ABSTRACT
This Mentored Research Career Development Award (K01) proposal includes a coordinated training plan
and research project that will facilitate the candidate's transition to independent investigator at the
intersection of adolescent substance use, in particular marijuana use, sleep disturbances and chronic pain.
Adolescent marijuana exposure predicts many negative outcomes, particularly for early, heavy users.
Chronic pain is an under-recognized, yet highly prevalent adolescent health problem. Evidence suggests
that chronic pain potentiates risk factors for substance use, in particular those related to sleep disturbances
and diminished inhibitory control. However, the interplay among sleep, pain, and inhibitory control, as it
relates to marijuana use in adolescence, remains minimally explored, which is significant given the unique
risk for frequent and heavy marijuana use in this population.
The proposed research project utilizes mobile health (mHealth) measurement techniques, combining
mobile phones and wearable devices, to enhance our understanding of the longitudinal interplay among
these mechanisms in patient’s natural settings. The long-term goal of this K01 award is for the candidate to
establish an independent research career aimed at developing and implementing mechanistically informed
interventions for marijuana use disorders in youth with chronic pain and sleep disturbances using mHealth
approaches. To do so,
specific short-term training is required in: 1) conducting adolescent substance use
research, with a focus on marijuana use;
2) conducting randomized controlled trials; 3) sleep and circadian
biology and sleep measurement techniques; 4) the use of mHealth technologies and protocols and 5) the
responsible conduct of research.
Two independent, yet related studies are proposed to characterize the relation among sleep, pain,
inhibitory control, and marijuana use
in an adolescent chronic pain population. A first study will interrogate a
large cross-sectional sample of youth with chronic pain to understand the association that particular pain
dimensions (i.e. intensity, frequency and interference) show with marijuana use, both directly and through
associations with sleep and inhibitory control. Given the potentially complex interplay among factors, a
longitudinal assessment is vital to map the unfolding of pathophysiological processes. The second study will
therefore combine ecological momentary assessments, mobile app-based cognitive tests, and passive
collection of sleep data to provide time-sensitive and ecologically valid models of the longitudinal interplay
among risk factors within the context of the individual’s daily life.
Such methods are vital for mapping temporal sequences of events and developing specific interventions
to interrupt this perpetual cycle and reduce risks, which will be the goal of a subsequent R01 grant.