Pilot randomized trial of MOMENT, a motivational counseling–plus–ecological momentary intervention to reduce marijuana use in youth
Open accessAbstract
Background: Ecological momentary interventions (EMIs) influence behavior in real time, in real life. We evaluated trial feasibility and preliminary efficacy of MOMENT, a counseling-plus-EMI to reduce frequent marijuana use in youth in primary care. Methods: Primary care patients age 15–24 years using marijuana at least 3 times/week were randomized to MOMENT [motivational enhancement therapy (MET)/smartphone-based momentary assessment/responsive motivational messaging] vs. No-messages (MET/momentary assessment) vs. MET-only. In MOMENT, two MET sessions were followed by 2 weeks of momentary assessment of marijuana use and factors related to use, with motivational messaging displayed after report of marijuana triggers, desire, use, and effort to avoid use. We evaluated study feasibility (recruitment, retention, and response rates; feedback survey responses) and explored intervention effects on marijuana desire and use at three months with linear mixed effects modeling. Results: Seventy youth [mean (M) =20.7 years, 60% female] were assigned to MOMENT (n=27), No-messages (n=15; assignment suspended to enrich other arms), or MET-only (n=28). Most attrition occurred during baseline, before MET. Of those completing MET session 1, 82% completed their assigned treatment and 79% provided 3-month data. Participants highly rated acceptability; comments reflected changing motivation and behavior. Across arms, participants reported significantly lower marijuana use, desire, and problems at follow-up vs. baseline. Momentary marijuana desire declined more in MOMENT vs. MET-only. Marijuana use following a targeted context or behavior was less likely in MOMENT and No-messages, vs. MET-only. Conclusions: The MOMENT intervention is feasible to deliver, acceptable, and potentially efficacious in reducing marijuana desire and use among adolescent and young adults in primary care. A larger randomized trial to evaluate efficacy is warranted.
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Young cannabis users (mean age 20 years) who followed two sessions of motivational enhancement therapy combined with a mobile relapse prevention intervention reported a reduction of craving and a decrease in the amount of cannabis consumed.
“Young cannabis users (mean age: 20 years) who followed two sessions of motivational enhancement therapy combined with a mobile intervention designed to prevent relapse have reported a reduction of the craving sensation and a decrease in the amount of cannabis consumed (101).”
From Mobile intervention for individuals with psychosis, dual disorders, and their common comorbidities: A literature review (2019) · cites this paper as [101]
The Study design and Participants and procedures sections describe two MET sessions followed by a mobile intervention in the MOMENT arm; Sample characteristics gives a mean age of 20.7 years. Key variables analyses reports a greater decline in marijuana desire with MOMENT and less frequent reported use in some contexts, but it does not establish a decrease in the amount of cannabis consumed. (LLM, conf=0.88)
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Moore, S. K., Boggis, J. S., Gauthier, P. R., Lambert-Harris, C. A., Hichborn, E. G., Bell, K. D., Saunders, E. C., Montgomery, L., Murphy, E. I., Turner, A. M., et al. (2024) · Journal of Medical Internet Research · doi:10.2196/53685 · Cited by 3 · see citing works
Helseth, S. A., Guigayoma, J. P., Price, D., Spirito, A., Clark, M. A., Barnett, N. P., & Becker, S. J. (2022) · JMIR Research Protocols · doi:10.2196/35402 · Cited by 3 · see citing works
“Although studies of both apps established the feasibility and potential efficacy of adjunctive smartphone apps for cannabis use [44,49-52], these apps were built for older, heavy cannabis users who were also receiving in-person therapy from skilled clinicians, and neither was designed for youth in low-resource setting…”
BackgroundDarharaj, M., Roshanpajouh, M., Amini, M., Shrier, L. A., Hamraz, I., & Habibi, M. (2025) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2025.112957 · Cited by 2 · see citing works
Guan, K., Amara, M., Gürbüz, S., Khan, I. A., Adlung, C., Cortiana, V., Ali, R. H., Iorio, C., Thalassinou, E., Smit, C. R., et al. (2026) · Journal of Medical Internet Research · doi:10.2196/84422 · Cited by 3 · see citing works
“Another pilot randomized trial found reduced odds of marijuana use after contextual or behavioral triggers (odds ratio 0.54, 95% CI 0.31 ‐ 0.95), alongside a greater decline in momentary marijuana desire [45].”
