Acceptability of using mobile Health (mHealth) as an intervention tool for people with drug use disorders in Tanga, Tanzania.

Evidence on the additional benefit in treatment and recovery process among PWDUD using digital health interventions is lacking. This study aimed to describe the acceptability of using a digital intervention to increase information access for PWDUD in Tanga region, Tanzania. This study was conducted among 465 participants in Tanga, a coastal region on the Northeast of Tanzania has the second highest number of PWDUD in Tanzania. This cross-sectional descriptive study used both quantitative and qualitative approaches. The majority of the PWDUD 67.6% do not own mobile phones. Out of the 156 participants with mobile phones, only 6.4% owned a smartphone. Most of the participants, 83.6%, reported living with someone who owns a mobile phone. Importantly, a significant number of participants, 98.5% from both areas showed readiness to use mobile phones to access information about the harmful use of substance and substance use disorder treatment options. Participants described how mobile phones can be useful to them in accessing information related to treatment and access to treatment options. The findings of this study helped to inform the target audience for the developed Huru App that should not be only PWDUD but the community at large.

Drug use and associated factors in a North Eastern region of Tanzania: a cross-sectional study.

Introduction: Tanzania has experienced an increase in the number of people who use drugs (PWUDs) and people who inject drugs (PWIDs). Understanding the characteristics of PWUDs is crucial to addressing the increasing burden of drug use in Tanzania. This study was set to examine drug use and its related factors among PWUDs in a North Eastern region of Tanzania. Methods: a cross-sectional study conducted among 481 PWUDs in Tanga region, Tanzania. R statistical language was used for analysis and plotting. Logistic regression was performed to establish associations between knowledge and practice scores with drug use. A p-value of < 0.05 was considered statistically significant. Results: people who inject drugs comprised mostly of male (97.5%) and those with primary level education (71.1%). About three in four PWUDs had poor knowledge and practices towards drug use. Factors associated with adequate knowledge and practices towards drug use included residing in urban setting (aOR: 0.47, 95% CI; 0.29 - 0.74, p=0.001) while low level of education and use of drugs for less than 10 years were independent predictors for poor practices. Conclusion: drug use poses a significant threat among male and individuals with low education in Tanga region. Poor knowledge and practices towards drug use was more pronounced among rural and lowly educated PWUDs. Owing to variabilities of predictors, tailored and innovative interventions are needed to curb this growing drug use and associated effects in Tanga and other settings with similar contexts.

Family-based intervention for adolescents with substance use disorders in Vietnam.

BACKGROUND: Adolescent substance use is a leading risk factor of medical and social problems in adults. However, evidence-based interventions for substance use disorders (SUD) among youth in resource-limited countries are lacking. Treatnet Family (TF), developed by United Nations Office on Drugs and Crime (UNODC), aims to make youth SUD care more affordable and accessible in low- and middle-income countries. This study explores the suitability of TF in Vietnam. METHOD: Twenty interviews were conducted with eight adolescents and their family members who participated in TF, and four practitioners who delivered TF. Questions centred on their experiences with the intervention and suggestions for improvement. Thematic analysis was used to evaluate the data. RESULTS: All adolescents were male with an average age of 19.3. Seven of them had left school. Most caregivers were female. Both family members and adolescents expressed a great demand for support, and both groups appreciated the immediate improvement in parent-child communication. However, the impact of TF could be compromised due challenges in recruiting families, possibly arising from the novelty of a family-based intervention in Vietnam and drug-related stigma. The perception of drug use as an acute condition instead of a chronic disorder, and the lack of a continuing care system, also made it difficult to retain participants. CONCLUSION: Vietnamese adolescents with SUD and their family members were in great need of support and access to evidence-based interventions. Building a comprehensive, health-centred substance use disorder treatment and care system would enhance treatment impact.

Fidelity Assessment of the Treatnet family (TF): A family-based intervention for adolescents with substance use disorders and their families.

