2007 NIDA International Forum: Technological Innovations To Build International Research Capacity

June 15-18, 2007
Quebec City, Canada

Executive Summary

More than 260 registrants from 40 countries participated in the NIDA International Forum, which was held June 15-18 in Quebec City, Canada. The meeting was cosponsored by the NIDA International Program; the Institute of Neurosciences, Mental Health, and Addiction of the Canadian Institutes of Health Research; and the Canadian Centre on Substance Abuse. More than 130 meeting participants presented their research at a joint NIDA International Forum/College on Problems of Drug Dependence international poster session.

NIDA International Program Director Dr. Steven W. Gust described how several years of flat or decreasing budgets have driven the Institute's interest in creating Web-based research and training tools. He also introduced the International Program's summary of 2006 activities, and previewed a NIDA International Program bibliographic study that identified 443 unique funding sources cited by drug abuse researchers who published articles in Addiction and Drug and Alcohol Dependence between 1998 and 2004.

Introducing the meeting theme, Technological Innovations to Build International Research Capacity, Daniel Olguin Olguin of the MIT Media Lab described developmental projects where researchers use electronic or social sensor technologies to track social signals provided by speech and body gestures as well as physiological responses to track individual or group communication patterns, develop mathematical models of human behavior, identify individuals or groups with similar interests, and automatically record organizational interactions. Mr. Olguin Olguin reviewed Media Lab interventions designed to treat depression and diabetes, and invited Forum participants to suggest drug abuse research applications.

Other plenary session speakers discussed high-tech tools – such as ecological momentary assessment, computerized intervention software, and automated clinical bookkeeping for contingency management programs – in drug abuse prevention and treatment research projects.

Dr. Warren Bickel, University of Arkansas, presented data from a randomized controlled trial of Community Reinforcement Approach behavioral therapy intervention delivered to buprenorphine maintenance patients either by an interactive, computer-based program or by a therapist. Dr. Bickel and his colleagues found that the computer-delivered intervention was as effective as the one delivered by a therapist, but that the computer-delivered intervention was more cost-effective, increased access to treatment, and ensured treatment fidelity.

Dr. Kenzie Preston, NIDA Intramural Research Program (IRP), described technology-dependent projects developed at the IRP outpatient substance abuse treatment research program, where she and her colleagues have been using electronic data collection and automated records systems for clinical research. Dr. Preston reported that an automated clinical management program used in conjunction with the IRP's electronic medical record system increased the efficiency of a contingency management intervention by allowing clinic staff to track real-time eligibility for incentives, conduct accurate and tamper-proof prize drawings, and track patients' choices to ensure that the incentives offered really do motivate patients. Dr. Preston also discussed a PDA-based ecological momentary assessment (EMA) project to track stress- vs. cue-induced relapse, which resulted in a 78 percent response rate to electronic prompts asking patients to complete an electronic diary of drug use or temptation to use drugs. Although the equipment costs for the research project were high, Dr. Preston reported that those costs were offset by reduced errors in patient responses, improved accuracy of records, improved fidelity to the research design, and reduced demand for clinical human resources.

A specialist in motivational interventions, Dr. Steven Ondersma demonstrated the fully authorable intervention development software designed by his team at Wayne State University, and discussed how computer-based interventions expand the population impact of behavioral interventions by delivering a moderately positive effect to larger numbers of people. Dr. Ondersma stressed that the computer-based intervention he tested with substance abusing new mothers was not a replacement for therapist-delivered interventions but a cost-effective and easily replicated tool to reach a population that was neither receiving nor seeking any substance abuse services.

Dr. James W. Hopper, Harvard Medical School, presented lessons learned from a recent study that employed a "minimalist" EMA technique to track ecstasy use and craving. The wrist actigraph/data recorder was selected because it was more simple and less obtrusive than standard PDA-based EMA devices. Data analysis required nesting to avoid having one variable unduly influence the results. Despite a low response rate to audible prompts from the actigraph, Dr. Hopper reported that the real life, near real-time data collection proved far more accurate than retrospective self-reports of drug use and craving.

During the poster session, more than 130 drug abuse scientists from around the world presented their research to NIDA Forum and CPDD participants while representatives from nine NIDA components and the NIH Fogarty International Center presented posters summarizing the units' goals, research interests, international focus, and international funding priorities.

Representatives from the Fogarty International Center and the Institute for International Education joined Program Analyst Dale Weiss of the NIDA International Program to discuss funding opportunities for International Program fellowship alumni. Dr. Flavio Pechansky, University of Porto Alegre, Brazil, discussed the individual and group actions necessary to build a regional research network. Among his suggestions were to work closely with mentors; collaborate with colleagues; develop a realistic, long-term plan; be prepared to compete for funding from multiple and ever-changing sources; recognize that funding may be dependent upon policy, not evidence; invest time and effort in developing professional grant-writing skills; study group dynamics to improve management skills; and be creative in developing cost-effective ways to collect data or analyze existing data.

Concurrent workshops focused on ethnographic research in HIV/AIDS; international trends in inhalant abuse and a multinational effort to better define and classify inhalants; and web resources supported by NIDA and the National Institutes of Health, including the National Library of Medicine, the NIDA International Virtual Collaboratory, and Publishing Addiction Research Internationally developed by the International Society of Addiction Journal Editors. Working groups also met during the Forum, focusing on the Addiction Severity Index, the Clinical Trials Network, Ethnography, HIV/AIDS in IberoAmerica and Central-Eastern Europe, and Inhalants Abuse. The Women, Children, and Families working group developed a mission statement to guide future activities.

• NIDA International Forum Women & Gender Working Group
  Mission Statement
  The international women's and children's health and gender group is a multidisciplinary forum. The purpose of the forum is to share findings about the consequences of substance use and abuse, and benefits of prevention, intervention and treatment to help forge future collaborations and research agendas.

CPDD International Committee Chair Dr. Gabrielle Fischer of Austria introduced the 2007 WHO/NIDA/CPDD International Traveling Fellows – Dr. Azarakhsh Mokri, Iranian National Center for Addiction Studies, and Dr. M.N. (Nancy) Phaswana-Mafuya, South African Human Sciences Research Council – and reviewed the accomplishments of the 2005 Fellows, Dr. Konstantyn Dumchev of Ukraine and Dr. Min Zhao of China.

The NIDA International Program presented its 2007 Awards of Excellence to honor mentors, researchers, and binational collaborative teams whose efforts support the International Program mission, including: Excellence in Mentoring, Wallace Mandell; Excellence in International Leadership: David S. Metzger; and Excellence in Collaborative Research: Mahmud Mazlan, Malaysia, and Richard S. Schottenfeld, Yale University.