Digital Interventions to treat hazardous drinking related to the COVID-19 pandemic

治疗与 COVID-19 大流行相关的危险饮酒的数字干预措施

• 批准号: 10359427
• 负责人: DONGJU SEO
• 金额: $ 12.56万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10359427
• 关键词: Address; Adrenal Glands; Adult; Aftercare; Alcohol consumption; Alcoholism; Alcohols; Ambulatory Care; Brain; COVID-19 pandemic; Clinical; Cohort Studies; Communities; Cues; Data; Early-life trauma; Emotions; Exposure to; Functional Magnetic Resonance Imaging; Future; Gender; Hormones; Hydrocortisone; Hypothalamic structure; Impairment; Individual; Interview; Knowledge; Link; Matched Group; Measures; Modeling; Monitor; Neurobiology; Outcome; Participant; Pathology; Patients; Pattern; Pituitary Gland; Prefrontal Cortex; Recording of previous events; Recovery; Relapse; Reporting; Research; Role; Scanning; Series; Sex Differences; Sex Ratio; Stress; Symptoms; System; Techniques; Time; Treatment outcome; Ventral Striatum; Work; alcohol behavior; alcohol comorbidity; alcohol cue; alcohol relapse; alcohol seeking behavior; alcohol use disorder; biological systems; comorbidity; coping; design; digital intervention; early experience; follow-up; hazardous drinking; high risk; hypothalamic-pituitary-adrenal axis; improved; multimodality; neural circuit; neural correlate; neurobiological mechanism; neuroimaging; neuromechanism; novel; novel marker; novel strategies; predict clinical outcome; prospective; relapse prediction; relapse risk; relating to nervous system; response; smartphone Application; social; therapy resistant

ABSTRACT/SUMMARY In times of national crisis, the prevalence of stress- and alcohol- related disorders increases substantially. In particular, risky drinkers with high levels of stress tend to have lasting binge drinking habits even after the crisis is resolved, highlighting the importance of timely interventions. During the COVID-19 pandemic, there has been a significant rise in mental health symptoms including emotional distress and alcohol/substance misuse, presenting unprecedented public health challenges. Immediate clinical interventions are exigent to reach out to vulnerable individuals in high-risk areas to evaluate and treat those at risk for alcohol- and stress- related disorders. However, the infectious nature of the pandemic is a significant obstacle to these efforts. Digital interventions have emerged as an effective tool to overcome this difficulty by allowing access to those residing in high-risk zones stricken with COVID-19. In response to NOT-AA-20-011/PA-18-591 requesting the investigation of the impact of the COVID-19 pandemic on alcohol misuse, this project aims to study the influence of COVID-19 related stress on increasing risk of alcohol misuse and relapse after digital interventions. This project proposes a 1-year digital intervention study using a prospective clinical outcome design with two demographically-matched groups of risky drinkers (total N=40; equal gender ratio) with high versus low COVID-19 related stress. We will utilize a digital intervention method that combines telehealth- and smartphone app- based interventions, allowing concurrent treatment and daily monitoring in a real-life setting. All participants will receive a 4-week telehealth intervention after which they will be prospectively followed for 30 days to monitor stress, alcohol use, social functioning, and other health-related behaviors via a smartphone app. A Specific Aim is to assess the impact of COVID-19 related stress on increasing risk of alcohol misuse and relapse after digital interventions during and in the aftermath of the COVID-19 pandemic. This project will also examine the impact of COVID-19 related social isolation on alcohol misuse and relapse. If successful, the proposed research has the potential to make a difference in clinical care by (1) establishing digital healthcare protocols for individuals at risk of alcohol use disorders; (2) providing timely telehealth access for those who suffer from stress-related drinking in times of national crisis; and (3) identifying the impact of the COVID-19 pandemic on stress, emotion, and social interactions and risk of alcohol misuse and relapse to prevent future risky drinking associated with traumatic events.

摘要/总结 在国家危机时期，与压力和酒精有关的疾病的流行率大幅增加。在 特别是，即使在危机之后，压力很大的危险饮酒者往往会有持久的酗酒习惯 问题得到解决，突出了及时干预的重要性。在COVID-19大流行期间， 精神健康症状显著增加，包括情绪困扰和酒精/药物滥用， 带来前所未有的公共卫生挑战。迫切需要立即采取临床干预措施， 在高风险地区的脆弱个人，以评估和治疗那些在酒精和压力相关的风险 紊乱然而，这一流行病的传染性是这些努力的一个重大障碍。数字 干预措施已成为克服这一困难的有效工具， 在新冠肺炎疫情高发地区。根据NOT-AA-20-011/PA-18-591要求， 该项目旨在调查COVID-19大流行对酒精滥用的影响，研究 COVID-19相关压力对数字化后酒精滥用和复发风险增加的影响 干预措施。该项目提出了一项为期1年的数字干预研究，采用前瞻性临床结局 设计有两组人口统计学匹配的高风险饮酒者（总N=40;性别比例相等）， 与低COVID-19相关压力相比。我们将利用一种数字干预方法， 基于智能手机应用程序的干预措施，允许在现实生活中同时进行治疗和日常监测。 所有参与者将接受为期4周的远程医疗干预，之后将对他们进行前瞻性随访， 30天通过智能手机监测压力，酒精使用，社交功能和其他健康相关行为 附录具体目标是评估COVID-19相关压力对酒精滥用风险增加的影响 以及在COVID-19大流行期间和之后进行数字干预后复发。该项目将 还研究了与COVID-19相关的社会隔离对酒精滥用和复发的影响。如果成功， 拟议的研究有可能通过（1）建立数字医疗保健， 为有酒精使用障碍风险的个人提供协议;（2）为那些 在国家危机时期遭受与压力有关的饮酒;以及（3）确定COVID-19的影响 大流行的压力，情绪和社会互动和风险酒精滥用和复发，以防止未来 与创伤事件有关的危险饮酒