4 - (SYM 7) Using Human-centered Design with Neurodivergent Young Adults and Community Partners to Develop a Smartphone-based Intervention for Problematic Drinking

Young adults (ages 18-25) are at highest risk for problematic alcohol use (e.g., binge drinking) of any age group (SAMHSA, 2018), yet strikingly few (5%) are treated (Chen et al., 2016). Attention-deficit/hyperactivity disorder (ADHD) increases this risk (Molina et al., 2018), in part due to executive functioning deficits like poor inhibitory control (difficulty stopping/modifying a behavior; Weafer et al., 2010). The TIPS mobile-health (mHealth) intervention (“training inhibitory control using personalized strategies”) is being developed to help improve problematic alcohol use by addressing the unique executive functioning needs of young adults with ADHD. By leveraging the smartphones young adults use daily to optimize intervention access and acceptability, TIPS aims to help build skills in the moment and in context, instill enduring habits, and disrupt problematic alcohol use (even in young adults who are not explicitly trying to reduce their use) by targeting upstream executive functioning.

The core elements of the TIPS mHealth intervention are rooted in executive functioning theory: inhibitory control monitoring, personalized feedback on ADHD symptoms, and tailored behavioral strategy suggestions (“tips”) delivered in drinking and non-drinking contexts. Critically, to complement theory with practical usability, the specific content and features are being co-designed with end users and community partners through multiple stages of development: 1:1 cognitive interviews, iterative virtual focus groups and quantitative acceptability measures among young adult drinkers with ADHD piloting the intervention, and meetings with a diverse community advisory board (e.g., young adults with ADHD who use alcohol, therapists, psychiatrists, college disabilities specialists).

This talk will describe the application of human-centered design principles in the development of the TIPS intervention. We will discuss the cyclical design process and illustrate specific human-centered design methods that have enhanced the intervention. We will also highlight how collaborating with end users and community partners early and throughout the intervention development process has crucially helped tailor the intervention to the needs of young adults with ADHD, especially those who are not seeking support for their drinking, while building sustainable, synergistic partnerships. Importantly, the invaluable benefits of a community engaged, human-centered approach to alcohol research will be discussed, alongside key pitfalls to avoid.