Project Summary This candidate is requesting support for a four-year program of training and research to use digital phenotyping to gain a novel understanding of how digital media influences like exposure to drug and alcohol- related content online can impact adolescent substance procurement and use. Addressing adolescent substance use is challenging due to the diverse social and environmental factors that can impact a youth’s decision to experiment with drugs or alcohol. Digital media use, including online exposure to substance-related content, is one such potential factor of growing daily influence in adolescent lives. However, little is currently known about how exposure to drug and alcohol-related content differs across media platforms (e.g. gaming, social media), nor whether exposure on one media platform may be more likely to facilitate drug procurement or precipitate an instance of substance use. This limitation in our understanding of these relationships is secondary to both recall bias and the cross-sectional survey methodology used in prior studies. This project will leverage novel digital phenotyping (DP) technology to collect smartphone sensor data in combination with active surveys about digital media exposures and substance use. In this manner, we plan to identify more accurately those digital media exposures and experiences that impact adolescent use of drugs and alcohol, and improve upon existing clinical guidance accordingly. In the proposed training plan, the candidate will build upon her previous experience in use of digital phenotyping to understand high-risk adolescent digital media use. Her training plan includes training in: 1) statistical methods for multivariate longitudinal analysis, 2) design and implementation of digital phenotyping tools that capture high-risk digital experiences/exposures in real time, 3) design and piloting of ecological momentary intervention protocols, and 4) responsible conduct of digital phenotyping research in adolescents with a history of substance use. In line with NIDA’s mission of identifying behavioral, environmental and social causes of substance use across the lifespan, this research plan will 1) determine which subtypes of digital media use are more frequently associated with exposure to drug and alcohol-related content and 2) assess which exposures are more frequently associated with instances of substance procurement and use. We will also explore the potential moderating effects of psychiatric symptoms and online victimization on the relationship between exposure to substance-related content and substance use. This study will be performed across 2 years in subjects between 15 and 18 years of age. A subsequent R01 proposal will then outline the design and pilot of an ecological momentary intervention protocol with the goal of intervening in real time upon digital exposures/experiences associated with adolescent substance use.

Adolescent-onset substance use disorders are linked to poorer psychosocial outcomes and are predictive of mortality in early adulthood. For this reason, it is important to identify social and environmental factors that increase an adolescent’s risk of using substances and address those factors in clinical guidance and treatment planning. This study proposes the use of digital phenotyping technology to examine the complex and growing influence of digital media, including online exposure to substance-related content, on adolescent use and procurement of drugs and alcohol.