Brief Personalized Feedback Intervention for Latinx Hazardous Drinkers: A Community-Based Intervention

项目摘要/摘要 尽管拉丁裔人口是美国最大、增长最快的人口之一，但 经历显著的健康差距，特别是在危险饮酒和共存升高方面 焦虑。这些危险因素的共同出现会导致以下人群的身体/心理健康状况更差 拉丁裔个体。到目前为止，很少有干预措施针对高度焦虑的背景下的危险饮酒 在拉丁裔人中。目前的第一阶段STTR项目直接与已公布的NIAAA SBIR/STTR保持一致 研究兴趣1，包括开发“移动设备应用程序…”为了提高有效性， AUD和共发病障碍的行为干预的可及性和使用“和”解决方案 少数群体健康和健康差距，以及在农村、偏远和以下地区的能力-- 资源丰富/服务不足的社区。目前的提议的最终目标是改进战略，以 在高危人群中预防酒精滥用、酒精使用障碍和与酒精相关的后果 在这些情况下。此外，它还加强了NIAAA支持的研究对公共健康的影响 关于美国增长最快、人口规模最大的人群之一，他们在危险物质方面表现出差异 喝酒。我们的目标是消除治疗机会和成本的障碍，并通过提供 以智能手机交付、个性化、短暂干预的形式提供的数字治疗产品，名为 Aliento，旨在解决危险饮酒和相关的焦虑加剧问题。我们将利用和迭代 使用专家意见和拉丁裔危险饮酒者焦虑症升高的焦点小组(N=21)的方法 告知原型的设计和功能。然后，我们将评估计划导航和实施 在焦虑升高的Latinx危险饮酒者(N=5)中测试Aliento的可用性，并准备决赛 原型。通过最终的原型，我们将评估Aliento的可行性、可接受性和效果 从联邦合格健康机构招募的拉丁裔有焦虑症状的危险饮酒者(N=50) 中心(FQHC)。这款低成本的应用程序将解决阻碍此类干预措施交付的基础设施障碍 在护理地点(即社区卫生中心)，并将以西班牙语提供，以减少语言 障碍。这项研究代表着在翻译Basic的更大范围内迈出的重要和关键的一步 研究在服务不足的人群中减少危险饮酒的更有效策略 生物行为合并症。我们期望有强有力的证据证明该疗法的可行性、可接受性和临床实用性。 将支持进行第二阶段开发和评估的Aliento移动应用程序。Aliento填补了一个 当地社区卫生中心管理员和临床医生的要求证明了关键的利基市场是 基于丰富的理论和经验派生的干预，并具有足够的实用性，适合移动 在社区卫生中心分娩。我们坚信，这一干预措施将提供一个有前途的、有利可图的 解决服务不足人群中与酒精/焦虑有关的差异的办法。

PROJECT SUMMARY/ABSTRACT Despite being one of the largest and fastest-growing demographics in the United States (US), Latinx persons experience striking health disparities, particularly in terms of hazardous drinking and co-occurring elevated anxiety. The co-occurrence of these risk factors contributes to worse physical/mental health outcomes among Latinx individuals. Few interventions to date have targeted hazardous drinking in the context of high anxiety among Latinx persons. The current Phase I STTR project directly aligns with the published NIAAA SBIR/STTR Research Interests1, including developing “Mobile device applications … to improve the effectiveness, accessibility, and use of behavioral interventions for AUD and co-occurring disorders” and “Solutions for minority health and health disparities with capabilities of reaching persons in rural, remote, and under- resourced/under-served communities.” The current proposal has the end goal of improving strategies to prevent alcohol misuse, alcohol use disorder, and alcohol-related consequences among an ‘at-risk’ population for these conditions. In addition, it enhances the public health impact of NIAAA-supported research by focusing on one of the fastest-growing and largest demographics in the US who demonstrate disparities in hazardous drinking. We aim to remove barriers of treatment access and cost and increase treatment appeal by offering a digital therapeutic product in the form of a smartphone-delivered, personalized, brief intervention named Aliento, designed to address hazardous drinking and associated elevated anxiety. We will utilize and iterative approach using expert input and focus groups (N = 21) of Latinx hazardous drinkers with elevated anxiety to inform the design and functionality of the prototype. We will then assess program navigation and conduct usability testing of Aliento among Latinx hazardous drinkers with elevated anxiety (N = 5) and prepare the final prototype. With the final prototype we will evaluate the feasibility, acceptability, and effects of Aliento among Latinx hazardous drinkers with elevated anxiety symptoms (N = 50) recruited from a Federally Qualified Health Center (FQHC). The low-cost app will address infrastructure barriers that prevent delivery of such interventions in point-of-care settings (i.e., community health centers) and will be delivered in Spanish to reduce language barriers. This study represents an important and pivotal step in the larger landscape of translating basic research to more efficacious strategies for reducing hazardous drinking in underserved populations with biobehavioral comorbidities. We anticipate robust evidence for the feasibility, acceptability, and clinical utility of the Aliento mobile app that will support proceeding to Phase II development and evaluation. Aliento fills a crucial niche as evidenced by requests from local community health center administrators and clinicians, is based on a theoretically rich and empirically derived intervention and is practical enough to lend itself to mobile delivery in community health centers. We strongly believe this intervention will offer a promising and profitable approach to address alcohol/anxiety-related disparities among an underserved population.