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Cannabis use is the most prevalent among adolescents and young adults; frequent consumption is associated with cannabis use disorder (CUD) and psychosis, with a high prevalence (up to 50%) of CUD in individuals with first-episode psychosis (FEP). Early Intervention Services (EIS) for psychosis include face-to-face psychosocial interventions for CUD, because reducing or discontinuing cannabis use improves clinical and health care service use outcomes. However, multiple barriers (eg, staff availability and limited access to treatment) can hinder the implementation of these interventions. Mobile health (mHealth) interventions may help circumvent some of these barriers; however, to date, no study has evaluated the effects of mHealth psychological interventions for CUD in individuals with FEP.
This study describes the protocol for a pilot randomized controlled trial using a novel mHealth psychological intervention (iCanChange [iCC]) to address CUD in young adults with FEP. iCC was developed based on clinical evidence showing that in individuals without psychosis, integrating the principles of cognitive behavioral therapy, motivational interviewing, and behavioral self-management approaches are effective in improving cannabis use–related outcomes.
Consenting individuals (n=100) meeting the inclusion criteria (eg, aged 18-35 years with FEP and CUD) will be randomly allocated in a 1:1 ratio to the intervention (iCC+modified EIS) or control (EIS) group. The iCC is fully automatized and contains 21 modules that are completed over a 12-week period and 3 booster modules available during the 3-month follow-up period. Validated self-report measures will be taken via in-person assessments at baseline and at 6, 12 (end point), and 24 weeks (end of trial); iCC use data will be collected directly from the mobile app. Primary outcomes are intervention completion and trial retention rates, and secondary outcomes are cannabis use quantity, participant satisfaction, app use, and trial recruiting parameters. Exploratory outcomes include severity of psychotic symptoms and CUD severity. For primary outcomes, we will use the chi-square test using data collected at week 12. We will consider participation in iCC acceptable if ≥50% of the participants complete at least 11 out of 21 intervention modules and the trial feasible if attrition does not reach 50%. We will use analysis of covariance and mixed-effects models for secondary outcomes and generalized estimating equation multivariable analyses for exploratory outcomes.
Recruitment began in July 2022, and data collection is anticipated to be completed in July 2024. The main results are expected to be submitted for publication in 2024. We will engage patient partners and other stakeholders in creating a multifaceted knowledge translation plan to reach a diverse audience.
If feasible, this study will provide essential data for a larger-scale efficacy trial of iCC on cannabis use outcomes in individuals with FEP and CUD.
ClinicalTrials.gov NCT05310981; https://www.clinicaltrials.gov/ct2/show/NCT05310981
PRR1-10.2196/40817
Globally, cannabis consumption has increased by 18% between 2010 and 2019, and adolescents and young adults have reported the highest levels of use [
Early Intervention Services (EIS) for psychosis provide pharmacological treatments and psychosocial therapies for young individuals (ie, 12-35 years of age) with FEP. Psychosocial interventions are the mainstay of CUD treatment, over and above pharmacotherapy, which lack robust supporting evidence [
The widespread access to the internet and ownership of smartphones have facilitated the rapid expansion of the mobile health (mHealth) field, and it is estimated that more than 10,000 mental health apps are available for download [
Consistent with the promising role of technology-based psychological interventions in addressing CUD in individuals with psychosis, we developed a psychological mobile app–based intervention (iCanChange [iCC]) and a pilot randomized controlled trial (RCT) to compare iCC with EIS in participants with FEP. The primary objectives are to assess intervention completion and trial retention rates. The secondary objectives are to conduct a preliminary assessment of the effect of iCC on the quantity of cannabis used, participant satisfaction, and app use and to evaluate trial recruiting parameters. We include exploratory outcomes (eg, psychotic symptoms, motivation to change cannabis consumption, and cannabis use protective behaviors) to strengthen our understanding of the benefits of using iCC in clinical settings.
