Tailored Mobile Text Messaging to Reduce Problem Drinking

描述（由申请人提供）：本申请是为了响应NIAAA的计划公告，行为和综合治疗发展计划，PA-10-013而提交的，与NIH最近对开发适应性移动的干预措施的兴趣一致。拟议的开发研究题为“定制移动的短信以减少问题饮酒”，旨在为有兴趣停止或减少酒精消费的个人开发和测试定制的自适应短信/短信服务（SMS）干预。过量饮酒是一个严重的个人和公共健康问题，也是一个社会经济问题。尽管问题饮酒（PD）的严重后果，大多数有酒精问题的人从不寻求正式治疗。虽然基于互联网的干预（IBIs）的出现扩大了问题饮酒者的访问和短暂的干预机会，但传统的IBIs遭受高损耗，主动满足的能力有限 PD发生的个体，并适应实时需求。戒烟研究的最新证据强调，SMS干预可能提供必要的强化，帮助个人在自然环境中最需要的时候增强自我调节，减少问题酒精的使用。此外，由于PD通常具有规则的情节模式，定制的交互式设计可能特别有效。本研究旨在开发和测试PD的交互式自适应移动的消息干预，其中包括针对基线评估结果（包括饮酒时间）定制的消息，这些消息通过交互式生态瞬时评估（EMA）适应持续饮酒模式和目标实现。 其他功能包括参与者发起的帮助消息和支持网络警报。我们将对40名问题饮酒者进行beta研究，以评估信息偏好和可接受性，然后对10名PD进行试点测试。在第1b阶段，我们的目标是测试这种干预措施，并了解不同的短信干预措施的作用机制与200个问题饮酒者在12周的时间。我们建议比较四种类型的消息传递：1）适合参与者当前状态的定制内容和定时消息传递（阶段1a干预）~ 2）每天下午3点发送的定制内容消息传递（非自适应或定时）~ 3）每天下午3点发送的基于非定制结果的消息~和4）仅简短反馈和EMA。将在基线时、通过SMS每周一次的EMA以及在第12周通过基于网络的随访评估完成评估。 主要结果包括饮酒日的饮酒量、大量饮酒的天数和 通过每周EMA测量。 其他结果将包括饮酒相关的后果，目标承诺和干预满意度。结果将用于修改干预措施，并为更大的1c期RCT做准备。 公共卫生相关性：过量饮酒会对个人和公共卫生造成严重后果。 基于互联网的问题饮酒干预措施已被证明是温和有效的，但帮助个人保持变化的能力有限。特克斯消息干预措施可以主动支持个人，并根据个人的 具有实时交互功能的当前状态。 我们建议创建一个自适应特克斯消息干预，以减少酒精消费和相关问题，并测试是否有针对性的自适应消息是上级的随机对照试验中的非定制的消息。 这种干预措施很容易传播，并有可能改善长期的 心理社会和健康结果的问题饮酒者。

DESCRIPTION (provided by applicant): This application is submitted in response to NIAAA's program announcement, Behavioral & Integrative Treatment Development Program, PA-10-013 and is consistent with NIH's recent interest in developing adaptive mobile interventions. The proposed development study entitled, Tailored Mobile Text Messaging to Reduce Problem Drinking is designed to develop and test a tailored adaptive text messaging/short message service (SMS) intervention for individuals interested in stopping or reducing their alcool consumption. Excessive alcohol consumption is a serious personal and public health issue and economic problem to society. Despite the significant consequences of problem drinking (PD), most persons with alcohol problems never seek formal treatment. While the emergence of internet based interventions (IBIs) has expanded access and brief intervention opportunities to problem drinkers, traditional IBIs suffer from high attrition, limited ability to proactively meet individuals where PD occurs and adapt to real-time needs. Recent evidence from smoking cessation studies highlight that SMS interventions may provide the needed reinforcement to help individuals enhance self-regulation and reduce problem alcohol use when they need it most in their natural environment. Moreover, because PD typically has regular episodic patterns, tailored interactive designs may be particularly effective. This study is designed to develop and test an interactive adaptive mobile messaging intervention for PD, which includes messages tailored to baseline assessment results (including drinking times) that are adaptive to ongoing drinking patterns and goal achievement via interactive ecological momentary assessment (EMA). Other features include participant initiated help messaging and support network alerts. We will conduct beta research with 40 problem drinkers to assess messaging preferences and acceptability, and then conduct a pilot test with 10 PDs. In Stage 1b, we aim to test this intervention and understand the mechanisms of action of different text messaging interventions with 200 problem drinkers over a 12-week period. We propose to compare four types of messaging: 1) Tailored content and timed messaging adaptive to the participants current state (Stage 1a intervention)~ 2) Tailored content messaging (not adaptive or timed) sent at 3 pm every day~ 3) Untailored consequence based messages sent at 3 pm every day~ and 4) Brief feedback and EMA only. Assessments will be completed at baseline, through weekly EMA via SMS and at week 12 via a web-based follow-up assessment. Primary outcomes include drinks per drinking day, days of heavy drinking, and average drinks per week as measured through weekly EMA. Additional outcomes will include drinking related consequences, goal commitment and intervention satisfaction. Outcomes will be used to modify the intervention and to prepare for a larger Stage 1c RCT. PUBLIC HEALTH RELEVANCE: Excessive alcohol consumption has serious personal and public health consequences. Internet based interventions for problem drinking have proven mildly effective but have limited ability to help individuals maintain changes. Tex messaging interventions can support individuals proactively and be tailored to an individual's current state with real-time interactive features. We propose to create an adaptive tex messaging intervention to reduce alcohol consumption and related problems and test whether tailored adaptive messaging is superior to untailored messaging in a randomized controlled trial. This intervention could be easily disseminated and potentially improve long-term psychosocial and health outcomes for problem drinkers.