A Mobile Phone-Based Decision Support System for Substance Use Screening and Referral in a Resource Limited University Setting.

Background:

Substance use disorders (SUDs) lead to considerable harm to the individuals, families and societies as a whole¹. The use of alcohol and other substances during adolescence and early adulthood is a serious public health problem in many developing countries such as Kenya². This is due to the fact that adolescence and young adulthood are periods of high risk for substance use leading to short and long-term harm³. Stigma associated with SUDs leads to missed opportunities in identification, referral and linkage to care⁴. Clinical decision making support (CDS) tools have a potential to improve early diagnosis and care provision⁵⁶. This study on university students, pilots a peer mentorship led SUDs early screening and referral tool.

Methods

Based on the emerging field of implementation science, the study design was quasi-experimental. An experimental group of peer mentors were trained to use mHealth platform for their intervention while a comparative group of controls used treatment as usual practice. The two groups were selected purposely from two different and geographically separated university campuses. Using mobile health technology(mHealth), the experimental group implemented a decision making and referral support to prevent alcohol and substance use among university students. Mobile telephones employing the Open Data Kit⁷ technology used the Alcohol Use Disorders Identification Test (AUDIT) and Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) tools to identify at risk students, brief intervention and referral to prevent SUDs.

Results

Over 96% of the 52 peer mentors who participated in this study as the experimental cohort approved the use mHealth for peer mentoring. 92% found the use mHealth beneficial. 78% found it flexible to use.

Conclusion

mHealth technology enabled the university to early-identify high risk students for SUDs and to link them to preventive care and support. mHealth technology is highly acceptable to the university. mHealth technologies provide a promise for improved behavioral interventions for substance use prevention among university students in resource limited setting.