This study is a two-arm, parallel group (1:1 ratio) pilot RCT of iCC for decreasing cannabis use and modified Early Intervention Services for psychosis (mEIS) compared with EIS for young adults with FEP. Study participation may last up to 28 weeks and include a 14-day screening period (with an additional 14-day window to complete the baseline assessments), a 12-week intervention period, and a 12-week booster session and follow-up period (
Study flowchart. EIS: Early Intervention Services; iCC: iCanChange; mEIS: modified Early Intervention Services.
Eligible participants will meet the following criteria: (1) aged 18-35 years; (2) first-episode psychosis, with diagnosis of any psychotic disorder (ie, schizophrenia, schizoaffective disorder, bipolar disorder with psychotic features, delusional disorder, psychotic disorder not otherwise specified, brief psychotic disorder, and substance-induced psychotic disorder); (3) a minimum of 3 months of follow-up at an early psychosis clinic (and still in active follow-up at study inclusion); (4) a diagnosis of CUD based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria [
The study will be conducted at 6 participating clinics that provide EIS for psychosis (ie, 5 sites in the province of Quebec and 1 in Nova Scotia), and additional sites may be added as needed over the course of the study to maximize recruitment.
Potential participants will be identified by the clinical staff who will document on the screening form the general eligibility and exclusion criteria and obtain permission from the participants to be contacted for research purposes. The research assistant will contact potential participants in person at the clinic or using an internet-based communication platform.
Once informed consent is obtained, the research staff will conclude the eligibility assessment by documenting on the screening form the eligibility and exclusion criteria reserved for the research staff. The enrollment process will conclude with the collection of participant contact information using the locator form.
mHealth trial information provided during the consenting process will include the expected benefits of iCC in decreasing or ceasing cannabis use, a summary of the iCC content, expected participation in iCC (eg, number, duration, and frequency of modules), intervention services offered for CUD in both study arms, and the possibility of using iCC if randomized to the control group after the study end point assessment. Those who do not own a smartphone will be provided with a smartphone for the duration of the study. The research staff will assist participants in downloading iCC from Apple Store or Google Play Store and setting their passwords and will inform the participant that clinical staff (eg, physicians and case managers—such as nurses, occupational therapists, social workers, or ergotherapists—henceforth
Before the consent form is signed, a comprehension “quiz” about the study participation will be administered to potential participants and further explanations will be provided as needed. Research personnel will inform participants that all the information collected during the research project will remain strictly confidential to the extent prescribed by law and that at no point will any individually identifiable information be revealed in any research publication or presentation. Participants’ name, date of birth, and any other identifying information gathered during the study will be stored in the source documents and kept under lock. Computerized data will be encoded and held at the Centre Hospitalier de l’Université de Montréal’s (CHUM) data-management core in secure, password- and firewall-protected servers.
The study was approved by the Research Ethical Committee of the CHUM (University of Montréal Health Centre; MP-02-2021-9622, 21.310) and registered on ClinicalTrials.gov (NCT05310981).
The development of the iCC intervention was informed by the work of (and communications with) Copeland et al [
Throughout the development process, we consulted with patient partners (individuals in different phases of recovery from psychosis and CUD who were followed up at the CHUM) to coconstruct the app, adapt the design of the app and the content based on their feedback, and pilot-test with them the preliminary versions of the app and its content. Furthermore, critical for the adaptation and development of the mobile-based intervention were the results of formative research that included (1) a qualitative methodology study (ie, focus group with individuals with psychosis and CUD and interviews with clinicians) aimed at exploring psychological intervention practices, intervention targets, and factors related to the development and implementation of a mobile-based app for CUD [
Activities and behavioral change techniques for section 1 (preparing for change).
