Developing a Smartphone Application to Support Veteran Opioid Use Disorder Treatment

Theoretical Framework of Acceptability (TFA) scale

The Theoretical Framework of Acceptability provides a rigorous framework for assessing the acceptability of health information technology, offering both prospective and retrospective acceptability scales, which respectively assess how acceptable one believes they will find a health intervention and how acceptable they found the intervention after use. The investigators will use the prospective scale (i.e., assessing how acceptable participants think the ACT to RECOVER app would be if they were to use as part of their treatment). The TFA's scale asks participants to rate 7 dimensions of acceptability (affective attitude towards a health intervention, burden, value alignment, understanding of intervention functioning, perceived benefit, perceived effectiveness, and self-efficacy) on a 5-point scale, with avg.'s \>3 indicating minimum degrees of acceptability.

App usage: Openings

Continuously-recorded via smartphone apps in respective conditions as a frequency count of the number of times a respective app is opened.

App usage: Duration

Continuously-recorded via smartphone apps in respective conditions as the total duration of time (as number of minutes) spent using the respective app.

Enrollment: Enrollment Rate

Participant enrollment rate. Study target is \>2 participants/month on avg., assessed upon completion of Stage 3 study procedures.

Usability Survey

The usability survey items are drawn from a questionnaire developed by Wilson and Lankton (2004) to measure a range of health information technology areas. Each item is scored on a 7 point Likert scale where 1 = strongly disagree and 7 = strongly agree. There are 8 subscales: 1. Satisfaction with Medical Care Scale (3 items, range 3 - 21); 2. Health Knowledge Scale (2 items, range 2 to 14); 3. Internet Dependence Scale (4 items, range 4 to 28); 4. Information-seeking Preference Scale (4 items, range 4 to 28); 5. Intrinsic Motivation Scale (3 items, range 3 to 21); 6. Perceived Ease of Use Scale (3 items, range 3 to 21); 7. Perceived Usefulness: Extrinsic Motivation Scale (3 items, range 3 to 21); 8. Behavioral Intention to Use E-health Scale (2 items, range 2 - 14). For each scale, items are summed, with higher score indicating greater levels of satisfaction, knowledge, dependence, information preference, motivation, ease of use, usefulness, and intention to use the system.

Values-based living (VQ)

Valued living will be assessed using the Valuing Questionnaire (VQ), which assesses the extent to which personal values have been enacted within the past week. It is designed to capture the quality of valued action (i.e., the extent to which behaviors accord with what one values) using everyday language and without reference to specific life domains.

Multidimensional Experiential Avoidance Questionnaire (MEAQ)

A 62-item self-report measure of experiential avoidance, including subscales on Behavioral Avoidance (11 items, range 11 to 66), Distress Aversion (13 items, range 13 to 78), Procrastination (7 items, range 7 to 42), Distraction \& Suppression (7 items, range 7 to 42), Repression \& Denial (13 items, range 13 to 78), and Distress Endurance (11 items, range 11 to 66). The scale for all items ranges from 1 (strong disagree) to 6 (strongly agree). Greater scores within each subscale indicate greater levels of the named construct. A total score can be obtained with the following calculation: Behavioral Avoidance + Distress Aversion + Procrastination + Distraction \& Suppression + Repression \& Denial + (77 - Distress Endurance).

Veteran's RAND 36 (VR-36)

Quality of Life will be assessed using the Veteran's RAND 36-item Health Survey (VR-36), which is designed to assess health-related quality of life with respect to role limitations, social and physical functioning, general and mental health, energy and fatigue, and bodily pain. It is often summarized into physical and mental functioning components, and is one of the most widely utilized and valid measures of physical and psychological well-being.