InfluentialDarnell, D. A., Parker, L. E., Engstrom, A., Fisher, D., Diteman, K. D., & Dunn, C. W. (2019) · Journal of Clinical Medicine Research · doi:10.14740/jocmr4018 · Cited by 2 · see citing works
Shrier, L. A., & Harris, S. K. (2022) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2022.09.002 · Cited by 2 · see citing works
Salgin, L., Kellogg, D., Helm, J. L., Blashill, A. J., Myers, M. G., Jun, H., Lim, A. C., & Calzo, J. P. (2025) · JMIR Research Protocols · doi:10.2196/71927 · Cited by 2 · see citing works
“The remuneration schedule is consistent with previous EMA research of similar duration with adolescent samples [38,39].”
Calihan, J. B., & Levy, S. (2023) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2023.03.001 · Cited by 2 · see citing works
Helseth, S. A., Piper, K. N., Dunne, C. J., Kemp, K. A., Barnett, N. P., Clark, M. A., Spirito, A., & Becker, S. J. (2025) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-025-01370-6 · Cited by 1 · see citing works
“Both adjunctive apps employed ecological momentary assessment or intervention programming (Heron & Smyth, 2010) and demonstrated feasibility and efficacy (Dennis et al., 2015; Kells & Shrier, 2017; Shrier et al., 2018; Shrier, Rhoads, Burke, Shrier et al., 2014a, b; Shrier et al., 2014).”
Ma, Y., West, B. T., & McCabe, S. E. (2025) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2025.112974 · Cited by 1 · see citing works
Kwon, M., Song, J. Y., Hwang, J. Y., Seong, S. J., Park, K. J., Jo, Y. T., Kim, Y. J., Ahn, M. E., & Lee, S.-K. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1717544 · Cited by 1 · see citing works
“For example, one study asked youth participants to select their top three triggers for use from lists of emotional states, social settings, and activities (54).”
Willoughby, J. F., Gibbons, S., & Hundley, S. L. (2022) · Journalism & Mass Communication Quarterly · doi:10.1177/10776990221112949 · Cited by 1 · see citing works
“EMI has been used to help participants address obesity (Boh et al., 2016), cannabis use (Shrier et al., 2018), smoking cessation (Hébert et al., 2018), increased healthy food consumption (Brookie et al., 2017), and other topics (Kauer et al., 2012; Riordan et al., 2015).”
Contexts of Marijuana Use and Cessation among Frequently-Using Youth in Primary Care
Mehta, C. M., Burke, P. E., & Shrier, L. A. (2020) · Youth & Society · doi:10.1177/0044118x20951060 · Cited by 1 · see citing works
“Negative use expectancies (anticipated negative consequences of use) have been associated with fewer lapses during marijuana abstinence attempts (Shrier et al., 2018).”
