Lessons Learnt from the conduct of a Pilot Study of a Codesigned Mobile Attention Bias Modification Intervention during the COVID-19 Pandemic (Preprint)

BACKGROUND Substance use disorders are prevalent globally, that of opioid use disorders. Conventional treatment involves a combination of both pharmacological and psychological approaches. With advances in experimental psychology, there is now a better understanding of attentional biases in substance use disorders. Prior meta-analytical review has highlighted the existence of robust attentional biases amongst opioid using individuals. To date, there remains limited evaluation of bias modification amongst an Asian cohort of participants. Whilst there has been attempts to better the conventional methods of assessment through co-design, such co-designed application has yet to be evaluated. OBJECTIVE The primary objective of this pilot randomised trial was to refine the intended processes of the definitive study (i.e. the recruitment of participants, the process of randomisation into two separate intervention arms, and the administration of the intervention). METHODS The study design was that of a non-blinded randomised controlled trial. Participants were allocated to receiving either the conventional attention bias modification task or the newly designed co-designed task by means of simple randomisation. The study was conducted on the inpatient unit at the National Addictions Management Service, Institute of Mental Health Singapore. Convenience sampling was used to recruit participants over a period of 12 months, with all participants being screened for the presence of baseline biases. On each day of the intervention, participants must undertake both a bias assessment and modification task. RESULTS Over a period of 4 months, a total of 12 participants were invited to participate, of which 4 declined, thus leaving 8 participants who consented to participate. The study was terminated early because of the COVID-19 Pandemic. Of these 8 potential participants, only 3 screened positive. There was a 66.7% attrition rate as two of the 3 participants completed the planned interventions. CONCLUSIONS Our pilot study has provided preliminary evidence of the feasibility of the planned methods, despite the small sample size. Several findings arising from this current pilot (such as there being an absence of baseline biases in some participants) have resultant implications when planning the definitive randomised trial.