Hollings researchers secure funding for trial to reduce vaping among adolescents

June 15, 2021
Vaping App Screenshots
The $320,000 small business technology transfer grant awarded by the National Institute on Drug Abuse will help researchers to develop a smartphone app designed to help adolescents quit vaping.

MUSC Hollings Cancer Center researchers have found most adolescents want to stop vaping. The challenge is how to support them in dropping an addictive behavior. For many young people, helping them to cope with depression is key.

Enter onto the scene Jennifer Dahne, Ph.D., an assistant professor at MUSC’s College of Medicine and a member of Hollings’ Cancer Control Program. She recently received one of the first National Institutes of Health-funded grants aimed at reducing vaping among adolescents. The $320,000 small business technology transfer grant awarded by the National Institute on Drug Abuse will help researchers to develop a smartphone app designed to help adolescents quit vaping.

“Most of my research focuses on development of various technology-based interventions. I focus mostly on depression treatment and smoking cessation,” said Dahne. “Those are my interest areas because they affect a lot of people. With my program of research, I think about how we develop interventions, evaluate them and get them out there in a way that really is going to get us the most bang for our buck.”

This trial will further Hollings’ cancer control research program by addressing an issue affecting more and more adolescents. According to previous studies cited in Dahne’s work, the number of adolescents who reported vaping has increased from near zero in 2011 to 27.8% in 2019.

“The idea behind the small business technology transfer grant program is to take tax dollars that we’re paying to NIH’s research portfolio and invest them in research that then is going to move toward products being commercialized and generating revenue that goes back into the economy,” said Dahne.

Jennifer Dahne holds smartphone-enabled devices used in remote clinical trials 
Dr. Jennifer Dahne focuses her research on technology and digital tools that help make interventions more widely available.

The project is one of the latest examples of collaboration within MUSC. Dahne partnered with the MUSC Foundation for Research Development in applying for, and receiving, funding for the trial that will help to advance innovation at MUSC.

“I think MUSC is doing a fantastic job at thinking about how to innovate in a way that will allow us to commercialize our innovations that then brings money back to the university, and to the economy more broadly, and gets our interventions out there on a wider scale,” Dahne said.

The project involves a multidisciplinary team, including Hollings researchers Tracy Smith, Ph.D., and Matthew Carpenter, Ph.D., also in the Cancer Control Program, and Lindsay Squeglia, Ph.D., with the Department of Psychiatry and Behavioral Sciences at MUSC.

The team is working with the small business MountainPass Technology LLC, to create an app that will address some of the biggest risk factors that may cause adolescents ages 16 to 20 to start, and continue, vaping.

Jack Kustanowitz, principal at MountainPass Technology, said his group has worked with Dahne on other projects and likes the opportunity to partner with researchers. “Our early apps were single-platform, iOS only, and mirrored the paper and pencil approach fairly closely,” he said. “Over the years, the ability to develop cross-platform for both iOS and Android had improved greatly, and our new designs reflect our growing understanding of how mobile app users interface with technology to manage the treatment process.”

This is critical to reaching the targeted age group, said Dahne. “We wanted to do a digital intervention because we know about 98% of this age group is using smartphones really frequently.”

Examining what triggers vaping usage, researchers identified one of the biggest risk factors as being depressive symptoms, reported by 36% of adolescent vapers. The app will focus on an evidence-based treatment for depression called behavioral activation.

“You’re treating depression by helping a patient to identify activities that they can complete that are important to them, that will be enjoyable to them, and that they can schedule into a daily calendar,” she said.

Users will be able to track their successes and accomplishments through the app, which will also allow them to see changes in their vaping habits. The app is specifically being created and tested to appeal to younger generations.

“We’ve added in some of these gamification elements that are really popular with this age group. So the more that you engage with the app, the more you do in the app, your vape score goes up,” Dahne said. “Right now, we have things like a leader board, where they can see where they fall relative to other people, which we hope will be reinforcing in getting them to continue interacting with the app.”

Kustanowitz acknowledges the challenges this study poses for both researchers and app developers. He said the target demographic in this study is different and more focused than ones they’ve worked with in the past.

“I believe our approach of design, validation through interviews, development and then user feedback will let us produce something of measurably high quality that we hope we will be able to continue to develop beyond the initial study,” Kustanowitz said.

Researchers will gather feedback on the app from the target age group before the trial begins. Once the app has been tested, Dahne will partner with Vanessa Diaz, M.D., an MUSC family medicine physician, to test 30 adolescent participants, 20 of whom will use the app and 10 of whom will receive traditional care at MUSC Health and other affiliated primary care facilities throughout South Carolina.

“Most people with depression are getting their treatment through their primary care provider, not from a mental health specialist,” Dahne said. “What we know about primary care is that it is incredibly busy. They have very little time for each patient, and there’s a lot to handle in that time.”

“We have this opportunity here to intervene early to help folks to quit vaping and perhaps cut that progression to transitioning to cigarette smoking. I think that’s why it is really important for our cancer control program.”
— Dr. Jennifer Dahne

Each participant will be enrolled in the trial for four weeks, but Dahne estimates that it will take at least six months to complete the trial. Once complete, researchers will measure and compare results with the group who used the app versus those who received traditional primary care treatment. Researchers will specifically measure changes between how much users reported vaping, whether they tried to quit, how long they quit, and where they fell on a depression scale.

“You can no longer develop an intervention, especially for this age group, where you’re going to say, ‘You’re going to come in and do group therapy, in-person, for 12 weeks, and everything is going to be done on paper,’” Dahne said of the importance of the app features.

Dahne hopes this trial will also encourage healthier choices for adolescents in the future.

“We have this opportunity here to intervene early to help folks to quit vaping and perhaps cut that progression to transitioning to cigarette smoking,” she said. “I think that’s why it is really important for our cancer control program.”

Dahne said the long-term goal of this initial study and trial is to create a commercial product that could be readily available to adolescents across the country. Work on the app began at the beginning of May, and the study is expected to run through the end of April 2022.

“The idea with an app-based intervention like this is it could be very easily recommended within a short period of time within primary care,” she said. “So if a primary care provider, or a pediatrician, or a school nurse sees an adolescent who is vaping, they can be like ‘Hey there’s this app that is available to you that you may find beneficial.’”

Parents who are interested in getting their adolescents involved in the project or young people up to age 20 should contact program coordinator Noelle Natale at natalen@musc.edu.