Real-Time Assessment of Triggers and Coping Responses in China

描述(申请人提供)：针对阿片类药物使用者中艾滋病毒/艾滋病的高感染率，中国最近实施了美沙酮维持治疗(MMT)计划，以降低注射吸毒者(IDUs)中的艾滋病毒风险。虽然中国在实施MMT方面取得了很大进展，但MMT患者中阿片类药物的持续使用率和辍学率仍然存在问题。改进的自我监测和自我管理是慢性病管理的重要元素，但对于中国的MMT提供者和患者来说，这些概念相对较新。根据认知行为理论，管理触发因素/风险和建立应对技能是预防复发和持续康复的关键。更好地了解MMT患者的共同诱因和有效的应对策略将为制定有效的干预措施提供基础。在中国，通信技术和手机的普及为患者提供了接触和建立网络的机会，并收集了触发因素和应对反应的生态瞬时评估数据。拟议的项目将测试EMA使用手机和短信技术收集触发因素和应对反应的数据的可行性和可接受性。加州大学洛杉矶分校的研究人员开发了一个名为“ANDWellness”的开源移动健康平台，用于支持自我监测和行为干预。我们建议在这个创新平台的基础上，对中国MMT患者的触发因素和应对反应进行实时评估。这项研究的目标是(1)开发一种由手机支持的交互式移动健康原型，该原型建立个性化的风险或触发因素简档，并 这将支持知识和技能建设，包括应对战略；以及(2)开展一项试点研究，以评估环境管理评估数据的可靠性和有效性。第二个目标是获得与结果数据有关的自我监测的初步证据(例如，MMT保留、禁欲)。该项目将分两个阶段完成：第一阶段将开发基于智能手机的ANDWellness应用程序原型。我们还将评估原型的可接受性和可行性。第二阶段将包括一项试点测试，以检查ANDWellness原型的可接受性和遵从性，收集关于触发和反应的EMA数据，EMA与回溯性召回和尿液测试的对应关系，以及EMA与一些有限结果的关系。这些试点工作将为我们未来基于手机技术的干预开发做好准备。这一系列研究的长期目标是开发有前景的战略，通过利用手机使用的普及来优化治疗效果并支持持续恢复，并调整和应用循证原则来解决药物使用和艾滋病毒/丙型肝炎病毒危险行为。因此，这项研究将有助于有关触发因素和应对策略的文献 并将扩大NIDA发布以研究为基础的干预措施的使命，以改善治疗服务并减少艾滋病毒/丙型肝炎病毒在全球的传播。

DESCRIPTION (provided by applicant): Responding to high rates of HIV/AIDS among opiate users, China has recently implemented methadone maintenance treatment (MMT) programs in order to reduce HIV risks among injection drug users (IDUs). While China has made strides in the implementation of MMT, high rates of continued opiate use and dropout among MMT patients remain problematic. Improved self-monitoring and self-management are important elements in chronic disease management, but these concepts are relatively new to Chinese MMT providers and patients. According to cognitive behavioral theories, managing triggers/risks and building coping skills are critical in relapse prevention and sustained recovery. A better understanding of common triggers and effective coping strategies among MMT patients will provide a foundation for developing effective interventions. Communication technologies and the proliferation of cellphones in China provide great opportunities to engage and network with patients and to collect ecological momentary assessment (EMA) data on triggers and coping responses. The proposed project will test the feasibility and acceptability of EMA data collection of triggers and coping responses using cellphone and text messaging technology. An open-source mobile health platform, called "ANDWellness," has been developed by UCLA researchers for supporting self-monitoring and behavioral interventions. We propose to build upon this innovative platform to conduct real-time assessment of triggers and coping responses among MMT patients in China. The study aims are (1) To develop an interactive cellphone-supported mobile health prototype that establishes individualized profiles of risks or triggers and that supports knowledge and skill building, including coping strategies; and (2) To conduct a pilot study to assess the reliability and validity of the EMA data. A secondary objective is to obtain preliminary evidence on self-monitoring in relation to outcome data (e.g., MMT retention, abstinence). The project will be accomplished in two phases: Phase I will develop a smartphone-based prototype of the ANDWellness application. We will also assess the acceptability and feasibility of the prototype. Phase II will consist of a pilot test to examine th acceptability of and compliance with the ANDWellness prototype collecting EMA data on triggers and responses, the correspondence of EMA with the retrospective recall and urine testing, and the relation between EMA and some limited outcomes. These pilot efforts will prepare us for future intervention development based on cellphone technology. The long-term goal of this line of research is to develop promising strategies that optimize treatment effectiveness and support sustained recovery by taking advantage of the popularity of cellphone use, and adapting and applying evidence-based principles to address drug use and HIV/HCV risk behaviors. Thus, the study will contribute to the literature on triggers and coping strategies and will extend NIDA's mission of promulgating research-based interventions to improve treatment services and reduce HIV/HCV transmission globally.