BASICS-ED: A Momentary Intervention for Concurrent Smoking and Heavy Drinking

描述（由申请人提供）：大学生重度间歇性饮酒（HED）是一个持续存在的公共卫生问题，具有严重后果，包括物质使用障碍，心理社会问题，健康风险，意外伤害和死亡的发展。美国全国调查数据显示，超过80%的大学生报告在过去一年中饮酒，44%的大学生报告在过去两周内至少有一次重度间歇性饮酒（HED;男性/女性每次饮酒5/4）。此外，据报道，几乎所有的大学吸烟者都喝酒，通常吸烟和HED同时发生。美国一项全国性的调查发现，98%的吸烟者饮酒，44-59%的饮酒者吸烟。此外，在报告饮酒量较大（OR=4.21，p< .0001）、有饮酒问题（OR = 3.31，p< .0001）和报告使用饮酒来科普问题（OR=2.19，p< .05）的学生中，共同发生风险最大。为了更好地了解这些风险行为，并确定潜在的干预点，拟议的研究的总体目标是制定一个个性化的，针对大学生吸烟者HED的计算机化干预。本研究的第一个目的是获得更好地了解这些过程，使用生态瞬时评估（EMA）。从EMA每日饮酒和吸烟报告中获得的信息将用于模拟HED近端影响的动态。这些模型的结果将为从事HED的大学生吸烟者确定干预点。根据这项基础研究，我们计划将模型转化为干预措施，通过安装在电子设备上的交互式程序实时管理。拟议研究的最终目的将是在一项随机对照试验中评估基于计算机的干预的有效性，该试验将计算机干预与仅电子评估的对照组进行比较，样本为从事HED的大学生吸烟者（n=126）。更具体地说，计算机化干预将纳入成功干预的组成部分，大学生简短酒精筛查和干预（BASICS），以及最近开发的针对非寻求治疗的大学生吸烟者的简短吸烟干预。干预，BASICS-ED，将在电子设备上实时管理。该程序将使用分支算法开发，因此对个人环境中瞬间变化的持续评估将确定模块的选择和排序，提供个性化的BASICS信息和实时吸烟干预。 公共卫生相关性：在美国各地的大学校园里，严重的间歇性饮酒和吸烟是严重的公共卫生问题。这项研究最突出的好处是开发了一种针对大学生同时饮酒和吸烟的干预措施。如果有效，那么该计划可以广泛分发给大学生，并有可能减少大学校园中高危酗酒和吸烟的发生率。

DESCRIPTION (provided by applicant): Heavy episodic drinking (HED) among college students is a persistent public health problem with severe consequences, including development of substance-use disorders, psychosocial problems, health risks, accidental injuries, and death. National US survey data indicate more than 80% of college students report consuming alcohol in the past year, with 44% reporting heavy episodic drinking (HED; 5/4 drinks per occasion for men/women) at least once in the previous 2 weeks. In addition, it has been reported that nearly all college smokers drink alcohol and usually smoking and HED co-occur. One National US survey found 98% of current smokers drank alcohol and 44-59% of drinkers smoked cigarettes. Furthermore, the co-occurrence risk was greatest among students who reported greater alcohol consumption (OR=4.21, p< .0001), having a drinking problem (OR = 3.31, p< .0001), and those who reported using drinking to cope with their problems (OR=2.19, p< .05). In order to achieve a better understanding of these risk behaviors and identify potential points for intervention, the overall aim of the proposed study is to develop an individually-tailored, computerized intervention targeting HED among college student smokers. The first aim of this research is to gain a better understanding of these processes using ecological momentary assessment (EMA). The information obtained from EMA daily reports of drinking and smoking will be used to model the dynamics of proximal influences on HED. The results from these models will thereby identify points of intervention for college student smokers who engage in HED. Following from this basic research, we plan to translate the models into an intervention that would be administered in real-time via an interactive program installed on an electronic device. The final aim of the proposed study will be to evaluate the efficacy of the empirically-based intervention in a randomized controlled trial comparing the computerized intervention to an electronic assessment-only control groups in a sample (n=126) of college student smokers who engage in HED. More specifically, the computerized intervention will incorporate components of the successful intervention, Brief Alcohol Screening and Intervention for College Students (BASICS), as well as a recently developed brief smoking intervention for non- treatment seeking college student smokers. The intervention, BASICS-ED, will be administered in real-time on an electronic device. The program will be developed using branching algorithms, such that ongoing assessment of momentary changes in an individual's environment will determine the selection and ordering of modules, providing individually-tailored BASICS messages and the smoking intervention in real-time. PUBLIC HEALTH RELEVANCE: Heavy episodic drinking and smoking are significant public health problems on college campuses across the United States. The most salient benefit of the proposed research will be the development of an intervention designed to target concurrent drinking and smoking among college students. If effective, then the program could be widely distributed to college students and potentially reduce the incidence of high-risk heavy drinking and smoking on college campuses.