jbrehm2, August 5, 2014 | View original publication
Texting offers new way to study substance abuse
The mercurial nature of homelessness has kept researchers from pinpointing which factors limit substance use — and how others trigger it — among the nearly 3 million American youth living on the streets.
With a new $400,000 grant from the National Institutes of Health's National Institute on Drug Abuse, UNL researcher Kimberly Tylerwill use technology to address this sociological challenge for the sake of confronting the societal one.
Tyler, a professor of sociology, will distribute prepaid cell phones to 150 homeless teens and young adults recruited from service agencies in Omaha and Lincoln. She will then use an automated texting system to send them a series of questions each morning, afternoon and evening for 30 days.
This data collection technique, known as SMS (short message service) surveying, will give Tyler real-time insights into a population that’s at least twice as susceptible to substance use as those living under a roof.
Tyler will specifically track whether alcohol and drug use among homeless youth changes in combination with the presence of social resources — including support networks, positive role models and homeless services — that may buffer against it.
“There’s very little research that focuses on the strengths of homeless youth because they have so many risks that the research overwhelmingly tends to focus on those," Tyler said. "We are trying to also focus on positive factors among this population.”
Tyler will also use SMS surveying to determine whether drug use varies alongside social and psychological stress experienced on the streets. Texts aimed at assessing this stress will ask where participants slept; whether they have been assaulted or struggled to find basic necessities; and whether they have felt anxious or depressed.
SMS surveying represents one of the few conceivable methods for gleaning these daily insights from so many participants, Tyler said.
“This is a difficult population to access, sample and collect data on,” said Tyler, whose study is housed within the Nebraska Center for Research on Children, Youth, Families and Schools. “It’s not like with general population samples — the majority of which own cell phones — where we can send them a hyperlink and ask them to answer survey questions. Texting will provide us with additional and unique data that has not previously been collected with this hard-to-sample population.”
The real-time nature of SMS surveying, Tyler said, should also begin to clarify whether connections among substance use, social resources and stressors are causal or correlational.
“A youth could be assaulted and subsequently drink, or they may be drinking and thus are at higher risk of being assaulted,” Tyler said. “Alternatively, they might occur together. We’re hoping that the texting data will help shed additional light on the relationship between victimization and substance use.”
The SMS surveying will follow in-person interviews with the study’s participants, whose elevated risk of substance use may stem from growing up in especially difficult conditions, Tyler said. Accordingly, the initial interviews will determine whether recent substance use correlates with childhood burdens such as physical and sexual abuse, parental drug use, and foster care placement.
“I don’t think you can look at their current situation without understanding where they came from,” Tyler said. “Many of these young people have had bad things happen to them on the street, but many of their current difficulties are also linked to their early family history.”
In addition to asking about social resources, the interviews will assess the presence of psychological strengths such as self-efficacy and self-esteem. The answers will help Tyler test her hypothesis that these collective “protective factors” can diminish the potential link between childhood disadvantages and substance use on the streets, she said.
The study’s findings could further curb alcohol and drug use among the homeless, Tyler said, by serving as the foundation of a follow-up that explores texting’s use in intervention programs.
“We could test the effectiveness of an intervention using what we learn in this study,” Tyler said. “If we find that, say, self-efficacy or positive role models really matter for homeless youth, then those would be factors we could focus on.
“I think texting could be a huge tool for intervention. It could really help this population reduce substance use, which is the ultimate goal.”
The NIH grant is No. 1 R21 DA036806-01A1.