{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:30:52Z","timestamp":1791394252861,"version":"4.3.3"},"reference-count":60,"publisher":"JMIR Publications Inc.","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Misuse of substances is common, can be serious and costly to society, and often goes untreated due to barriers to accessing care. Woebot is a mental health digital solution informed by cognitive behavioral therapy and built upon an artificial intelligence\u2013driven platform to deliver tailored content to users. In a previous 2-week randomized controlled trial, Woebot alleviated depressive symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to adapt Woebot for the treatment of substance use disorders (W-SUDs) and examine its feasibility, acceptability, and preliminary efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>American adults (aged 18-65 years) who screened positive for substance misuse without major health contraindications were recruited from online sources and flyers and enrolled between March 27 and May 6, 2020. In a single-group pre\/postdesign, all participants received W-SUDs for 8 weeks. W-SUDs provided mood, craving, and pain tracking and modules (psychoeducational lessons and psychotherapeutic tools) using elements of dialectical behavior therapy and motivational interviewing. Paired samples t tests and McNemar nonparametric tests were used to examine within-subject changes from pre- to posttreatment on measures of substance use, confidence, cravings, mood, and pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The sample (N=101) had a mean age of 36.8 years (SD 10.0), and 75.2% (76\/101) of the participants were female, 78.2% (79\/101) were non-Hispanic White, and 72.3% (73\/101) were employed. Participants\u2019 W-SUDs use averaged 15.7 (SD 14.2) days, 12.1 (SD 8.3) modules, and 600.7 (SD 556.5) sent messages. About 94% (562\/598) of all completed psychoeducational lessons were rated positively. From treatment start to end, in-app craving ratings were reduced by half (87\/101, 86.1% reporting cravings in the app; odds ratio 0.48, 95% CI 0.32-0.73). Posttreatment assessment completion was 50.5% (51\/101), with better retention among those who initially screened higher on substance misuse. From pre- to posttreatment, confidence to resist urges to use substances significantly increased (mean score change +16.9, SD 21.4; P&lt;.001), whereas past month substance use occasions (mean change \u22129.3, SD 14.1; P&lt;.001) and scores on the Alcohol Use Disorders Identification Test-Concise (mean change \u22121.3, SD 2.6; P&lt;.001), 10-item Drug Abuse Screening Test (mean change \u22121.2, SD 2.0; P&lt;.001), Patient Health Questionnaire-8 item (mean change 2.1, SD 5.2; P=.005), Generalized Anxiety Disorder-7 (mean change \u22122.3, SD 4.7; P=.001), and cravings scale (68.6% vs 47.1% moderate to extreme; P=.01) significantly decreased. Most participants would recommend W-SUDs to a friend (39\/51, 76%) and reported receiving the service they desired (41\/51, 80%). Fewer felt W-SUDs met most or all of their needs (22\/51, 43%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>W-SUDs was feasible to deliver, engaging, and acceptable and was associated with significant improvements in substance use, confidence, cravings, depression, and anxiety. Study attrition was high. Future research will evaluate W-SUDs in a randomized controlled trial with a more diverse sample and with the use of greater study retention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov NCT04096001; http:\/\/clinicaltrials.gov\/ct2\/show\/NCT04096001.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/24850","type":"journal-article","created":{"date-parts":[[2021,1,31]],"date-time":"2021-01-31T17:13:25Z","timestamp":1612113205000},"page":"e24850","source":"Crossref","is-referenced-by-count":258,"title":["A Therapeutic Relational Agent for Reducing Problematic Substance Use (Woebot): Development and Usability Study"],"prefix":"10.2196","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7925-326X","authenticated-orcid":false,"given":"Judith J","family":"Prochaska","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7193-8720","authenticated-orcid":false,"given":"Erin A","family":"Vogel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2739-7338","authenticated-orcid":false,"given":"Amy","family":"Chieng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4065-1217","authenticated-orcid":false,"given":"Matthew","family":"Kendra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7571-5268","authenticated-orcid":false,"given":"Michael","family":"Baiocchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3201-0353","authenticated-orcid":false,"given":"Sarah","family":"Pajarito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1393-1563","authenticated-orcid":false,"given":"Athena","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2021,3,23]]},"reference":[{"key":"ref1","year":"2018","journal-title":"Global status report on alcohol and health"},{"key":"ref2","unstructured":"Institute for health metrics and evaluationGlobal burden of disease study 2016 results database20172021-02-17http:\/\/ghdx.healthdata.org\/gbd-results-tool"},{"key":"ref3","unstructured":"Substance Abuse and Mental Health Services AdministrationKey substance use and mental health indicators in the United States: results from the 2018 National Survey on Drug Use and HealthCenter for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration20192021-02-17https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/cbhsq-reports\/NSDUHNationalFindingsReport2018\/NSDUHNationalFindingsReport2018.pdf"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.61.8.807"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12578"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2017.00954"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s40501-019-00190-y"},{"key":"ref8","unstructured":"PerrinATurnerESmartphones help blacks, Hispanics bridge some - 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