Module and activities | Behavioral change techniquesa | |||
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Complete cannabis use diary Select personal reasons for changing cannabis use Read about prevalence of cannabis use and CUDb |
Self-monitoring of behavior Social, personal, and emotional consequences (MIc) Normative feedback Provide contingent rewards (badge) |
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Read information about CUD Self-assessment of severity of dependence |
Provide information on consequences Monitoring with awareness or feedback on behavior |
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Evaluate knowledge about health effects of cannabis consumption Self-assessment of cannabis use consequences |
Provide information about behavior-health link Health, social, and emotional consequences or monitoring with awareness (MI) |
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Select perceived benefits (eg, social, cognitive, and emotional) of decreasing cannabis use Prioritize these benefits |
Prompt positive self-talk MI (preparatory change talk) |
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Self-evaluate psychological strengths (eg, wisdom, bravery, and moderation) Read a personalized feedback based on their strengths |
Focus on past success Mental rehearsal of successful performance Prompt self-talk MI (preparatory change talk) |
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Identify personal cannabis consumption triggers (eg, social, activities, and emotional) Select the most important triggers Read strategies about dealing with triggers |
Provide information Avoiding or changing exposure to cues for the behavior Monitoring with awareness or relapse prevention Provide contingent rewards (badge) |
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Watch an educational video about withdrawal symptoms Select experienced withdrawal symptoms Identify preferred coping strategies |
Provide information Skills training with focus on withdrawal symptoms Monitoring with awareness or relapse prevention Prompt behavioral practice |
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Watch an educational video about craving symptoms Select experienced craving symptoms Read craving coping strategies Identify preferred coping strategies |
Provide information Skills training with focus on craving symptoms Monitoring with awareness or relapse prevention Prompt behavioral practice |
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Education about cannabis and medication in psychosis Watch 2 video testimonials about the effects of cannabis in psychosis Report their perceptions related to the effects of cannabis on psychotic symptoms Identify preferred psychotic symptoms coping strategies |
Provide information Social comparison Monitoring with awareness Prompt behavioral practice |
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Read a summary of all reasons and capacities of changing Chose a cannabis use goal: stop, decrease, or maintain current use Decide on a plan to reduce or stop cannabis use (eg, date) Select cannabis harm reduction strategies |
MI Prompt cannabis use goal setting or action planning and commitment Provide general encouragement Provide contingent rewards (badge) |
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Follow-up on their objective defined in module 10. This module can be offered for a maximum of 2 times once participants start section 2. |
Prompt barrier identification Relapse prevention Provide general encouragement Prompt review of behavioral goals |
aCorresponding to the taxonomy of behavior change techniques published by Abraham and Michie [
bCUD: cannabis use disorder.
cMI: motivational interviewing.
The app is fully automatized and contains 2 sections and 3 booster modules. The first section contains 10 modules that are completed sequentially at a recommended frequency of 2 per week; however, faster progress will be permitted upon reading a prompt related to the recommended frequency. Two weeks after module 10, in which participants will self-identify a cannabis use goal, an additional module (that can be repeated after 2 weeks) will be offered to facilitate consolidating and reviewing participant goals (
A summary of personalized responses provided in each module will be saved and can be accessed by the participant through the app dashboard. Additional dashboard features will include an information tab that provides links to relevant web-based resources related to psychosis and cannabis consumption; a “Profile” tab where the participant can rapidly access the most relevant information provided during module completion; a “Settings” tab where they will select their preferred language (English or French) and notification preferences; and an emergency button that will allow them to contact their case manager (see
The app that hosts the intervention and the video components (ie, information and storytelling) was designed in collaboration with Akufen, a Montréal-based media design company [
Activities and behavioral change techniques for section 2 (strategies for supporting the change).
