Smartphone Addiction Recovery Coach for Adolescents (SARC-A) Experiment

At discharge from outpatient treatment, researchers will recruit 300 adolescents and randomly
assign them to recovery support as usual control condition or the Smartphone Addiction
Recovery Coach for Adolescents (SARC-A) experimental condition. Participants in the
experimental conditions will receive a smartphone, a calling/texting/data plan, and the
SARC-A mobile applications for the first 6 months post treatment discharge. Experimental
participants will 1) complete a 2-3 minute recovery-focused ecological momentary assessment
(EMA) at 5 random times a day, receive feedback on their current answers, and provided access
to behavioral charting of their past answers over time; and 2) receive continuous access to a
suite of self-initiated ecological momentary interventions (EMI) to support their recovery
via tool box of coping tools, apps related to getting support, and apps related to
maintaining a healthy lifestyle. Data include standardized assessments, urine tests, mobile
phone metadata, EMA responses, and EMI utilization. The study's aims and their associated
hypotheses are:

Aim 1: Test the effects of experimental assignment on the frequency of substance use.

H1 Relative to the control group, participants in the experimental group will have lower
scores on the quarterly Substance Frequency Scale (3, 6, 9 months post- discharge). Aim 2:
Evaluate the extent to which the experimental effects are moderated by baseline substance use
frequency. H2 The Substance Frequency Scale Scores at intake will moderate the effects of
experimental on the quarterly subsequent Substance Frequency Scale scores. Aim 3: Test the
extent to which the frequency of substance use mediates the effects of experimental
assignment on other aspects of recovery including SUD symptoms, HIV risk behavior, quality of
life, mental wellness, and days of school. H3a Relative to the control group, participants in
the experimental group will have better scores on other aspects of recovery (reverse of
number of SUD symptoms, reverse of HIV risk behaviors, quality of life, mental wellness, days
of school) in the quarterly interviews. H3b Higher Substance Frequency Scale scores
(regardless of assignment) in a given quarter will be associated with worse scores on other
aspects of recovery in the next quarter. H3c Substance Frequency Scale scores in a given
quarter will mediate the impact of the experimental assignment on other aspects of recovery
in the next quarter. Aim 4: Within the experimental condition, determine the degree to which
EMA responses (e.g., use, withdrawal, craving, negative and positive affect) and EMI
utilization predict the duration of abstinence (to be done within experimental condition.)
H4a The duration of abstinence will be negatively related to EMA measures of the recency of
use, withdrawal, craving, low self-efficacy to resist relapse, increased negative affect, and
decreased positive affect. H4b The duration of abstinence will be positively related to
immediate and cumulative EMI utilization.

Inclusion Criteria:

1. discharge from an adolescent outpatient SUD treatment program to the community;

2. substance use during the 90 days prior to treatment;

3. aged 15 to 18 at the time of discharge;

Exclusion Criteria:

4. inability to read and communicate in English;

5. does NOT reside or plan to stay in Chicago during the next 9 months; and

6. unable to provide parental/guardian consent if under age 18.