A Clothing-Adhered Wearable to Monitor Biomarkers of Cognitive/Emotional State and Deliver Just-in-Time Behavioral Interventions

PROJECT SUMMARY Recovery from substance use disorders (SUDs) is greatly impacted by the cognitive and emotional state of the individual, and learning new thought and behavioral patterns can facilitate successful treatment and recovery. Specifically, fluctuations in stress or anxiety can trigger lapses to drug use. Even when actual use is avoided, stress-induced craving is likely to be distracting and to reduce productivity and quality of life. One promising approach to this problem is the continuous, passive monitoring of autonomic indicators that relate to cognitive/emotional state, stress, and craving, and providing behavioral triggers and guidance at appropriate moments. Existing wearable devices do not provide this type of feedback and those that do are research tools not amenable to daily use in terms of practicality, cost, and wearer acceptance. To solve these issues and provide a device suitable for daily, widespread use, our company, Spire, Inc., created a novel form-factor wearable health monitor, the Spire Health Tag, that makes ​the user’s existing clothing​‘smart.’ The Health Tag has a Band-Aid-like adhesive that the user adheres on an article of clothing. The Health Tag was inspired by Spire’s first commercial product, a clothing-attached (rather than adhered) device called the Spire Stone. The Stone was the first commercially available health monitor to provide just-in-time behavioral interventions for cognitive/emotional regulation. It functions by monitoring changes in ​respiratory patterns​and providing alerts and guidance to the wearer via the smartphone app. The Stone and Health Tag are designed to help users manage stress by making them aware of the situations and conditions that trigger it. The Stone is currently the most successful wearable device for cognitive/emotional health in both Amazon.com and Apple’s retail stores; the Tag builds on its features. Though used primarily by subclinical populations in a consumer context, we believe Spire devices can be extended to other populations such as those treated being for SUDs. This application will test the hypotheses that (a) the Health Tag form factor is suitable to appeal and high adherence among individuals with SUDs and (b) monitoring and feedback with the Health Tag can help reduce stress during recovery. To this end, we have partnered with researchers at NIDA IRP on a broader research agenda and this application aims to investigate Spire’s impact. First, this study will develop an in-app, adaptive stress management program, utilizing the Spire Health Tag, to reduce stress and anxiety among individuals with SUDs. Once this has been achieved, we will evaluate the feasibility of the intervention with a small, 6-week pilot study of individuals with SUDs (n=40), assessing its perceived utility and impact on stress and anxiety. We hypothesize that use of the Spire Health Tag and the accompanying program targeted at SUD will be welcomed by target patients and help reduce stress and anxiety for many or most wearers. If successful, the implementation of this scalable, discreet, and affordable technology could complement existing therapies to reduce the incidence of relapse and re-initiation by helping users manage the situations that lead to cravings. If the proposed Phase 1 program meets or exceeds its measurable goals, we will leverage the research and assessments of Phase 1 in the creation of a competitive Phase 2 proposal.PROJECT NARRATIVE The ability of an addict to recover from substance abuse disorders is greatly impacted by the cognitive and emotional state of the individual, and learning new thought and behavioral patterns can facilitate successful treatment and recovery. This project will test the ability of a clothing-adhered smart device, the Spire Health Tag, to help drug addicts manage the stress and anxiety that influences cravings by monitoring their physiological patterns and issuing real-time feedback and prompts to trigger the behavioral change that improves stress and anxiety management.