Module and activities | Behavioral change techniquesa | |||
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Read about suggested distraction strategies Decide on and plan to engage in 2 cannabis-free activities |
Behavior substitution Prompt goal setting Prompt behavioral practice Behavioral activation |
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Read about the importance of having an adequate support system Identify supportive persons |
Provide information on social support (general and emotional) Prompt goal setting (social support) Prompt behavioral practice Behavioral activation |
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Rank psychological and activity domains affected by cannabis use and psychosis Read information to promote a healthy lifestyle (eg, diet and sleep) Select a lifestyle modification goal and make a plan |
Provide information Prompt intention formation Prompt goal setting Action planning Behavioral activation |
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Identify stress symptoms Read about false stress triggers Read about stress coping strategies |
Provide information Cognitive restructuring Monitoring with awareness Prompt behavioral practice Provide contingent rewards (badge, upon completion of 4 strategies) Behavioral activation |
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Read about problem-solving steps Participate in exercises that incorporate problem-solving techniques |
Provide information Skills training focused on problem-solving Behavioral activation |
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Read about verbal and nonverbal communication techniques Identify used communication techniques |
Provide information Monitoring with awareness Skills training focused on problem-solving Behavioral activation |
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Read about communication modalities Participate in exercises that exemplify the use of assertive communication |
Skills training focused on verbal and nonverbal communication Self-affirmation Behavioral activation |
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Identify positive behavioral changes Select preferred encouragements Choose rewarding activities |
Self-reward Anticipation of future rewards Prompt goal setting (activities) Provide contingent rewards (badge, upon completion of 8 strategies) Behavioral activation |
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Self-assessment of reaching cannabis use and personal goals Identify useful strategies and behaviors Provide plans for future projects Access web-based resources about cannabis and psychosis |
Provide feedback on outcomes and behavior Prompt goal setting (activities) Monitoring with awareness or relapse prevention Provide general encouragement Provide contingent rewards (badge) |
aCorresponding to the taxonomy of behavior change techniques published by Abraham and Michie [
Activities and behavioral change techniques for follow-up modules (boosters).
Module and activities | Behavioral change techniquesa | |||
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Read a personalized report about reasons or motivations for behavioral change, cannabis dependence, and goals Self-assess their progress toward goal achievement Read a personalized report about psychological strengths, triggers, withdrawal cravings, and stress symptoms Identify useful strategies Identify reasons for not reaching their goal (if applicable) and receive tailored solutions |
Review of behavioral and outcome goals Provide feedback on outcomes and behavior Monitoring with awareness or relapse prevention Provide general encouragement Prompt goal setting (for those who did not reach their goals) Prompt behavioral practice |
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Reassess their severity of dependence Set a cannabis use goal for the next month Update preferred strategies |
Same as for booster 1 |
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Report on positive changes and successful strategies (abstinent) Complete questionnaires related to influence of cannabis on psychotic symptoms; cannabis use consequences (nonabstinent) Self-report of social functioning, symptoms, and useful strategies (nonabstinent) |
Same as for booster 1 |
aCorresponding to the taxonomy of behavior change techniques published by Abraham and Michie [
Participants in the control group will receive EIS for psychosis through an interdisciplinary approach offered by teams of clinicians, including physicians and case managers with various backgrounds (eg, nurses, occupational therapists, and social workers), and interact with clinicians as per standard EIS procedures, which commonly include weekly case manager visits and follow-up visits with physicians every 3 weeks. At EIS clinics, individuals with FEP will receive intensive treatment (typically for 3 years) with the possibility of extension based on case-by-case evaluation. Services offered will comprise medication management; psychiatrist and case manager follow-up; and a range of psychosocial interventions including psychoeducation, psychotherapy (eg, CBT for psychosis), family interventions, peer support, interventions for substance use disorder (including CUD; ie, psychosocial interventions such as MI, CBT, psychoeducation, and harm reduction), support for basic life needs (eg, food and shelter), and support for improving social functioning (eg, employment and education). The receipt of interventions or services for cannabis use will be documented in the Intervention and Services Form at weeks 6, 12, and 24 assessments.
Participants in the intervention arm will receive all services included in EIS, with the exception of concomitant formal psychological interventions for treating CUD, such as MI or CBT individual or group therapy sessions. Clinicians will be assigned an active supporting role, as our formative research showed that participants would like to receive support from clinicians for completing app modules or feedback related to their progress in the intervention at a frequency of approximately once per week. This implies asking about any difficulties with iCC and offering support with the content during each clinical encounter, as requested by the participants. Clinicians will use personalized login credentials to access the iCC dashboard and monitor the progress of the participants in the intervention (eg, number of modules completed and frequency) if allowed by the participant to do so.
