Development and usability testing of e-Covery: A geographic ecological momentary intervention for people reporting...

Individuals engaged in co-occurring alcohol and opioid use face myriad challenges in sustaining recovery, including how specific places can serve as triggers precipitating return to use. Smartphone apps have the potential to curtail the effects of such triggers. We aimed to develop and test a geospatial ecological momentary intervention, e-Covery, for individuals reporting co-occurring alcohol and opioid use.

We conducted semi-structured interviews with 31 individuals reporting alcohol and opioid use who had attended substance use treatment in the past year. Individuals were recruited primarily through substance use treatment facilities and asked about their experiences with location-based triggers and how they coped with such triggers. Interviews were conducted between April 2020 and January 2022. We used thematic analysis to generate and classify messages for an mHealth intervention.

Based on interviews, we generated approximately 50 intervention messages. We then conducted a usability trial of the mHealth intervention. During the seven-day trial, participants received messages when near pre-identified trigger locations. Following the trial, we interviewed participants and asked them to complete a survey including measures of intervention user-friendliness, feasibility, and acceptability. We tested e-Covery with 10 individuals reporting alcohol and opioid use.

Participants: 1) found the app easy to use, 2) described intervention components as useful and therapeutic; 3) experienced challenges with the timing and functionality of messaging and survey components; and 4) wanted the app to be more engaging. e-Covery is a user-friendly, feasible, and acceptable intervention for individuals reporting co-occurring alcohol and opioid use seeking to change their use.