June 2014 – Matters of Substance

Imagine you’re out enjoying a sunny patio at a pub with a few friends. You’re just about to finish your pint of beer and are really craving another one, but are trying to cut back on your drinking. You pull out your phone and open up an app that reminds you your goal for the week is to not have more than two standard drinks per day, and that pint you punched into the tracker was actually 1.7. You pause for a moment, then take a look at coping strategies you’ve tracked over the past few weeks to help deal with the desire to drink. One you’ve found particularly effective is treating yourself to a fancy booze-free cocktail while out with friends, so you order one of those instead of another beer.

Given our society’s increasing tech obsession, it’s no surprise that harm-reduction tools have made their way into the digital realm. Here are three helpful Canadian web- or app-based harm-reduction tools we’ve come across in our travels (or, in one case, created ourselves). Are there others you’d like to add? Share them with us!

Saying When: How to quit drinking or cut down: This app was designed by the Centre for Addiction and Mental Health. It’s the app I basically described above: it starts by asking you some questions about your drinking habits, the impacts of your drinking and goals you would like to set for yourself, then reminds you of Canada’s low-risk drinking guidelines. You can then track both your drinks and urges to drink, document effective coping strategies and access other information on tips for meeting your goals or accessing more help if you feel you need it. It actually reminds me of some popular fitness tracker apps that are available these days.

Good to Go? This app was developed as part of our Drugs and Driving website, which is aimed at helping young people to make informed decisions about getting behind the wheel after using a substance. The app includes a brief quiz that asks you questions about things like your mood, what substances you’ve used and how long ago you used them and then lets you know if you are “good to go” or not. But it is really designed more as a fun educational resource with embedded videos and factual content than as a real-time screening tool. It builds awareness about how different substances and other factors can impair your driving in different ways.

Gam_iQ: This quiz website is one of BC Responsible Gaming‘s prevention efforts. Answer the questions to find out how much you know about gambling, how to gamble responsibly and the resources available if you are a problem gambler. It’s also aimed at younger folks and initially launched with a chance to win a post-secondary scholarship. While the prize has already been awarded, it’s a brief and interactive way to get people thinking about gambling responsibly. The website also contains lots of other online tools aimed at different age groups or demographics.

If you have found any other harm-reduction apps, websites or digital tools, we would love to hear about them!

Author: Amanda Farrell-Low, Research Assistant: Social Media, Centre for Addictions Research of BC

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC

Kevan (name changed) participated in one of two participatory focus groups held in Victoria and Vancouver in the spring of 2013 to provide advice on helping create services for men living with HIV who smoke tobacco products. During the focus group he learned that smoking rates among gay men and persons living with HIV (PLWH) are 2 – 4 times higher than the general population. Smoking is a major modifiable determinant of health associated with significant comorbidities (e.g., cardiovascular, neuropsychiatric, pulmonary, renal diseases) and HIV disease progression. Among gay and bisexual men, heavier tobacco use is associated with more severe illness symptoms and higher smoking rates are associated with comorbid illness. Previous smoking reduction and cessation (SRC) interventions used generalized (one-size-fits-all) approaches that have limited success with gay men. Tailoring SRC interventions to the unique needs of gay PLWH may improve the success of SRC with these men. Working with gay men living with HIV who smoke, the BC Lung Association’s QuitNow Program, and researchers from the Schools of Nursing at the University of British Columbia and the University of Ottawa are exploring the use of personas and empathy mapping to develop a tailored SRC web-assisted tobacco intervention (WATI).

Kevan and his peers were invited to become researcher-participants in the development of personas representing the typical gay man living with HIV who smokes. Personas are used in marketing to develop “detailed descriptions of imaginary people constructed out of well-understood, highly specified data about real people.” Personas help people who do not belong to a target market understand the needs of people like Kevan and how their culture influences health promotion and smoking behaviors. During participatory design sessions, Kevan and his peers generated a name and demographic information for their ‘persona’ and ascribed unique thoughts, feelings, and behaviors to each persona. Four personas emerged from the design sessions, Joe Average, Biff Barista, Riley Homo, and Joe Schmo.

Joe Average, for example, is an HIV positive gay man living with his partner in a mid-sized city. He works full time He is a pack-a-day smoker who often smokes with his partner, co-workers, or friends. He is strongly goal oriented and he strives to manage his HIV. He makes sure that he eats right and gets plenty of exercise. Often under deadlines for his job, he finds himself smoking to relieve stress. He smokes as part of his many routines, including taking medications and vitamins, activities of daily living (e.g., showering), socializing with co-workers, smoking marijuana with his partner, and he sometimes smokes cigarettes after getting high on marijuana. Although concerned with his health, he hasn’t been able to quit smoking.

The four personas created by Kevan and his peers were analyzed using ethnographic and thematic analysis techniques to understand the collective needs of HIV positive gay men who smoke and how culture influences their SRC efforts. The first theme that emerged was navigating life and HIV, followed by triple stigma (i.e. gay-related stigma, HIV-related stigma, smoking-related stigma), immunity to public health messages, complexity of managing HIV, complexity of managing identity, benefits of smoking, anxiety about life, and apathy about life. Our goals with Kevan and his peers are to engage with gay men living with HIV who smoke as researcher-participants. This approach affords gay men living with HIV who smoke the opportunity to collaborate with each other, policy makers, researchers, and clinicians in the development of a WATI that includes input and collaboration from all stakeholders.

Authors:

J. Craig Phillips, PhD, LLM, RN, ARNP, PMHCNS-BC, ACRN, Associate Professor, School of Nursing, University of Ottawa

Jack Boomer, MPA, B.Ed., Director, QuitNow, BC Lung Association, Principal, Context Research

Leanne M. Currie, PhD, RN, Associate Professor, School of Nursing, University of British Columbia

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC

Month: June 2014

Reducing harm? There’s an app for that.

Tailoring tobacco smoking reduction and cessation interventions with gay men living with HIV