Clinical research assistants will conduct all assessments at baseline and at weeks 6, 12, and 24 after consent, in person, over the phone, or using telemedicine. Data will be stored in REDCap (Research Electronic Data Capture), a secure, web-based software platform designed to support data capture for research studies [
Schedule of enrollment, allocation, interventions, and assessments. W: week.
For both outcomes, the denominator will represent the total number of participants randomized to the intervention or control groups. For iCC intervention completion, the numerator represents the number of participants who completed all 10 modules of the first section and at least 1 follow-up module related to involvement in reaching their cannabis use objective. This information will be collected through iCC. For participants randomized to the control group, the numerator will represent the total number of those who participated in EIS and ongoing engagement with EIS at the time of the 12-week assessment. The ongoing engagement with EIS will be documented using data collected through the Intervention and Services Form related to the receipt of services for cannabis use (at all study visits) and data from medical health records pertaining to receipt of any interventions that are offered at the clinic. For retention rate in both study groups, the numerator will be the number of participants who completed all week 12 (end point) assessments.
The secondary outcomes are as follows:
Cannabis use will be measured using a self-report tool, the Timeline Follow Back (TLFB) [
Participant satisfaction with using iCC or programs for CUD offered as part of EIS (control group) will be measured with the validated 8-item Client Satisfaction Questionnaire (CSQ-8) [
App use: Considering the importance of evaluating app use and adoption metrics in eHealth trials [
Trial parameters: Information collected during enrollment and study visits (stored in REDCap) will allow us to calculate the number of participants who were referred to the study, screened, eligible, provided informed consent, randomized, initiated the intervention (ie, who both logged into iCC and complete module 1), and completed baseline and follow-up assessments.
The exploratory outcomes are as follows:
Cannabis use frequency (and abstinence) will be measured using the TLFB. Participants who declare using alcohol will be asked about the frequency and quantity of use, and those who consume other substances (eg, cocaine, amphetamine, opioids) will be asked about the frequency of use and route of administration.
Cannabis-related negative social, occupational, physical, and personal consequences will be assessed using the 19-item unidimensional self-report instrument, the Marijuana Problems Scale (MPS) [
Cannabis use disorder severity will be measured with the 5-item Severity of Dependence Scale (SDS), which has been validated in people with early psychosis [
Confidence in resisting cannabis use in 8 different situations (eg, “if other people treated me unfairly or interfered with my plans”) will be measured using the validated Drug-Taking Confidence Questionnaire (DTCQ) [
The measurement of intentions to stop using cannabis has been informed by and adapted from the Precaution Adoption Process Model [
The severity of positive and negative symptoms of psychosis will be measured using an interviewer-administered scale, the Positive and Negative Syndrome Scale (PANSS-6) [
To measure cannabis-related harm, we will use the 17-item Protective Behavioral Strategies-Marijuana (PBSM) questionnaire, which has been shown to be valid and free of bias in terms of gender, sex, race, ethnicity, and recreational marijuana use legal status [
Participants will report their Satisfaction with Life pertaining to 4 domains (ie, living situation, social relationships, work, self, and present life) using the 18-item Satisfaction with Life questionnaire (SWL), which has been validated for schizophrenia and schizophrenia-related disorders [
Self-reported health service use data using the Health Care form will include emergency department visits and hospitalizations for psychological, emotional, or mental health issues in the last 30 days (yes or no). In the case of hospitalization, additional data will be collected (ie, number of admissions, duration of stay, reason for admission, and confirmation using medical records).
Sample size calculations were guided by the results of studies that used psychological app-based interventions targeting cannabis use in individuals without psychosis [
Once baseline assessments are completed, participants will be randomized to either (1) iCC+mEIS or (2) EIS. Within each stratum, based on biological sex, a random 1:1 group allocation sequence is generated using a permuted block design with blocks of varying sizes to decrease the likelihood of predictability of group assignment. The group allocation will not be masked, and the baseline visit concludes with participants logging into iCC and completing the introductory module. If a participant drops out of the study at any point following randomization, the randomization slot will not be reallocated to a new participant. The randomization schedule is concealed within the secure REDCap system and was created by the CHUM Center for the Integration and Analysis of Medical Data (CITADEL). The study participants, clinicians, and research staff conducting assessments will not be blinded to the group assignment, while individuals performing analyses will be blinded.
