Wearable Sensor and Mobile App-Based mHealth Approach for Investigating Substance Use and Related Factors in Daily Life: Protocol for an Ecological Momentary Assessment Study.

BACKGROUND: Digital health technologies using mobile apps and wearable devices are a promising approach to the investigation of substance use in the real world and for the analysis of predictive factors or harms from substance use. Moreover, consecutive repeated data collection enables the development of predictive algorithms for substance use by machine learning methods. OBJECTIVE: We developed a new self-monitoring mobile app to record daily substance use, triggers, and cravings. Additionally, a wearable activity tracker (Fitbit) was used to collect objective biological and behavioral data before, during, and after substance use. This study aims to describe a model using machine learning methods to determine substance use. METHODS: This study is an ongoing observational study using a Fitbit and a self-monitoring app. Participants of this study were people with health risks due to alcohol or methamphetamine use. They were required to record their daily substance use and related factors on the self-monitoring app and to always wear a Fitbit for 8 weeks, which collected the following data: (1) heart rate per minute, (2) sleep duration per day, (3) sleep stages per day, (4) the number of steps per day, and (5) the amount of physical activity per day. Fitbit data will first be visualized for data analysis to confirm typical Fitbit data patterns for individual users. Next, machine learning and statistical analysis methods will be performed to create a detection model for substance use based on the combined Fitbit and self-monitoring data. The model will be tested based on 5-fold cross-validation, and further preprocessing and machine learning methods will be conducted based on the preliminary results. The usability and feasibility of this approach will also be evaluated. RESULTS: Enrollment for the trial began in September 2020, and the data collection finished in April 2021. In total, 13 people with methamphetamine use disorder and 36 with alcohol problems participated in this study. The severity of methamphetamine or alcohol use disorder assessed by the Drug Abuse Screening Test-10 or the Alcohol Use Disorders Identification Test-10 was moderate to severe. The anticipated results of this study include understanding the physiological and behavioral data before, during, and after alcohol or methamphetamine use and identifying individual patterns of behavior. CONCLUSIONS: Real-time data on daily life among people with substance use problems were collected in this study. This new approach to data collection might be helpful because of its high confidentiality and convenience. The findings of this study will provide data to support the development of interventions to reduce alcohol and methamphetamine use and associated negative consequences. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44275.

Usefulness of Implementation Outcome Scales for Digital Mental Health (iOSDMH): Experiences from Six Randomized Controlled Trials.

OBJECTIVES: Measuring implementation outcomes for digital mental health interventions is essential for examining the effective delivery of these interventions. The "Implementation Outcome Scale of Digital Mental Health" (iOSDMH) has been validated and used in several trials. This study aimed to compare the iOSDMH for participants in six randomized controlled trials (RCTs) involving web-based interventions and to discuss the implications of the iOSDMH for improving the interventions. Additionally, this study examined the associations between iOSDMH scores and program completion rate (adherence). METHODS: Variations in total scores and subscales of the iOSDMH were compared in six RCTs of digital mental health interventions conducted in Japan. The web-based intervention programs were based on cognitive behavioral therapy (2 programs), behavioral activation (1 program), acceptance and commitment (1 program), a combination of mindfulness, behavioral activation, and physical activity (1 program), and government guidelines for suicide prevention (1 program). Participants were full-time employees (2 programs), perinatal women (2 programs), working mothers with children (1 program), and students (1 program). The total score and subscale scores were tested using analysis of variance for between-group differences. RESULTS: Total score and subscale scores of the iOSDMH among six trials showed a significant group difference, reflecting users' perceptions of how each program was implemented, including aspects such as acceptability, appropriateness, feasibility, overall satisfaction, and harm. Subscale scores showed positive associations with completion rate, especially in terms of acceptability and satisfaction (R-squared = 0.93 and 0.89, respectively). CONCLUSIONS: The iOSDMH may be a useful tool for evaluating participants' perceptions of features implemented in web-based interventions, which could contribute to improvements and further development of the intervention.

Effectiveness of an Online Peer Gatekeeper Training Program for Postsecondary Students on Suicide Prevention in Japan: Protocol for a Randomized Controlled Trial.

