Engaging veterans in the development of mobile health interventions to support medication treatment for opioid use...

Opioid Use Disorder (OUD) is an ongoing and pervasive public health problem. Despite the availability of efficacious Medication treatments for OUD (MOUD), many patients require additional support to address OUD's wide-ranging consequences. Mobile Health Interventions (MHIs), or smartphone-based software applications ("apps"), could serve as a scalable and flexible medium to increase adjunctive care access within MOUD.

As an initial step in potential MHI creation, we conducted semi-structured interviews with U.S. military veterans receiving MOUD (N = 21) via rapid qualitative methods. Our team developed a start-list of interview questions. Interview transcripts were independently coded by interviewers, who then convened to discuss and refine code definitions, develop summary templates, organize codes into hierarchical structures, and refine domain categories through consensus.

Twenty-one veterans participated [M[SD]Age = 59.95[10.50]; 90.48% male sex-assigned-at-birth; 80.95% White; 85.71% Non-Hispanic/Latinx; 52.38% on buprenorphine, 47.62% on methadone at time of interview]. Veteran attitudes were typically either neutral- positively valenced and characterized by willingness (Open Prudency) or neutral-negatively valenced and characterized by concern and contingencies for use, such as assurance for continued access to in-person care (Hesitancy). A small but notable proportion of veterans expressed strongly favorable views towards MHIs, often grounded in their own technological fluency (Enthusiasm). Outright Opposition to MHIs was rare. Desired MHI functions were variable and included their use for enhancing care accessibility and convenience (e.g., Resource Centralization, Patient-Provider Communication), as well as supporting autonomy, motivation and individualization (e.g., Self-Monitoring, Positive Reinforcement, Adjunctive Intervention).

Results from this qualitative investigation of U.S. military veterans provide foundational data to guide future development of MHIs for supporting MOUD engagement. Findings suggest that veterans receiving MOUD are generally open towards and interested in using MHIs as part of their care regimens, which were broadly described as potential means to enhance treatment accessibility, convenience, and individualization.