Behavioral economic and wellness-based approaches for reducing alcohol use and consequences among diverse non-student emerging adults

基于行为经济学和健康的方法，用于减少不同非学生新兴成年人的饮酒及其后果

• 批准号: 10157726
• 负责人: JAMES G. MURPHY
• 金额: $ 34.65万
• 依托单位: UNIVERSITY OF MEMPHIS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-05 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10157726
• 关键词: Address; Affective Symptoms; African American; Age; Alcohol abuse; Alcohol consumption; Arousal; Behavioral; Behavioral Mechanisms; Belief; COVID-19 pandemic; Clinical Research; Communities; Development; Drug usage; Education; Educational Intervention; Elements; Ethnic group; Evaluation; Feedback; Future; Goals; Health; Healthcare; Heavy Drinking; Income; Informal Social Control; Institute of Medicine (U.S.); Intervention; Laboratory Research; Marketing; Measures; Mediating; Mental Depression; Mental Health; Modality; Moods; National Institute on Alcohol Abuse and Alcoholism; Outcome; Participant; Physiological; Population; Poverty; Preventive care; Psychological reinforcement; Race; Randomized; Randomized Clinical Trials; Relaxation Therapy; Reporting; Research; Rewards; Risk; Risk Factors; Site; Stress; Suggestion; Symptoms; Testing; Woman; Workplace; active method; age group; alcohol consequences; alcohol demand; alcohol measurement; alcohol misuse; alcohol related consequences; alcohol related problem; alcohol use disorder; base; behavior change; behavioral economics; brief alcohol intervention; chronic alcohol ingestion; college; community center; comorbidity; control trial; coping; cost effective; depressive symptoms; discounting; dissemination research; dissemination trial; drinking; economic impact; efficacy evaluation; emerging adult; experience; follow-up; heavy drinking college student; help-seeking behavior; high risk; member; negative affect; novel; post intervention; preference; racial and ethnic; reduced alcohol use; reduced substance use; secondary outcome; sex; social; stress management; telehealth; tool; treatment response; university student

Brief alcohol interventions (BAI) are among the most cost-effective preventive care measures available and the evaluation of these interventions with high-risk and difficult-to-reach populations is an NIAAA priority. Although emerging adults (EAs) who attend college often have access to brief alcohol interventions (BAIs), there is a critical need to enhance both the efficacy and potential for dissemination of these approaches with high-risk non-student EAs. EAs who are not 4-year college students or graduates report higher levels of alcohol-related problems, greater levels of comorbid drug use and mental health symptoms, and higher risk for chronic alcohol use disorder compared to college graduates. Most BAIs include a single session focused explicitly on discussing risks associated with drinking and correcting normative beliefs about drinking rates without addressing the reasons why EAs may drink, including stress and limited behavioral alternatives to drinking. Because many EAs who do not graduate from college are socially and economically marginalized, an approach that encourages them to drink less without providing the tools to reduce stress and develop mood- enhancing behavioral substitutes to drinking or drug use is unlikely to be successful. The Substance-Free Activity Session (SFAS) attempts to increase engagement goal-directed activities that might provide alternatives to alcohol use and also includes strategies for coping with stress/depression. The two-session (plus booster) BAI+SFAS approach has demonstrated efficacy for reducing both alcohol use/problems and depressive symptoms in two randomized clinical trials with college EAs and may be a more promising approach than single-session BAIs for higher-risk non-student EAs. Two critical next steps are to: 1) evaluate the BAI+SFAS with non-student EAs, and 2) determine if a two-session Relaxation Training (RT) +SFAS approach, which would enhance wellness and address two synergistic risk factors for alcohol misuse, demonstrates similar efficacy as the BAI+SFAS intervention. If so, this wellness-based approach may have greater potential for dissemination than approaches that include a BAI because the session content may be more appealing to EAs (managing stress and increasing positive activities). Thus, the primary goal of the proposed study is to establish the efficacy of these novel BAI approaches with high-risk community dwelling EAs, and a secondary goal is to identify factors that may increase potential for dissemination. We will conduct a randomized 3-group (BAI+SFAS vs. RT+SFAS vs. education control) trial with 525 EAs (175 per group; estimated 50% women & 50% African American) who report recent heavy drinking and who are not students or graduates of 4-year colleges. Outcomes will be assessed at 1, 3, 6, and 12 months post-intervention. We hypothesize that at follow-up both BAI+SFAS and RT+SFAS participants will report significantly greater reductions in alcohol use and problems relative to education control participants, with no differences in outcomes between the two active treatment conditions.

短暂酒精干预(BAI)是现有的最具成本效益的预防保健措施之一， 在高危和难以接触的人群中评估这些干预措施是NIAAA的优先事项。虽然 上大学的新兴成年人(EA)通常有机会进行短暂的酒精干预(BAIS)，有 迫切需要提高这些高风险方法的有效性和传播潜力 非学生助教。非四年制大学生或毕业生的EAS报告与酒精有关的水平较高 问题，更高水平的共病药物使用和精神健康症状，以及更高的慢性酒精风险 与大学毕业生相比，使用障碍。大多数BAI包括一个单独的会议，明确地关注 讨论与饮酒相关的风险并纠正关于饮酒率的规范性信念 解决EA可能饮酒的原因，包括压力和有限的行为替代饮酒。 因为许多没有从大学毕业的EA在社会和经济上被边缘化，一个 这种方法鼓励他们减少饮酒，但没有提供减压和养成情绪的工具- 将行为代用品改进为饮酒或吸毒不太可能成功。不含物质的 活动会话(SFAS)尝试增加以参与目标为导向的活动，这些活动可能会提供 酒精使用的替代品，还包括应对压力/抑郁的策略。两会 (加助剂)BAI+SFAS方法已证明在减少酒精使用/问题和 在两个大学EA随机临床试验中出现抑郁症状可能是更有前途的 对于风险较高的非学生EA，采用比单期BAIS更好的方法。接下来的两个关键步骤是：1)评估 BAI+SFAS与非学生EA，以及2)确定两节放松训练(RT)+SFAS 这将增进健康并解决酒精滥用的两个协同风险因素， 显示出与BAI+SFAS干预相似的疗效。如果是这样的话，这种基于健康的方法可能会 比包括BAI的方法有更大的传播潜力，因为会话内容可能是 对企业经理更有吸引力(管理压力和增加积极活动)。因此，该计划的主要目标是 建议的研究是确定这些新的BAI方法在高危社区住宅中的有效性 第二个目标是确定可能增加传播潜力的因素。我们将进行 一项随机的3组试验(BAI+SFAS与RT+SFAS与教育对照)，包括525个EAS(每组175个； 据估计，50%的女性和50%的非裔美国人)最近酗酒，而且不是学生或 四年制大学毕业生。结果将在干预后1、3、6和12个月进行评估。我们 假设在随访时，BAI+SFAS和RT+SFAS参与者报告的 减少酒精使用和与教育控制组参与者相关的问题，在 两种积极治疗条件之间的结果。