The 1-sided chi-square 95% CI will be calculated to estimate the lower bound of iCC completion and trial retention rates. We will consider participation in iCC acceptable if more than 50% of the participants completed at least 11 out of 21 intervention modules at week 12. The trial will be considered feasible if the attrition at week 12 does not reach 50%. An analysis of covariance model will be used to provide a preliminary assessment of the effect of treatment on the quantity of cannabis use (dependent variable) at 12 weeks (end of intervention). The independent variables will be the quantity of cannabis use at baseline and a dichotomous variable reflecting arm allocation. The second model will include covariates that were found to be different between the groups at baseline. For participants’ satisfaction with the intervention, we will calculate the CSQ total scores as well as the mean and SD. The groups will be compared using a mixed-effects model with random intercepts for each site. For app use and trial parameters, we will use univariate analyses and report the distribution (frequency tables), central tendency (mean, median, and mode), and dispersion (range and SD).
For exploratory outcomes, we will compute descriptive statistics and bivariate and multivariable analyses using generalized estimating equation (GEE) models. The generalized estimating equation is a repeated-measures regression model that accounts for the correlations between repeated measures for each person [
Missing entries for fields where missing values account for <5% of the sample may be imputed using the sample mean for continuous variables and sample mode for categorical variables. Fields with >5% missing entries may be excluded from multivariate models. In the case of missing visits, the proposed types of analyses (linear mixed-effects models and GEE models) will include all participants with at least one nonmissing visit, which may increase statistical power and reduce estimation bias. Our analysis plan includes both intention-to-treat and per-protocol analyses.
The study staff will receive training on all assessments and procedures as per protocol, and include assessments, study interventions, safety procedures, data management, and collection. Special training sessions will be organized for clinicians to support the use of iCC and include a description of the functionalities of the app, content, and structure. In addition, clinicians will receive free access to the app for a period of 7 days (using a special account) to facilitate the use of the dashboard and discussions with participants about iCC use. Additional training sessions will be organized throughout the study as needed.
An independent Data and Safety Monitoring Board (DSMB) will conduct periodic reviews (every 9 months) to monitor the safety of the interventions and the validity and integrity of the data from the study. On the basis of the DSMB’s recommendations, alterations can be made to the study design (eg, increase or decrease in the number of sites, sample size) based on poor accrual or recruitment, retention, or iCC acceptability. The DSMB may recommend stopping the study early because of an excess of adverse events.
Patient partners will also be involved during the trial with the lead site team, providing input and feedback on study conduct and any challenges that may arise.
Study enrollment began in July 2022. We expect to complete participant enrollment in January 2024 and data collection in July 2024. The main results are expected to be submitted for publication in 2024. We will engage patient partners and other stakeholders in creating a knowledge translation plan and developing plain language summaries, reports, briefing notes, and other documents that will be used to disseminate our results to a wider audience.
The manuscript describes the protocol of a pilot RCT that aims to evaluate the acceptability of iCC, a new mobile-based psychological intervention for helping young adults with psychosis and CUD decrease their cannabis use, and the feasibility of conducting the study in participants who receive EIS for psychosis. In addition, the trial will provide preliminary data related to cannabis use and other outcomes relevant in clinical practice. To our knowledge, this is the first RCT of an mHealth intervention that incorporates CBT and MI approaches to address CUD in this population.
