A Pilot Test of a Mobile App for Drug Court Participants

The U.S. criminal justice system refers more people to substance abuse treatment than any other system. Low treatment completion rates and high relapse rates among addicted offenders highlight the need for better substance use disorder treatment and recovery tools. 

Mobile health applications (apps) may fill that need by providing continuous support. In this pilot test, 30 participants in a Massachusetts drug court program used A-CHESS, a mobile app for recovery support and relapse prevention, over a four-month period. Over the course of the study period, participants opened A-CHESS on average of 62% of the days that they had the app. Social networking tools were the most utilized services. 

The study results suggest that drug court participants will make regular use of a recovery support app. This pilot study sought to find out if addicted offenders in a drug court program would use a mobile application to support and manage their recovery.

Below:  A-CHESS mobile app user interface

Below:  Percentage of days in which participants used A-CHESS

Below:  Average number of times participants who used each service used it over the total study period

Below:  Social network map of all participants including staff

Below:  Social network map of drug court participants

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By:  Johnson K1, Richards S2, Chih MY3, Moon TJ4, Curtis H5, Gustafson DH1.

• 1Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, USA.
• 2Communications Coordinator, Population Health Institute, University of Wisconsin-Madison, Madison, WI, USA.
• 3Research Assistant, Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, USA.; Assistant Professor, University of Kentucky, Lexington, KY, USA.
• 4Honorary Fellow, Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, USA.
• 5Advocates, Inc., Ayer Concord Drug Court, Ayer, MA, USA. 
• Subst Abuse. 2016 Feb 14;10:1-7. doi: 10.4137/SART.S33390. eCollection 2016.

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User Interface Design for Mobile-Based Sexual Health Interventions for Young People: Design Recommendations from a Qualitative Study on an Online Chlamydia Clinical Care Pathway

Below:  Application prototype used in focus group discussions (Registration screen)

Below:  Application prototype used in focus group discussions (medical consultation screen)

Below:  Visual probe animation of underlying clinical pathway

Nine focus group discussions were conducted (n = 49) with two age-stratified samples (16 to 18 and 19 to 24 year olds) of young people from Further Education colleges and Higher Education establishments. Discussions explored young people’s views with regard to: the software interface; the presentation of information; and the ordering of interaction steps. Discussions were audio recorded and transcribed verbatim. Interview transcripts were analysed using thematic analysis.

Four over-arching themes emerged: privacy and security; credibility; user journey support; and the task-technology-context fit. From these themes, 20 user interface design recommendations for mobile health applications are proposed. For participants, although privacy was a major concern, security was not perceived as a major potential barrier as participants were generally unaware of potential security threats and inherently trusted new technology. Customisation also emerged as a key design preference to increase attractiveness and acceptability.

Considerable effort should be focused on designing healthcare applications from the patient’s perspective to maximise acceptability. The design recommendations proposed in this paper provide a valuable point of reference for the health design community to inform development of mobile–based health interventions for the diagnosis and treatment of a number of other conditions for this target group, while stimulating conversation across multidisciplinary communities.

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