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NIH grant 1IK2RD001916-01A1: Development of a mobile health intervention to support functioning of Veterans with substance use disorders
Institute: {'code': 'VA', 'abbreviation': 'VA', 'name': 'Veterans Affairs', 'admin_org_id': '12500964', 'admin_funding_url': ''}. PI: Shannon Willis Schrader. Award: $.
Start: 2026-10-01T00:00:00.
Significance to VA: Over 2.4 million Veterans meet criteria for a SUD, which can have particularly harmful
effects on Veteran functioning. Residential SUD treatment programs, which are highly structured treatment
settings with 24/7 care and support, are standard clinical care for SUDs. Despite the intensity of residential
SUD treatment, rates of relapse after treatment completion remain high, especially in the first month after
completion of residential SUD treatment, as this time is a pivotal transition to settings that offer less support,
structure, and oversight as well as more opportunity for relapse. The time immediately following intensive
residential SUD treatment completion is a juncture where additional intervention could aid Veterans in
successfully navigating this difficult transition. To sustain functional improvements gained during residential
SUD treatment that can – in turn – prevent return to use, continued support and engagement in treatment
during this timeframe is of crucial importance. Digital health interventions (DHIs) that target recovery-oriented
outcomes are promising avenues to support Veteran functioning during this transition.
Innovation and Impact: This goal of this CDA2 is to develop, refine, and evaluate a smartphone app
grounded in Motivational Enhancement Therapy (“Motivational Enhancement Therapy Skills for Veterans” or
“METS4Vets”) to support the functioning of Veterans with SUDs during the transition from residential SUD
treatment to outpatient care settings. Delivering MET content via an app – the direction the intervention field is
moving – allows for accessing support in vivo when it is needed the most while increasing portability,
accessibility, and ease of use. Digital delivery of MET can also directly support Veteran psychosocial
functioning, as MET focuses on increasing and sustaining motivation via creating a life consistent with personal
values and goals, rather than solely on clinical symptom reduction. Thus, METS4Vets ultimately has the
potential to engender improvement across multiple clinical and functional domains that are applicable to a
broad Veteran population. In addition, METS4Vets will be developed with not simply for Veterans with SUDs
by directly engaging them in all steps of the development process to ensure that the resultant product will
actually be used by Veterans.
Specific Aims: Aim 1) develop content for METS4Vets; Aim 2) refine METS4Vets via field-based iterative
testing; and Aim 3) conduct a feasibility and acceptability evaluation of METS4Vets.
Methodology: Participants will be Veterans drawn from the VA Connecticut Healthcare System residential
SUD treatment program. Aim 1: Develop preliminary app content and protocol and present content, design,
and interface to VA clinicians (n=10) and Veterans (n=10). Revise the app based on this stakeholder input. Aim
2: Refine the delivery mode and intervention content via field-based iterative testing with Veterans (n=12-15)
receiving the intervention across 3 iterative waves (n=4-5 Veterans per wave). Aim 3a: Conduct a single arm
open pilot trial (n=40) to assess the feasibility, acceptability, and usability of METS4Vets and study procedures.
Aim 3b: Collect preliminary data on functional and clinical outcomes.
Path to Translation/Implementation: This proposed CDA2 will test the feasibility, acceptability, and usability
of METS4Vets and study procedures, and will identify challenges with implementation and allow for
modifications to be made before conducting a full-scale RCT. If results indicate the intervention is acceptable
and that the study methods are feasible, the next step will be to conduct a fully powered RCT in which
hypothesis testing would be appropriate and efficacy data can be obtained. If METS4Vets is ultimately found to
be efficacious, future research can investigate the feasibility of a treatment protocol that is adapted to support
Veterans navigating other critical transitions (i.e., from homelessness to independent living environments,
active duty to civilian life, or bridge clinics to longer-term primary care).document fetched 2026-10-24 02:46