Development of a behavioral economic intervention with personalized resource allocation feedback to reduce young adult alcohol misuse

摘要 大多数人的酒精使用量在年轻时达到顶峰， 发展阶段的风险与许多后果和社会成本有关。个性化反馈 干预措施（PFIs）是减少青少年滥用酒精的最有效的干预措施之一， 然而，关于影响的程度和持续时间以及PFI的影响程度仍然存在问题。 年轻人（Young Adults）以前的研究已经证明了YA对实际反馈的偏好 信息，包括酒精的财务支出。行为经济学模型表明， 是通过对酒精和分配给酒精的资源的过度估价来索引的（即，花费的金钱和时间 酒精），大量的研究支持这些模型。虽然有些个人财务报告包括以下信息： 酒精相关的资源分配，他们往往不是反馈的主要重点，也不是个性化的， YAs报告的个人兴趣或财务目标通常非常简短，范围有限， 在广泛的时间范围内提供反馈。这项研究旨在建立一个全面的网络， 基于资源分配PFI（RA-PFI），总结了YAs的日常财务和分配给酒精的时间- 相关的活动，每周个性化的信息量身定制的个人自己的个人财务和 时间分配目标。RA-PFI将专门针对行为经济风险因素进行开发 显示与酒精滥用有关，包括酒精需求（例如，关于总体和 酒精的最高财务支出），延迟折扣（例如，关于下列支出的反馈意见： 即时奖励[酒精]与延迟奖励[储蓄]）和时间分配（例如，对所花时间的反馈 酒精与无酒精活动）。为此，第一阶段将包括对发展 RA-PFI，包括评估年轻人对特定RA反馈成分的偏好的定性工作。 第二阶段将是一项试点研究，150名年轻的成年饮酒者（年龄21-29岁）将被随机分配到一个RA-PFI 干预（n=75）或仅评估控制（n=75）状况，并将完成在线基线 评估，3周的资源分配每日评估和每周个性化反馈，以及1- 以及3个月的在线随访评估。那些在RA-PFI将收到每周个性化的反馈， 酒精使用的行为经济指标，包括消费模式，支出，时间分配， 努力实现财务目标。我们将测试RA-PFI的可行性和可接受性， 检查干预对酒精使用的影响，相关后果和行为经济指标， 滥用酒精这些发现具有重要的公共卫生意义，因为我们将开发、完善和测试一种 通过理论上和经验上的针对性，具有很大的传播潜力和青年人兴趣的干预措施 支持行为经济风险因素，以减少年轻人的酒精滥用。

ABSTRACT Alcohol use across the life course peaks for most individuals in young adulthood, and use during this developmental period is associated with numerous consequences and societal costs. Personalized feedback interventions (PFIs) are among the most effective interventions for reducing young adult alcohol misuse, however questions remain regarding the magnitude and duration of effects and the extent to which PFIs are of interest to young adults (YAs). Previous studies have demonstrated YA preferences for feedback on practical information including financial expenditures on alcohol. Behavioral economic models posit that alcohol misuse is indexed by an excessive valuation of alcohol and resources allocated to alcohol (i.e., money and time spent on alcohol), and considerable research supports these models. Although some PFIs include information on alcohol-related resource allocation, they are often not the primary focus of feedback, are not personalized to YAs’ reported personal interests or financial goals, are often very brief and limited in scope, and provide feedback in reference to broad timeframes. This proposed research aims to develop a comprehensive web- based Resource Allocation PFI (RA-PFI) that summarizes YAs’ daily finances and time allocated to alcohol- related activities with weekly personalized information tailored to an individual’s own personal financial and time allocation goals. The RA-PFI will be developed to specifically target behavioral economic risk factors shown to be associated with alcohol misuse, including alcohol demand (e.g., feedback regarding overall and peak financial expenditures on alcohol), delay discounting (e.g., feedback regarding expenditures on immediate rewards [alcohol] vs. delayed rewards [savings]) and time allocation (e.g., feedback on time spent in alcohol vs. alcohol-free activities). To do so, Phase 1 will include formative research on the development of the RA-PFI, including qualitative work assessing young adult preference for specific RA feedback components. Phase 2 will be a pilot study where 150 young adult drinkers (ages 21-29) will be randomized to an RA-PFI intervention (n=75) or an assessment only control (n=75) condition and will complete an online baseline assessment, 3-weeks of daily assessments on resource allocation and weekly personalized feedback, and 1- and 3-month follow-up online assessments. Those in the RA-PFI will receive weekly personalized feedback on behavioral economic indices of alcohol use including spending patterns, expenditures, time allocation, and progress working towards financial goals. We will test the feasibility and acceptability of the RA-PFI and examine intervention effects on alcohol use, related consequences, and behavioral economic indices of alcohol misuse. Findings have important public health implications as we will develop, refine, and test an intervention with high potential for dissemination and interest to YAs by targeting theoretically and empirically supported behavioral economic risk factors to reduce young adult alcohol misuse.