Alcohol use disorders-Mobile based Brief Intervention Treatment (AMBIT): Technological innovation to bridge the treatment gap for hazardous drinking.

酒精使用障碍 - 基于移动的简短干预治疗 (AMBIT)：通过技术创新缩小有害饮酒的治疗差距。

• 批准号: MR/P020348/1
• 负责人: Abhijit Nadkarni
• 金额: $ 19.31万
• 依托单位: Sangath
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2017
• 资助国家: 英国
• 起止时间: 2017 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FP020348%2F1
• 关键词: Alcohol; use; disorders; Mobile; based

The World Health Organization (WHO) defines three levels of problematic alcohol consumption, namely hazardous drinking (HD) (which puts a person at risk of developing health/social problems), harmful drinking (where health/social problems are already occurring), and alcohol dependence (where serious problems have already occurred). Although HD and harmful drinking affects a larger proportion of the population (and causes many more problems) than alcohol dependence (the 'prevention paradox'), in India health policy focuses mainly on institutional delivery of care for alcohol dependence. Extensive evidence globally demonstrates the effectiveness of Brief Interventions (BIs) in reducing drinking in HD. However, in India, the major barriers to providing such evidence-based psychosocial treatments are the lack/inequitable distribution of trained healthcare professionals and concerns about the cultural generalisability of psychosocial interventions developed in the West. One innovation to overcome the human resource barrier is to use mobile phone technology like SMS (Short Messaging Service) and interactive voice response (IVR) to deliver BIs to large numbers of HDs, quickly and at low cost, as demonstrated in interventions for smoking cessation. Furthermore, a growing body of evidence demonstrates that following a systematic methodology to culturally adapt psychosocial interventions increases acceptability by recipients and delivery agents, and feasibility of delivery.The overall objective of AMBIT is to develop a contextually appropriate BI for HD that can be delivered using mobile phone technology to overcome barriers to access in low resource settings. The specific aims of AMBIT are to 1) Develop a BI package delivered using mobile phone technology, in partnership with our technology partner; 2) Examine if it is acceptable/feasible to deliver such an intervention in an Indian setting; 3) Conduct preliminary testing to see if the intervention helps in reducing drinking; and 4) Fine-tune procedures for the definitive testing of the effectiveness of the intervention. The aims of the programme will be achieved through a range of processes including identification of the existing evidence; development of the intervention in partnership with our technology partner and utilising feedback from a range of individuals and groups including Hazardous Drinkers; refinement of the intervention; and testing of its preliminary impact. The output of this treatment development process would be a contextually acceptable and feasible mobile-technology-delivered BI package which can then be tested in a larger trial. To summarise, we want to help hazardous drinkers to reduce levels of harm caused to them, their families and society in general, by transforming a way of helping (BIs) which has in the past been delivered face-to-face by healthcare workers into a much more accessible and widely available form, by using mobile phones (widely owned across India and other LMICs) and SMSs (widely used across India and other LMICs). HD is a big and growing problem, both in itself, and also because many people with HD will go on to develop even more problematic versions of AUD. If successfully developed and found to be cost-effective, our intervention can reach millions of people across the world (as mobile phone use has increased exponentially even across the developing world) and could be a real game changer in the field of public health.

世界卫生组织（WHO）将有问题的酒精消费定义为三个级别，即危险饮酒（HD）（使一个人处于发展健康/社会问题的风险中），有害饮酒（已经发生健康/社会问题）和酒精依赖（已经发生严重问题）。虽然血液透析和有害饮酒对人口的影响比酒精依赖（“预防悖论”）大得多（造成的问题也多得多），但印度的卫生政策主要侧重于酒精依赖的机构护理。全球广泛的证据证明了简短干预（BI）在减少HD饮酒方面的有效性。然而，在印度，提供这种循证心理治疗的主要障碍是缺乏/不公平的分布训练有素的医疗保健专业人员和对西方发展的心理干预的文化普遍性的担忧。克服人力资源障碍的一项创新是使用移动的电话技术，如SMS（短消息服务）和交互式语音应答（IVR），以快速和低成本向大量HD提供BI，如戒烟干预措施所示。此外，越来越多的证据表明，采用系统的方法来适应文化上的心理社会干预可以提高接受者和交付代理人的可接受性以及交付的可行性。AMBIT的总体目标是开发一种适合背景的HD BI，可以使用移动的电话技术来交付，以克服资源匮乏环境中的访问障碍。AMBIT的具体目标是：1）与我们的技术合作伙伴合作，开发使用移动的电话技术提供的BI包; 2）检查在印度环境中提供这种干预措施是否可接受/可行; 3）进行初步测试，以确定干预措施是否有助于减少饮酒;以及4）微调干预措施有效性的最终测试程序。该计划的目标将通过一系列过程实现，包括识别现有证据;与我们的技术合作伙伴合作开发干预措施，并利用包括危险饮酒者在内的一系列个人和团体的反馈;完善干预措施;并测试其初步影响。该治疗开发过程的输出将是一个上下文可接受的和可行的移动技术交付的BI包，然后可以在更大的试验中进行测试。总而言之，我们希望通过使用移动的电话（在印度和其他中低收入国家广泛使用）和短信（在印度和其他中低收入国家广泛使用），将过去由医护人员面对面提供的帮助方式（BI）转变为更容易获得和广泛使用的形式，帮助危险饮酒者减少对他们、他们的家庭和整个社会造成的伤害。HD是一个越来越大的问题，无论是在本身，也因为许多人与HD将继续开发更有问题的版本的AUD。如果成功开发并发现具有成本效益，我们的干预措施可以惠及世界各地数百万人（因为即使在发展中国家，移动的电话使用也呈指数级增长），并可能成为公共卫生领域真实的游戏规则改变者。

项目成果

Brief intervention for hazardous drinking delivered using text messaging: a pilot randomised controlled trial from Goa, India.

• DOI: 10.1017/s1368980022000313
• 发表时间: 2022-02-18
• 期刊: Public health nutrition
• 影响因子: 3.2
• 作者: Nadkarni A;Fernandes D;Bhatia U;Velleman R;D'souza E;D'souza J;Marimilha Pacheco G;Sambari S
• 通讯作者: Sambari S

Experiences of a mobile phone delivered brief intervention for hazardous drinking: A qualitative study nested in the AMBIT trial from Goa, India.

• DOI: 10.1017/gmh.2023.51
• 发表时间: 2023
• 期刊: CAMBRIDGE PRISMS-GLOBAL MENTAL HEALTH
• 作者: Fernandes, Danielle;D'Souza, Ethel;Sambari, Seema;Pacheco, Marimilha;D'Souza, Joseline;Velleman, Richard;Bhatia, Urvita;Nadkarni, Abhijit
• 通讯作者: Nadkarni, Abhijit