Web-facilitated intervention for heavy drinking and HIV risk

针对酗酒和艾滋病毒风险的网络辅助干预

• 批准号: 8921751
• 负责人: Christopher W. Kahler
• 金额: $ 23.36万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2018-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8921751
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Alcohol abuse; Alcohol consumption; Alcohols; Anus; Attention; Behavior; Behavior Therapy; Behavioral; Biological; Clinical; Cognitive; Communities; Counseling; Data; Development; Developmental Process; Epidemic; Epidemiology; Evaluation; Feedback; Focus Groups; Foundations; Future; Goals; HIV; HIV Infections; HIV risk; Healthcare; Heavy Drinking; Human Resources; Human immunodeficiency virus test; Individual; Infection; Intervention; Interview; Lead; Literature; Methodology; Modification; North America; Outcome; Pharmaceutical Preparations; Phase; Pilot Projects; Population; Positioning Attribute; Prevalence; Prevention; Preventive Intervention; Procedures; Process; Protocols documentation; Public Health; Qualitative Research; Randomized; Randomized Controlled Trials; Research; Research Support; Resources; Risk; Risk Behaviors; Risk Reduction; Role; Sampling; Services; Sexual Partners; Solutions; Staging; Tablet Computer; Tablets; Technology; Testing; Training; Treatment Efficacy; Treatment Protocols; United States; Unsafe Sex; alcohol risk; base; behavioral outcome; brief intervention; community setting; cost; efficacy research; efficacy testing; evidence base; fighting; flexibility; forgetting; health disparity; high risk; high risk behavior; high risk men; improved; innovation; intervention effect; intervention program; mHealth; meetings; member; men; men who have sex with men; motivational enhancement therapy; prevention service; programs; public health relevance; sex; sex risk; success; theories; tool; transmission process; trend

 DESCRIPTION (provided by applicant): Annual rates of new HIV infections among men who have sex with men (MSM) in the United States continue to grow rapidly, despite stability or decline among other groups. This trend highlights the ongoing importance of developing new tools to fight the continued expansion of the HIV epidemic among MSM. Although a number of sex risk reduction interventions exist for MSM, important limitations have restricted their impact. These include barriers to dissemination and/or implementation, such as lengthy treatment protocols, the need for highly- trained interventionists, and confining delivery only to healthcare settings. Interventions have also failed to address pivotal factors that lead to high-risk behavior specifically heavy drinking. Research testing the efficacy of interventions to reduce heavy drinking among MSM is scarce, and has mostly only explored lengthier treatment protocols that span several weeks or months. Single-exposure intervention approaches for reducing heavy drinking based on the principles of motivational interviewing (MI), commonly referred to as "Personalized Feedback Interventions," have been developed and tested in other populations with success. Similar brief interventions for HIV-risk reduction based on stages of change and MI-principles, such as Personalized Cognitive Counseling, have also been shown to produce meaningful reductions in unprotected sex among these individuals. These parallel lines of research highlight the opportunity for developing a brief, combined intervention for reducing both alcohol use and sex risk among MSM. Adapting and delivering these interventions via a technology-based or mHealth format would also begin to allow the extension of interventions beyond the traditional interactions and settings, potentially improving efficacy, flexibility, and scalability. As such, the proposed research will serve as the foundation for a research program focusing on developing technology-assisted tools that can be easily delivered to high-risk individuals. This three-year project aims to develop and pilot test a brief, combined intervention for reducing heavy drinking and unprotected sex among MSM based on principles of MI. This combined intervention will be adapted to a tablet- based format and developed specifically for use with high-risk MSM in community-based settings. The research involves two phases: Phase 1 involves conducting qualitative research to (1) integrate alcohol use and sex risk intervention components, (2) adapt them to a technology-based format, and (3) understand and address challenges in implementation, feasibility, and acceptability. Phase 2 entails conducting a randomized- controlled pilot test of the intervention among MSM seeking HIV testing in community-based settings to explore its potential impact on alcohol and HIV-related behavioral outcomes. This research will ultimately produce a combined, theory-based, and technology-delivered intervention for heavy drinking and sex risk that is fully portable and has been preliminarily tested for efficacy in community settings where high-risk MSM engage with prevention services.

 描述（由申请人提供）：尽管其他群体的情况稳定或有所下降，但美国男男性行为者 (MSM) 的年新发艾滋病毒感染率继续快速增长。这一趋势凸显了开发新工具来对抗 MSM 中艾滋病毒流行持续蔓延的重要性。尽管针对 MSM 存在许多降低性风险的干预措施，但重要的局限性限制了其影响。 其中包括传播和/或实施的障碍，例如冗长的治疗方案、需要训练有素的干预人员以及仅限于医疗保健领域 设置。干预措施也未能解决导致高风险行为（特别是酗酒）的关键因素。测试减少 MSM 酗酒干预措施有效性的研究很少，而且大多只探索了长达数周或数月的较长治疗方案。基于动机访谈 (MI) 原则的用于减少酗酒的单次暴露干预方法（通常称为“个性化反馈干预措施”）已在其他人群中成功开发和测试。基于变化阶段和 MI 原则的类似的降低艾滋病毒风险的简短干预措施（例如个性化认知咨询）也被证明可以有效减少这些人中无保护性行为的发生。这些平行研究强调了开发简短的综合干预措施以减少 MSM 饮酒和性风险的机会。通过基于技术或移动医疗的形式调整和提供这些干预措施也将开始允许干预措施扩展到传统的互动和环境之外，从而有可能提高功效、灵活性和可扩展性。因此，拟议的研究将作为一个研究项目的基础，该项目的重点是开发可以轻松交付给高风险个体的技术辅助工具。这个为期三年的项目旨在根据 MI 原则开发并试点测试一种简短的综合干预措施，以减少 MSM 中的酗酒和无保护性行为。这种联合干预措施将采用基于平板电脑的形式，并专门针对社区环境中的高风险 MSM 进行开发。该研究分为两个阶段：第一阶段涉及进行定性研究，以（1）整合饮酒和性风险干预组成部分，（2）使它们适应基于技术的形式，以及（3）理解和解决实施、可行性和可接受性方面的挑战。第二阶段需要对在社区环境中寻求 HIV 检测的 MSM 进行干预的随机对照试点测试，以探讨其对酒精和 HIV 相关行为结果的潜在影响。这项研究最终将针对酗酒和性风险产生一种基于理论和技术的综合干预措施，该干预措施完全可移植，并已在高风险 MSM 参与预防服务的社区环境中进行了初步有效性测试。