INTRODUCTION: In transporting family-based interventions to community settings, establishing and maintaining fidelity to intervention is important. This exploratory study was implemented in the framework of a United Nations Office on Drugs and Crime (UNODC) global programme on Drug Dependence Treatment and Care. It is the first to examine an evidence-informed family-based intervention ("Treatnet Family"; TF) adherence for the treatment of adolescents with substance use disorders (SUD) among practitioners in community settings in Jakarta, Indonesia. METHOD: Twenty-three practitioners at five community-based counselling centres were trained in Treatnet Family and delivered it to 19 adolescents with SUD and their family members over a 6-week period. One of the five local Treatnet Family-trained supervisors randomly selected one session of the family-based intervention (TF) and observed the extent to which the practitioner's adhered to the TF manual. RESULTS: According to the supervisors' observation, all the practitioners used the Treatnet Family core skills such as positive reframing, positive relational reframing, perspective taking, relational questions, and going with resistance. There was a high level of agreement between practitioners' and supervisors' rating on the practitioners' use of specific therapeutic skills as measured using the Inventory of Therapy Techniques (ITT). CONCLUSION: Results suggest that Treatnet Family can be delivered with adherence by practitioners in community-based settings.

Acceptability and feasibility of using digital technology to train community practitioners to deliver a family-based intervention for adolescents with drug use disorders during the COVID-19 pandemic.

INTRODUCTION: By adhering to government preventative messages to stay-at-home and social distancing during the COVID-19 pandemic, training practitioners in person in implementing a family-based intervention (i.e., Treatnet Family) is not possible. The present study examined the feasibility and acceptability of using digital technology to remotely deliver Treatnet Family training to practitioners in community counselling services in Indonesia. METHOD: Fifteen practitioners, from the association of addiction counsellors in Indonesia, participated in the Treatnet Family workshop remotely. The training was delivered by four national Treatnet Family trainers remotely via a digital platform for five days with additional take-home assignments. RESULTS: All practitioners reported that Treatnet Family training have enhanced their skills in working with adolescents and their family. Most practitioners reported having confidence in conducting Treatnet Family and in applying core skills of family-based intervention. Participating in the workshop enabled practitioners to learn the core skills of the Treatnet Family at their own pace. However, some practitioners also stated few disadvantages in remote training, including having limited time for the discussion and feeling overwhelmed with the assignments. Some find it hard to attend such training from their home due to distractions. CONCLUSION: Digital technology is acceptable and feasible method for training community practitioners to deliver Treatnet Family to adolescents with SUDs and their families in Indonesia. These findings can inform the way to use digital technology to deliver core family-based skills to community practitioners in other low-resource settings.

An open trial investigation of Treatnet Family among adolescents with substance use problems.

INTRODUCTION: Studies that used evidence-based family therapies have demonstrated significant effects in reducing adolescent drug use and delinquent behaviours, and in reducing comorbid mental health problems. However, almost all these studies were conducted in high-income countries. The overall aim of the present study was to explore the effect of United Nations Office on Drugs and Crime's (UNODC) Treatnet Family (TF) in reducing substance consumption, drug-related activities, reducing mental health problems, and in improving family interaction among adolescents with substance-use problems. METHOD: Nineteen adolescents who had been referred to a community counselling clinic because of substance-use problems and their parents/family members participated in TF. They completed a set of questionnaires to measure substance use, family functioning, mental health problems, and life events at pre-, post-intervention as well as at a one month-follow-up assessment. RESULTS: TF had a positive significant impact in reducing alcohol use among adolescents with substance-use problems. The number of adolescents who smoked cigarettes and marijuana, and used amphetamines reduced across time. After participating in TF, the adolescents were involved with significantly fewer friends who consumed substances and participated in antisocial behaviours. Furthermore, parent/family member reported a significant decrease in mental health problems, and positive changes in adolescent's behaviours. CONCLUSION: The TF had a positive impact in reducing alcohol consumption and problems related to substance consumption among adolescents with substance-use problems when delivered by practitioners in routine community settings.