We adapted the content and design of the app based on the results of our formative research [
To consider the trial feasible, at least 50% of participants must complete all study assessments at week 12, which corresponds to the end of the iCC main intervention (excluding booster sessions). In the absence of similar trials in our target population, we chose this cutoff conservatively, as it is close to the maximum attrition rate of 65% reported in studies using app-based interventions for decreasing cannabis use in individuals
In individuals with psychosis, face-to-face psychological interventions were found to be more effective in decreasing the quantity than frequency of cannabis used [
Our study has some limitations. Due to the centralized randomization method, the variability in the number of clinicians at participating sites, and expected differences in enrollment activity across sites, it is possible that some clinicians may have patients in both study groups, which increases the risk for iCC components to be incorporated into the treatment of participants in the control group, resulting in type II errors. To document possible crossover effects, we will explore differences in outcomes between participants in the control group whose clinicians have patients in the iCC group and those whose clinicians do not. Despite being assigned an active supporting role for iCC completion, we expect a variable level of clinician involvement that could impact iCC completion rates. We will use dashboard use parameters (eg, number of logins) as a proxy for clinician support with iCC and explore the association between clinician engagement and iCC completion. To measure cannabis use, we relied exclusively on participants’ self-reports and the TLFB instrument. However, we estimated a relatively low risk of measurement bias associated with our approach, as the TLFB has been shown to have high levels of agreement with biological measures [
Given the dearth of mHealth interventions for CUD in individuals with psychosis, the results from this pilot trial will inform the adaptation of iCC to increase its acceptability and usability and provide critical data for designing a larger trial to evaluate the efficacy of the intervention in improving outcomes that are most relevant in this population. This study aligns with the current strategies of major research funding authorities to stimulate the development and rigorous testing of innovative mHealth interventions for individuals with mental health issues.
iCanChange push notifications.
iCanChange badges.
iCanChange screenshots.
cognitive behavioral therapy
Centre Hospitalier de l’Université de Montréal
Client Satisfaction Questionnaire
cannabis use disorder
Data and Safety Monitoring Board
Drug-Taking Confidence Questionnaire
Early Intervention Services
first-episode psychosis
generalized estimating equation
iCanChange
modified EIS
motivational interviewing
Marijuana Problems Scale
Protective Behavioral Strategies-Marijuana
randomized controlled trial
Severity of Dependence Scale
Satisfaction with Life
Timeline Follow Back
This study was supported by Health Canada and the Quebec Ministry of Health and Social Services. The funding bodies have no influence on the design of the study, data collection, analysis, interpretation, and the writing of the manuscript.
The authors wish to thank patient partners from the JAP (jeune adultes souffrant de psychose—young adults with psychosis) clinic at the Centre Hospitalier de l’Université de Montréal (CHUM) for their valuable input related to the content and design of iCanChange (iCC). The authors would like to thank Navdeep Kaur for the contribution to the development of iCC, and Jill Fikowski for the support in the development of the protocol. We would also like to thank Roy Nitulescu and Codjo Djignefa Djade from the CHUM Center for the Integration and Analysis of Medical Data (CITADEL) for their contribution to the statistical analysis plan. The authors would like to thank Bruno Choiniere and Marine Tréhorel from Akufen for coordinating the design process and the Osedea team for developing the iCC software. We acknowledge the support of Helen Kang in editing this manuscript. OT was supported by the Canadian Institutes of Health Research (CIHR) Frederick Banting and Charles Best Doctoral award (award no. FBD-170837). DJ-A holds a clinical scientist career award from Fonds de Recherche du Québec (FRQS).
The data sets generated during or analyzed during this study are not publicly available because the trial is ongoing but will be made available from the corresponding author upon reasonable request.
OT drafted the first version of the manuscript, tables, and figures. OT, AA-B, AW, TL, J Copeland, PL-T, SC-M, J Côté, DC, SD, SL'H, CO-P, M-AR, PGT, MV, and DJ-A contributed to the conception and design of the study, development of the app-based intervention, and development of the study protocol. DJA obtained funding and supervised study development and conduct. All authors critically reviewed and approved the manuscript.
PGT declares speaker fees and advisory board honoraria from Otsuka Lundbeck, Janssen, Abbvie, Teva Canada, in the last 2 years. DJ-A receives study material from Cardiol Therapeutics for a clinical trial funded by the Quebec Ministry of Health and Social Services. All other authors have no conflicts of interest to declare.