TY - JOUR
AU - Reilly, Rachel
AU - McKetin, Rebecca
AU - Barzi, Federica
AU - Degan, Tayla
AU - Ezard, Nadine
AU - Conigrave, Katherine
AU - Butt, Julia
AU - Roe, Yvette
AU - Wand, Handan
AU - Quinn, Brendan
AU - Longbottom, Wade
AU - Treloar, Carla
AU - Dunlop, Adrian
AU - Ward, James
PY - 2025
DA - 2025/2/28
TI - Web-Based Application for Reducing Methamphetamine Use Among Aboriginal and Torres Strait Islander People: Randomized Waitlist Controlled Trial
JO - J Med Internet Res
SP - e58341
VL - 27
KW - methamphetamine
KW - Aboriginal and Torres Strait Islander Health
KW - web-based intervention
KW - randomised controlled trial
KW - therapeutic program
KW - methamphetamine use
KW - substance use
KW - digital interventions
KW - treatment
KW - psychosocial wellbeing
KW - effectiveness
KW - app
KW - psychosocial distress
KW - mobile phone
AB - Background: Digital interventions can help to overcome barriers to care, including stigma, geographical distance, and a lack of culturally appropriate treatment options. “We Can Do This” is a web-based app that was designed with input from cultural advisors and end users to support Aboriginal and Torres Strait Islander people seeking to stop or reduce their use of methamphetamine and increase psychosocial well-being. Objective: This study aimed to evaluate the effectiveness of the “We Can Do This” web-based app as a psychosocial treatment for Aboriginal and Torres Strait Islander people who use methamphetamine. Methods: The web app was evaluated using a randomized waitlist controlled parallel group trial. Participants were Aboriginal and Torres Strait Islander people aged 16 years or older who self-identified as having used methamphetamine at least weekly for the past 3 months. Participants were randomized on a 1:1 ratio to receive either access to the web-based app for 6 weeks or a waitlist control group. Both groups received access to a website with harm minimization information. The primary outcome was days of methamphetamine use in the past 4 weeks assessed at 1, 2, and 3 months post randomization. Secondary outcomes included severity of methamphetamine dependence (Severity of Dependence Scale [SDS]), psychological distress (Kessler 10 [K10]), help-seeking behavior, and days spent out of role due to methamphetamine use. Results: Participants (N=210) were randomized to receive either access to the web-based app (n=115) or the waitlist control condition (n=95). Follow-up was 63% at 1 month, 57% at 2 months, and 54% at 3 months. There were no significant group differences in days of methamphetamine use in the past 4 weeks at 1 the month (mean difference 0.2 days, 95% CI –1.5 to –2), 2 months (mean difference 0.6 days, 95% CI –1 to 2.4 days) or 3 months (mean difference 1.4 days, 95% CI –0.3 to 3.3 days) follow-up. There were no significant group differences in K10 scores, SDS scores, days out of role, or help-seeking at any of the 3 follow-up timepoints. There was poor adherence to the web-based app, only 20% of participants in the intervention group returned to the web-based app after their initial log-in. Participants cited personal issues and forgetting about the web-based app as the most common reasons for nonadherence. Conclusions: We found poor engagement with this web-based app. The web-based app had no significant effects on methamphetamine use or psychosocial well-being. Poor adherence and low follow-up hindered our ability to accurately evaluate the effectiveness of the web-based app. Future web-based apps for this population need to consider methods to increase participant engagement. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12619000134123p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376088 International Registered Report Identifier (IRRID): RR2-10.2196/14084
SN - 1438-8871
UR - https://www.jmir.org/2025/1/e58341
UR - https://doi.org/10.2196/58341
DO - 10.2196/58341
ID - info:doi/10.2196/58341
ER -
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