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（由适用提供）：与男性发生性关系（MSM）的新艾滋病毒感染率的年度速率继续增长，在其他群体中，任务稳定或下降。这一趋势强调了开发新工具以抵抗MSM中艾滋病毒流行的持续扩展的持续重要性。尽管MSM存在许多减少性风险干预措施，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，例如长度治疗方案，对训练有素的干预主义者的需求以及仅限于医疗保健 设置。干预措施也未能解决导致高风险行为特别饮酒的关键因素。研究测试减少MSM大量饮酒的干预效率的研究很少，并且主要探索了几周或几个月的较长的治疗方案。基于动机访谈的原理（MI）的原理（通常称为“个性化反馈干预措施”）的单一暴露干预方法已在其他成功的人群中开发和测试。基于变化和MI-Principles的阶段（例如个性化认知咨询），对HIV风险的降低进行了类似的简短干预措施，也已被证明可以在这些个体之间产生有意义的无保护性别。这些平行的研究线突出了开发简短的，合并的干预措施，以减少MSM中的酒精使用和性风险。通过基于技术或MHEADH的格式调整和交付这些干预措施也将开始允许将干预措施扩展到传统的互动和环境之外，从而提高效率，灵活性和可扩展性。因此，拟议的研究将成为一项研究计划的基础，该研究计划着重于开发技术辅助工具，这些工具可以轻松地交付给高风险的人。为期三年的项目旨在根据MI原则来开发和试点测试，以简短，合并的干预措施，以减少MSM中的大量饮酒和无保护性。这种组合干预措施将适用于基于平板电脑的格式，并专门为在社区设置中与高风险MSM一起使用。这项研究涉及两个阶段：第1阶段涉及对（1）综合饮酒和性风险干预组件进行定性研究，（2）将它们适应基于技术的格式，以及（3）理解和解决实施，可行性和可接受性方面的挑战。第2阶段进行了对MSM寻求HIV测试的干预措施的随机控制试验测试，以探索其对酒精和HIV与HIV相关行为结果的潜在影响。这项研究最终将产生一种基于理论的和技术分配的重型饮酒和性风险干预措施，该干预措施是完全便携式的，并且已在高风险MSM参与预防服务的社区环境中进行了初步测试。