Real-Time Assessment of Triggers and Coping Responses in China

中国触发因素和应对反应的实时评估

• 批准号: 8507196
• 负责人: YIH-ING HSER
• 金额: $ 14.31万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-15 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8507196
• 关键词: AIDS/HIV problem; Abstinence; Address; Attention; Behavior Therapy; Behavioral; China; Chinese People; Chronic Disease; Cognitive; Collaborations; Communication; Communities; Coping Skills; Counseling; Data; Data Collection; Data Quality; Disease Management; Dropout; Drug Addiction; Drug abuse; Drug usage; Effectiveness; Environment; Feedback; Foundations; Future; Goals; HIV; HIV risk; Health; Health Personnel; Health Technology; Hepatitis C Transmission; Hepatitis C virus; Indium; Injecting drug user; International; Intervention; Knowledge; Link; Literature; Long-Term Care; Maintenance; Medical; Methadone; Mission; Monitor; Opiate Addiction; Opiates; Outcome; Outcome Measure; Patients; Pharmacotherapy; Phase; Pilot Projects; Provider; Public Health; Recovery; Relapse; Research; Research Personnel; Risk; Risk Behaviors; Self Management; Services; Social Environment; Technology; Testing; Text; Therapeutic; Time; Treatment Effectiveness; Urine; Validity and Reliability; base; coping; disorder later incidence prevention; effective intervention; evidence base; improved; innovation; methadone maintenance; novel; open source; prevent; prototype; response; skills; skills training; theories; therapy development; tool; treatment program

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.

描述（由申请人提供）：为了应对阿片类药物使用者中艾滋病毒/艾滋病的高发病率，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（IDU）中的艾滋病毒风险。尽管中国在实施 MMT 方面取得了长足进步，但 MMT 患者持续使用阿片类药物和退出率较高的问题仍然存在。改善自我监测和自我管理是慢性病管理的重要组成部分，但这些概念对于中国 MMT 提供者和患者来说相对较新。根据认知行为理论，管理触发因素/风险和培养应对技能对于预防复发和持续康复至关重要。更好地了解 MMT 患者的常见触发因素和有效的应对策略将为制定有效的干预措施奠定基础。中国的通信技术和手机的普及为与患者接触和建立联系以及收集有关触发因素和应对反应的生态瞬时评估（EMA）数据提供了绝佳的机会。拟议的项目将测试使用手机和短信技术收集触发因素和应对反应的 EMA 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，用于支持自我监控和行为干预。我们建议以这个创新平台为基础，对中国 MMT 患者的触发因素和应对反应进行实时评估。该研究的目标是 (1) 开发一种由手机支持的交互式移动健康原型，建立个性化的风险或触发因素档案， 支持知识和技能建设，包括应对策略； (2) 开展试点研究，评估 EMA 数据的可靠性和有效性。第二个目标是获得与结果数据相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 原型的可接受性和依从性，收集关于触发和反应的 EMA 数据、EMA 与回顾性回忆和尿液检测的对应性，以及 EMA 和一些有限结果之间的关系。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途的策略，通过利用手机使用的普及、调整和应用循证原则来解决吸毒和艾滋病毒/丙型肝炎风险行为，优化治疗效果并支持持续康复。因此，该研究将为有关触发因素和应对策略的文献做出贡献 并将扩展 NIDA 的使命，即颁布基于研究的干预措施，以改善治疗服务并减少全球艾滋病毒/丙型肝炎病毒的传播。