BACKGROUND: Postsecondary student suicide is one of Japan's most severe public health problems. Gatekeeper training (GKT) programs are a generally recommended suicide prevention intervention in Japan. For suicide countermeasures, an online program tailored to students may enhance self-efficacy as a gatekeeper. OBJECTIVE: This study aims to describe a research protocol to investigate the effect of a newly developed internet-delivered online peer GKT program to improve postsecondary student self-efficacy as gatekeepers for suicide countermeasures in Japan. METHODS: This study is a 2-arm, parallel, randomized controlled trial with a 1:1 (intervention: waiting list) allocation. Participants (n=320) will be recruited, and those who meet the inclusion criteria will be randomly allocated to the intervention or waiting list control group. An approximately 85-minute, 6-section, internet-based gatekeeper program for postsecondary students has been developed that includes videos to help participants acquire skills as gatekeepers. The intervention group will complete the program within 10 days. The primary outcome, self-efficacy as a gatekeeper, is measured using the Gatekeeper Self-Efficacy Scale at baseline, immediately after taking the program, and 2 months after the survey after completing the program follow-up. To compare the primary outcomes, a t test, where the significance level is 5% (2-sided), will be used to test the intervention effect on an intention-to-treat basis. RESULTS: The study was at the stage of data collection at the time of submission. We recruited participants for this study during August and September 2021, and data collection will continue until December 2021. The data analysis related to the primary outcome will start in December 2021, and we hope to publish the results in 2022 or 2023. CONCLUSIONS: This is the first study to investigate the effectiveness of an online GKT program for postsecondary students to improve self-efficacy as a gatekeeper using a randomized controlled trial design. The study will explore the potential of an online peer gatekeeper program for postsecondary students that can be disseminated online to a large number of students with minimal cost. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry UMIN000045325; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000051685. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/34832.

Effects of gratitude intervention on mental health and well-being among workers: A systematic review.

OBJECTIVES: Gratitude intervention, which requires participants to engage regularly in brief activities designed to cultivate a sense of gratefulness, is known as one of the most effective positive psychological interventions. Although numerous meta-analyses and systematic reviews have been conducted on gratitude intervention, no studies have focused on the working population. This study aimed to systematically summarize the effectiveness of gratitude interventions on workers' mental health and well-being. METHODS: Systematic search was conducted in February 2021 using five databases. Eligible studies included randomized controlled trials implementing gratitude activities among healthy workers and measuring mental health or well-being indicators and original articles or thesis in English. RESULTS: Nine out of 1957 articles met the inclusion criteria. Eight studies adopted gratitude list interventions, showing a significant improvement in perceived stress and depression; however, the effects on well-being were inconsistent. Interventions with gratitude list four times or less did not report significant changes in any outcomes. CONCLUSIONS: Most gratitude interventions incorporated a gratitude list, and some studies included gratitude activities as a part of the combined program. On the other hand, no studies focused on only behavioral gratitude expression among workers. Gratitude interventions might be effective in improving mental health, but their effects on well-being remain unclear. The total number of gratitude lists and reflections might influence the effect on mental health and well-being; however, due to the high heterogeneity of the studies, further studies are needed.

Development and validation of the Japanese version of the team job crafting scale for nurses.

Team job crafting, which refers to designing the task, relational, and cognitive aspects of a job, is thought to be beneficial for nurses working in the ward. There are no scales to assess team job crafting among nurses. This study aimed to develop and examine the reliability and validity of a scale to measure team job crafting. Based on literature reviews and interviews, potential items were created. A total of 293 nurses working on 19 wards in two hospitals in Japan were asked to complete a questionnaire twice. A series of exploratory factor analyses (EFAs) were conducted to select the final items. For convergent validity, multilevel correlations were calculated. Cronbach's α and intra-class correlation coefficients (ICCs) were calculated for reliability. A total of 190 participants responded to the baseline survey and 152 responded to the retest. The EFAs yielded a three-factor structure comprising 13 items. The three factors are task crafting considering the team's growth, cognitive crafting for members' respect and reflection of meaningfulness of work, and relational crafting for smooth information sharing. Cronbach's α ranged from .810 to .831, and test-retest ICCs ranged from 0.571 to 0.710. At the individual level, team job crafting had small-to-moderate correlations with individual levels of job crafting, job control, supervisor support, co-worker support, job satisfaction, workplace social capital, and work engagement. The ICC of the team job crafting scores of 0.125 indicated meaningful variation across wards. At the ward-level, nonsignificant but strong correlations were found with workplace social capital, job satisfaction, and psychological distress. This scale showed acceptable levels of reliability and validity. It would be useful in monitoring and improving team job crafting to increase team members' well-being and performance.