness in improving MOUD engagement.
• This approach offers a promising strategy for supporting individuals with OUD during transitions of care.