mHealth Early Intervention to Reduce Posttraumatic Stress and Alcohol Use After Sexual Assault (THRIVE): Feasibility and Acceptability Results From a Pilot Trial.
mHealth Early Intervention to Reduce Posttraumatic Stress and Alcohol Use After Sexual Assault (THRIVE): Feasibility and Acceptability Results From a Pilot Trial.
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DOI：
10.2196/44400
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发表时间：
2023-07-04
影响因子：
2.2
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中科院分区：
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性侵犯与创伤后应激障碍（PTS）和酒精滥用的风险增加有关。移动的保健干预措施在解决创伤幸存者的创伤后应激反应和药物使用方面显示出了希望，可能是一种有希望的战略，可以将早期干预措施的范围扩大到最近经历过创伤的个人。这项研究评估了THRIVE的可行性和可接受性，THRIVE是一种移动的健康早期干预措施，用于最近的性侵犯幸存者，涉及21天内每天使用的认知行为应用程序，每周进行电话辅导。20名过去10周性侵犯的成年女性幸存者，PTS和酒精使用升高，随机接受THRIVE干预，作为试点随机对照试验的一部分。我们试图通过检查干预活动的完成率和测试参与者自我报告的关键干预概念的知识从基线到干预后的变化来了解可行性。我们通过在后续调查中收集对干预和应用程序可用性的满意度的自我报告评级来评估可接受性。教练在辅导电话期间做笔记，以跟踪电话内容并记录参与者的反馈;对这些笔记进行定性分析，以详细说明上述领域。中等的活动完成率证明了可行性：所有参与者至少打开了应用程序，20名参与者中有19名（95%）完成了至少1项认知行为练习，20名参与者中有16名（80%）参加了所有4次辅导电话会议。参与者在21天中平均完成了10.40（SD 6.52）的认知行为练习。辅导电话记录记录了参与者的评论，即应用程序生成的提醒提高了完成率。从基线到干预后知识发生变化的发现也证明了可行性;这表明THRIVE成功地传达了关键概念。参与者对THRIVE可用性的高评分证明了可接受性;评分对应于B+可用性等级。指导电话会议记录表明，通过指导电话会议、应用程序练习的清晰度以及应用程序练习包含的建议，可用性得到了提高;然而，指导电话会议记录还表明，一些参与者发现应用程序练习的某些方面很难或令人困惑。参与者的满意度评级也证明了可接受性：大多数参与者（15/16，94%）将该应用程序评为中等帮助或非常有帮助。辅导电话记录表明，认知行为活动模块被认为是有吸引力的，干预的积极影响有助于提高参与者的满意度。这些研究结果表明，THRIVE对于最近性侵犯的幸存者来说是可行和可接受的，并且有必要对THRIVE进行进一步的测试。ClinicalTrials.gov NCT03703258; https://clinicaltrials.gov/ct2/show/NCT03703258
Sexual assault is associated with increased risk for both posttraumatic stress (PTS) and alcohol misuse. Mobile health interventions have shown promise in addressing PTS and substance use in trauma survivors and might be a promising strategy in extending the reach of early interventions to individuals who have recently experienced trauma. This study assesses the feasibility and acceptability of THRIVE, a mobile health early intervention for recent survivors of sexual assault involving a cognitive behavioral app used daily over 21 days with weekly telephone coaching. Twenty adult female survivors of past–10-week sexual assault with elevated PTS and alcohol use were randomized to receive the THRIVE intervention as part of a pilot randomized controlled trial. We sought to understand feasibility by examining rates of completion of intervention activities and testing changes in participants’ self-reported knowledge of key intervention concepts from baseline to after the intervention. We assessed acceptability by collecting self-report ratings of satisfaction with the intervention and app usability in a follow-up survey. The coach took notes during coaching calls to track call content and record participant feedback; these notes were qualitatively analyzed to elaborate on the aforementioned domains. Feasibility was demonstrated by moderate rates of activity completion: all participants at least opened the app, 19 (95%) of the 20 participants completed at least 1 cognitive behavioral exercise, and 16 (80%) of the 20 participants attended all 4 coaching calls. Participants completed cognitive behavioral exercises on an average of 10.40 (SD 6.52) out of 21 days. The coaching call notes documented participant comments that app-generated reminders increased completion rates. Feasibility was also demonstrated by the finding that knowledge changes occurred from baseline to after the intervention; this indicated that THRIVE was successful in conveying key concepts. Acceptability was demonstrated by high participant ratings of THRIVE’s usability; the ratings corresponded to a B+ usability grade. The coaching call notes documented that usability was increased by the coaching calls, the app exercises’ clarity, and the app exercises’ inclusion of suggestions; however, the coaching call notes also documented that some of the participants found aspects of the app exercises to be difficult or confusing. Acceptability was also demonstrated by participant ratings of satisfaction: most of the participants (15/16, 94%) rated the app as either moderately helpful or very helpful. The coaching call notes documented that the cognitive behavioral activity modules were seen as appealing and that the positive impact of the intervention contributed to participants’ satisfaction. These findings suggest that THRIVE is feasible and acceptable to survivors of recent sexual assault and that further testing of THRIVE is warranted. ClinicalTrials.gov NCT03703258; https://clinicaltrials.gov/ct2/show/NCT03703258