SBIR-STTR Award

Peers are increasingly recognized as an important asset in healthcare. Peer supports are historically most prominent for substance use disorder (SUD). For trauma and posttraumatic stress disorder (PTSD), there have been very few attempts at peer help. A key challenge of trauma peer groups is that they usually focus on "telling the story" of members' trauma histories, which can be overly triggering and distressing. Seeking Safety (SS) offers an excellent choice for peer-led care. It is an evidence-based, widely adopted model for PTSD/SUD. It is extremely well-suited to peer delivery because it is highly stabilizing, structured, optimistic, and educational; and it has already been successfully implemented in peer-led format for many years by many different entities. We propose a mobile app for delivery of peer-led Seeking Safety (PSS) in this Phase I application. The app would be highly innovative: the first app for any trauma/SUD model, the first for trauma/SUD peer support, and the first for PSS. It has no existing competitors on the market. Given the high rate of trauma/SUD comorbidity and its far-reaching impact, such an app could have major public health importance as well as strong commercial potential. Our aims are as follows. (1) To develop the peer-led Seeking Safety (PSS) mobile app. This will be an exciting, engaging Android app for smartphones and tablets. We emphasize three app domains for end-users to access as well as two key processes that apply across the domains (all described in detail in the proposal, including user experience and technical details). Overall, we would leverage technology to create PSS in an online environment that would support recovery "anytime, anywhere," powered by highly engaging content and delivery. Most people with trauma/SUD do not obtain formal treatment. The PSS app could address the need for access in remote locations, for anonymous help, and for convenient help, delivered by people who share their experiences as peers. Even for those who do attend in-person modalities, the app can provide additional support and unique features. For development of the app we emphasize an iterative process that includes focus groups with end-users as well as input from our outstanding consulting team, several of whom are peers themselves and/or have conducted PSS. (2) To conduct a feasibility study of the app. This pilot will obtain information on end-users experience, usage, and satisfaction with the app, which can inform a Phase II study if warranted by our Phase I results. Qualitative and quantitative data will be obtained pre and post, with an emphasis on validated instruments. Our truly stellar team has expertise in peer services; research on trauma/PTSD and SUD; telehealth; mobile app development for healthcare; and a focus on innovative products to improve care for vulnerable populations. This project would create a novel technology solution to provide care for an important population (people with trauma/SUD). The use of PSS in app form can create major impact from both a public health and commercial standpoint.

Public Health Relevance Statement:


Public Health Relevance:
We propose to develop a mobile application ("app") for peer-led Seeking Safety (PSS). PSS is designed to teach coping skills to people who have substance abuse and trauma problems. The app could be used on Android smartphones or tablets and is designed to help peers engage in PSS using exciting technology-based features.

Project Terms:
Address; Adopted; Adverse event; Alcohol or Other Drugs use; Alcoholics Anonymous; Android; Area; base; Behavior; Behavioral; behavioral health; Benchmarking; care systems; Caring; Cellular Phone; Client; Cognitive; Comorbidity; Consult; Coping Skills; Data; design; Development; Disease model; Distress; Educational process of instructing; Environment; evidence base; experience; Feasibility Studies; Focus Groups; health care delivery; Healthcare; improved; Incentives; Individual; innovation; instrument; Knowledge; Licensing; Location; Marketing; Measures; meetings; member; mobile application; Modality; Modeling; neighborhood safety; new technology; Participant; peer; Peer Group; peer support; Persons; Phase; phase 2 study; Pilot Projects; Play; Population; Post-Traumatic Stress Disorders; Process; psychoeducation; Psychological reinforcement; Public Health; public health relevance; Randomized Controlled Trials; Recording of previous events; Recovery; Research; Safety; satisfaction; Schedule; Services; skills; Small Business Innovation Research Grant; social; Structure; Substance abuse problem; Substance Use Disorder; success; Symptoms; Tablets; Technology; telehealth; TimeLine; Trauma; trauma symptom; user centered design; virtual; Vulnerable Populations

Peers are increasingly recognized as an important asset in healthcare. Peer support is historically most prominent for substance use disorder (SUD), such as the world-wide model of Alcoholics Anonymous and other 12-step groups. Yet for trauma and posttraumatic stress disorder (PTSD) there have been few attempts at peer help. A major challenge of trauma peer groups is that they usually focus on telling the story of members' trauma histories, which can be overly triggering and distressing. Seeking Safety offers an excellent choice for peer-led care. It is an evidence-based and is the most widely adopted model for SUD/PTD. It is present-focused, cognitive-behavioral, and provides psychoeducation and coping skills to help clients attain greater safety in their lives-- safety from unsafe behavior toward themselves and others, substance use, and trauma symptoms. It has been successfully implemented in peer-led format for many years and has been studied in various trials, including a recent randomized controlled trial (RCT) comparing peer versus professional delivery, with positive results. In Phase 1 we developed an exiting, beta version of a mobile app for peer-led Seeking Safety (PLSS). The Peer Safety (PS) app was based on extensive input from end users and was evaluated in a feasibility study. We found strong positive results in Phase 1 and now propose a Phase 2 project to continue this work. In Phase 2 we would enhance the app features and content and also conduct an RCT in a sample of adults with current SUD/PTSD to compare the PS app condition to a control app. They would have 12 weeks to use the app and participate in weekly online PLSS, and would be assessed pre, post and at 3-month followup using validated instruments. We will also measure app usage and satisfaction. The primary outcomes are substance use and emotion regulation. Our team offers an exceptional mix of expertise in SUD, PTSD, app development, clinical trials, Seeking Safety, peer services, and SBIRs. Our public health goal is to leverage technology to create PLSS in an online environment that would support recovery ?anytime, anywhere,? powered by highly engaging content and delivery. Most people with SUD/PTSD do not obtain formal treatment. The PS app could address the need for access in remote locations, for anonymous help, and for convenient, low cost help, delivered by people who share their experiences as peers. Even for those who do attend in-person modalities, the app can provide additional support and unique features. This project proposes a novel technology solution to provide care for an important population-- people with SUD/PTSD.

Thesaurus Terms:
Address; Adopted; Adult; Adverse Event; Alcohol Or Other Drugs Use; Alcoholics Anonymous; Base; Behavior; Behavioral; Benchmarking; Caring; Client; Clinical Trials; Cognitive; Commercialization; Comorbidity; Consult; Coping; Coping Skills; Cost; Craving; Data; Design; Development; Distress; Elements; Emotion Regulation; Enrollment; Environment; Evidence Base; Experience; Feasibility Studies; Feedback; Feeling; Goals; Handheld Mobile Device; Healthcare; High Risk; Hour; Improved; Innovation; Innovative Technologies; Instrument; Interview; Licensing; Location; Marketing; Measures; Member; Methodology; Methods; Mobile Application; Modality; Modeling; New Technology; Outcome; Participant; Pathway Interactions; Peer; Peer Group; Peer Support; Persons; Phase; Population; Post-Traumatic Stress Disorders; Power Analysis; Primary Outcome; Product Development; Psychoeducation; Public Health; Randomized Controlled Trials; Recording Of Previous Events; Recovery; Remote Location; Response; Safety; Sales; Sampling; Satisfaction; Secondary Outcome; Services; Small Business Innovation Research Grant; Social; Statistics; Structure; Substance Abuse Problem; Substance Use Disorder; Success; Sum; Technology; Telephone; Trauma; Trauma Symptom; Trend; Trial Comparing; Work;