Computerized Alcohol Misuse Intervention with Micro-targeted Normative Feedback

描述(由申请人提供)：在美国，酒精滥用仍然是一个主要的公共卫生问题，极大地增加了发病率、死亡率和社会成本。有确凿的证据支持从公共卫生和成本效益的角度对酒精滥用进行筛查和短暂干预(SBI)，这种做法得到了美国预防卫生服务工作组的支持。然而，将履行机构纳入主流医疗实践的努力面临障碍，因为时间和人员方面的严格限制是许多现代医疗保健提供环境的特点。需要新的方法将SBI无缝地融入主流医疗实践。拟议的第一阶段STTR项目旨在确定设计创新的计算机化履行机构方案的关键组成部分的可行性，该方案将适合在各种保健环境中使用。第一阶段的形成性研究将提供关键信息，指导设计计算机化的微目标个性化规范反馈产品，最终可能促进酒精更快地传播到医疗保健系统中。 与公共健康相关：设想中的印度国家石油公司产品将设计用于配备耳机的触摸屏平板电脑。整个筛查和干预过程将需要大约15分钟，以便患者可以在等待见他们的医疗保健提供者的同时完成计划。拟议的简短干预将以既定的社会行为理论为依据，并将使用有前景的微目标规范反馈和规范误解纠正战略。这些技术将把患者报告的行为和感知的规范与在年龄、种族和性别上与患者相似的个人的实际估计人群规范进行比较。规范性比较数据将从正在进行的国家级流行病学监测系统中获得，针对特定的亚群-行为组合进行分析，并嵌入该软件的特殊数据库中。针对行为规范反馈的参照组在年龄、种族和性别上与患者匹配，旨在增加患者的规范比较的共鸣，并代表着对规范反馈干预的微观目标定位达到前所未有的水平，这种干预可以很容易地在全国范围内的各种医疗环境中使用。关键系统组件将通过从当地社区卫生中心(成品的典型消费者)招募的参与者样本进行试点测试。参与者将通过深入的定性访谈来探索他们对这项技术的体验，并根据用户的反馈改进演示文稿。

DESCRIPTION (provided by applicant): Alcohol misuse continues to be a major public health problem in the United States, contributing substantially to morbidity, mortality, and social costs. There is a solid body of evidence supporting screening and brief intervention (SBI) for alcohol misuse on both public health and cost-effectiveness grounds, and the practice is endorsed by the U.S. Preventive Health Services Task Force. However, efforts to incorporate SBI into mainstream medical practice have faced barriers due to severe constraints on time and personnel that characterize many modern healthcare delivery settings. Novel methods for seamlessly integrating SBI into mainstream medical practice are needed. The proposed Phase 1 STTR project seeks to establish the feasibility of designing key components of an innovative computerized SBI program that would be appropriate for use within a variety of healthcare settings. The formative research in the Phase 1 STTR will provide critical information to guide the design of a computerized micro-targeted personalized normative feedback product that could ultimately facilitate more rapid diffusion of alcohol SBI into the healthcare system. PUBLIC HEALTH RELEVANCE: The envisioned SBI product will be designed for use on headphone-equipped touch screen tablet computers. The entire screening and intervention session will take approximately 15 minutes so that a patient can complete the program while waiting to see their healthcare provider. The proposed brief intervention will be informed by established social-behavioral theories and will use promising micro-targeted normative feedback and norms misperception correction strategies. These techniques will compare the patient's reported behaviors and perceived norms to the actual estimated population norm for individuals that are similar to the patient in age, race, and sex. Normative comparison data will be obtained from ongoing, national-level epidemiological surveillance systems, analyzed for specific subpopulation-behavior combinations, and embedded within a special database in the software. The targeting of the reference group for behavioral norms feedback to match the patient on age, race, and sex is designed to increase the resonance of the normative comparison for the patient, and represents an unprecedented level of micro-targeting for a normative feedback intervention that can be readily "scaled up" for use in a variety of medical contexts across the country. Key system components will be pilot tested by a sample of participants recruited from a local community-based health center (a typical consumer of the finished product). Participants' experiences with the technology will be explored via in-depth qualitative interviews, and the presentation refined based on user feedback.