CASA CHESS: An update on a bilingual mobile health app

Can a smartphone app reduce relapse and increase medication adherence among latinos with mental health and substance abuse disorders?

That’s the question that Dr. Jordana Muroff and her team at the Boston University School of Social Work are exploring with CASA CHESS, the Spanish language version of the A-CHESS application developed by the Center for Health Enhancement Systems Studies.  (See related story.)

Now at the end of the second year of a three-year research grant funded by SAMHSA, the CASA CHESS project is gathering and analyzing data about use of this adapted app.

The study participants are Latino adult men and women with co-occurring alcohol/other drug disorders and mental health disorders who have just successfully completed residential treatment. The majority of them speak predominantly Spanish. CASA CHESS includes all the features of A-CHESS, along with a new tool for medication adherence. Taking medication as prescribed is a critical need for patients managing mental health and substance use disorders along with HIV or other physical health complications. 

Response to CASA Chess has been positive, says Dr. Muroff.

“What we’ve observed so far is that the majority of people who have received the app are using it, and they are remaining active during the study period.”

One of the study aims is to increase patients’ access to linguistically and culturally competent services and to other people, including case managers, who can help support their recovery.

Dr. Muroff reports that the study participants are regularly using the features for social support and connecting to others.

“Having a tool that is in Spanish and culturally relevant has been received well,” comments Dr. Muroff. “Having a connection to peers, case managers, and clinicians has been very helpful.”

Patients also appreciate receiving reminders to take their medication. “If a patient hasn’t taken their medication, the app helps connect them to a case manager to address any identified barrier to medication adherence,” says Dr. Muroff.

Some participants note that sending and receiving message and participating in discussion threads have been helpful in keeping them motivated and preventing relapse.

The sobriety tracker and recorded recovery stories also remind participants of their successes. Some of the study participants have even recorded their own stories and added them to the library, so they can listen to their own stories along with others’.

Dr. Muroff notes that an important goal of the study is to better understand how the CASA CHESS app features are used over time. “We want to see what is most useful and what features are most effective in helping patients with co-occurring disorders avoid relapse, adhere to medication regimens, and connect to others.”

A consumer advisory board was involved in the translation of A-CHESS to make sure that the translated content reflects the Caribbean Spanish typical of Puerto Rico or the Dominican Republic and spoken by the majority of the study participants.

“We will look to extend our research to determine whether CASA CHESS improves outcomes among diverse groups of Spanish speakers,” says Dr. Muroff. “We’ll be examining the feasibility and efficacy of CASA CHESS with the goal of building the best tool we can for this population,” explains Dr. Muroff.

Related resources:

NIATx offers Spanish-language versions of some of our most popular process improvement tools:  Visit Recursos en Espanol to download a Spanish version of the Smart Chart and other tools!

The National Hispanic and Latino ATTC offers a range of tools for treatment organizations that provide treatment and recovery support services to Hispanic and Latino populations in the United States.