BackgroundTowards Addiction Treatment: Technological Advances & Applying Technology
Lemley, S. M., & Marsch, L. A. (2020) · Springer eBooks · doi:10.1007/978-3-030-36391-8_35 · Cited by 1 · see citing works
Cannabis use in youth: Consumption and health consequences
Halliday, D. M., Espinoza, S., Schneider, S., & Steinberg, J. K. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-818872-9.00153-9 · Cited by 1 · see citing works
Xuan, Z., & Ranker, L. R. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-818872-9.00188-6 · Cited by 1 · see citing works
Li, B. (2019) · mHealth · doi:10.21037/mhealth.2019.01.03
“Shrier (Figure 1) at Boston Children’s Hospital, Massachusetts has developed an interventional program called MOMENT (Momentary Self-Monitoring and Feedback + Motivational Enhancement Therapy), which combines brief motivational enhancement therapy provided in clinic followed by ecological momentary interventions deliv…”
The Social Cost of Pain: Rejection Sensitivity, Social Rejection, and Cannabis Use in Young Adults
Dambreville, N. (2019) · CUNY Academic Works (City University of New York)
Darharaj, M., Roshanpajouh, M., Amini, M., Shrier, L. A., & Habibi, M. (2023) · Internet Interventions · doi:10.1016/j.invent.2023.100669
Ruhlmann, R. E., Fairbairn, C. E., & Flanagan, J. C. (2023) · The Psychology of learning and motivation/The psychology of learning and motivation · doi:10.1016/bs.plm.2023.06.001
Working your way through self-esteem
Postma, M. R. (2024) · doi:10.26481/dis.20240111mp
Mobile-based collaborative interventions between target participants and circle participants
da Silva, J. C., Dantas, L. A., Marzo, M. A. D. D., Rodrigues, K. R. D. H., & Pimentel, M. D. G. C. (2024) · Simpósio Brasileiro de Sistemas Multimídia e Web (WebMedia) · doi:10.5753/webmedia_estendido.2024.243939
Guan, K., Amara, M., Gürbüz, S., Khan, I. A., Adlung, C., Cortiana, V., Ali, R., Iorio, C., Thalassinou, E., Smit, C. R., et al. (2025) · medRxiv · doi:10.1101/2025.09.01.25334834
“22,26 29 Physical health strategies in these JITAIs focused on incremental shifts, such as reducing sedentary behaviour and promoting daily walking in adolescents.”
InfluentialHalladay, J. E., Hira, V., Gex, K. S., Meisel, S. N., Bryant, Z., Wilson, J., Stockings, E., Slade, T. N., McDonald, A., & MacKillop, J. M. (2026) · Research Square · doi:10.21203/rs.3.rs-10525385/v1
“The trial included 248 youth to evaluate an in-person motivational enhancement therapy (MET) session alone compared to MET followed by two weeks of self-monitoring with (MOMENT) and without (EMA-only) supportive messages related to individuals’ personal triggers for cannabis (Shrier et al., 2018).”
Shrier, L. A., O’Connell, M., Palmer, A., Parker, S., Kossowsky, J., Katz‐Wise, S. L., Burke, P. J., Milliren, C. E., & Harris, S. K. (2026) · JMIR Research Protocols · doi:10.2196/105908 · Cited by 1 · see citing works
“In our previously developed intervention, which comprised in-person MET and an EMI, nearly all participants who were exposed to the MET rated it as excellent or good and reported changes in their cannabis use motivation and behavior related to cannabis use after counseling [51].”
Influential
- Authors
- Shrier, L. A., Burke, P. J., Kells, M., Scherer, E. A., Sarda, V., Jonestrask, C., Xuan, Z., & Harris, S. K.
- Affiliations
- Boston Children's Hospital (US)
- Dartmouth College (US)
- Boston University (US)
- Corresponding author
- Shrier, Lydia A.
- ORCID
- Venue
- mHealth
- Publisher
- AME Publishing Company
- Published
- 2018-07
- Volume
- 4
- Pages
- 29-29
- ISSN
- 2306-9740 (ISSN-L)
- PMC
- PMC6087802
- OpenAlex
- W2885802406
- Cited by
- 70
- References
- 35
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 12 · 2023: 7 · 2022: 10 · 2021: 12 · 2020: 10 · 2019: 6 · 2017: 1
- FWCI
- 5.47
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- mHealth (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute on Drug Abuse (R34DA030535)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- cannabis use, youth, motivational enhancement therapy, ecological momentary intervention, primary care, intervention feasibility, acceptability
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