Exercise as Alcohol Use Disorders Intervention for Non-Treatment Seeking Adults

描述（由申请人提供）：大约2600万美国人（8.5%）符合酒精使用障碍（AUD，即滥用或依赖）的标准，大多数有AUD的人从不寻求帮助。不寻求帮助的原因有很多，其中最主要的原因是耻辱和想要自己解决问题。因此，提供不污名化或不要求个体去看心理健康专家的AUD干预可能会增加AUD干预的效用和可接受性，并最终增加有效治疗的个体数量。这项初步研究评估了运动作为AUD干预的效果。由于运动对精神和身体健康有许多好处，因此被认为是AUD的潜在治疗方法。SOAR基金将增加现有的试点和启动资金，并通过广告从社区招募另外30名寻求非治疗的澳元患者。参与者将获得为期四个月的YMCA健身房会员资格，并将随机分配到两种情况之一：(1)仅评估（AO），或(2)两次动机增强疗法（MET）的组合，重点是增加运动量，间隔两个月，每周进行四个月的应急管理（CM），以坚持特定的锻炼活动。MET是一种以客户为中心的指导性方法，通过探索和解决矛盾心理来增强改变的内在动机，而CM是一种行为治疗，为个人提供有形的强化物，如完成特定目标行为的奖励。所有参与者的评估将在基线、2个月（治疗中期）和4个月（治疗后）进行，主要结果指标是酒精使用和运动参与指数。次要结局包括与健康相关的体能（例如，身体组成、心血管耐力和肌肉力量的测试）。我们假设，与AO相比，MET+CM将显示出锻炼和身体健康水平的提高，以及酒精使用的减少。这项初步研究的结果将指导未来关于运动作为干预非寻求治疗的AUD患者的方法的研究。

DESCRIPTION (provided by applicant): About 26 million Americans (8.5%) meet criteria for an alcohol use disorder (AUD; i.e., abuse or dependence), and most with an AUD will not ever seek help. A variety of reasons exist for not seeking help, with stigma and desire to handle the problem on one's own being primary among them. Therefore, offering interventions for AUD that do not stigmatize or require an individual to see a mental health professional may increase the utility and acceptability of AUD interventions and ultimately increase the number of individuals effectively treated. This pilot study evaluates exercise as an AUD intervention. Exercise has been proposed as a potential treatment for AUD due to its numerous mental and physical health benefits. SOAR funds will augment existing pilot and start-up funds and enable an additional thirty sedentary non-treatment seeking AUD individuals to be recruited from the community via advertisements. Participants will be given a four month YMCA gym membership and will be randomized to one of two conditions: (1) assessment only (AO), or (2) a combination of two motivational enhancement therapy (MET) sessions focused on increasing exercise spaced two months apart and four months of weekly contingency management (CM) for adhering to specific exercise activities. MET is a client-centered, directive method of enhancing intrinsic motivation to change by exploring and resolving ambivalence, and CM is a behavioral treatment offering individuals tangible reinforcers such as prizes for completion of specific target behaviors. Assessments of all participants will take place at baseline, 2-months (mid-treatment), and 4-months (post- treatment) with primary outcome measures being indices of alcohol use and engagement in exercise. Secondary outcomes include health-related physical fitness (e.g., tests of body composition, cardiovascular endurance, and muscle strength). We hypothesize that MET+CM will show increased levels of exercise and physical fitness and reductions in alcohol use in comparison to AO. Results from this pilot study will guide future investigations of exercise as a method for intervening with non-treatment seeking AUD individuals. PUBLIC HEALTH RELEVANCE: Alcohol use disorders are common and few individuals with the disorder ever seek help. This study proposes to intervene in a novel way - exercise, as it has many mental and physical health benefits and is an activity that is incompatible with simultaneous alcohol use. If effective, this non-stigmatizing intervention may increase the utility and acceptability of interventions for alcohol use disorders and ultimately increase the number of individuals effectively treated.