PROJECT SUMMARY
Patients with comorbid substance use (SUD) and anxiety disorders (AD) have significantly poorer health
outcomes than patients with SUD alone and experience increased risk for relapse. However, less than 10%
engage in treatment and only 18% of SUD facilities and 9% of mental health organizations report the capacity to
provide comprehensive care. Mobile health technologies have been increasingly applied for substance use and
anxiety treatments in an effort to create more comprehensive, patient centered approaches to care. Despite
increasing mobile application development, the majority of existing programs are designed to target SUD or
anxiety individually, few utilize evidence-based content or are clinically validated, and the majority are not
designed as integrative treatment components for patients with SUD-AD. The Unwinding Anxiety (UA) mobile
app can fulfill this need as it delivers digital, evidence-based psychoeducational training in a manualized,
scalable, and high-fidelity manner targeting mechanistic pathways consistent with previous research. The
proposed research will comprehensively assess the user experiences of UA for individuals with SUD-AD who
are in recovery and explore the role of exploratory behavioral and mental health outcomes (i.e., substance use,
craving, anxiety) among 48 individuals in long term recovery (>6 months). We will utilize a convergent parallel
mixed methods research study design involving the collection of both quantitative and qualitative measures
concurrently. We will quantitatively investigate usability, feasibility, and fidelity using the Systems Usability Scale,
educational module completion, and ecological check-in usage. Qualitatively we will collect data on usability of
UA within a sub-sample of participants (n=18) conducting focused interviews weekly (4 x <30 min. sessions;
n=18) and 3 focus groups (k=3; n=15). Our secondary aim is to determine the degree to which UA engages
exploratory outcomes specifically substance use, craving, and anxiety in preparation for future trials. Completion
of this study will result in: (1) comprehensive range of customizations grounded in patients lived experience
which will be used to refine one of the first mobile applications for patients with SUD-AD serving as a scalable,
evidence-based adjunctive therapy; (2) provide preliminary data for a post-doctoral NIH grant application testing
this customized mobile application to improve adjunctive therapies for SUD-AD treatment.
