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）：在美国，男男性行为者（MSM）的新发艾滋病毒感染率继续快速增长，尽管其他群体保持稳定或下降。这一趋势突出表明，开发新的工具以遏制艾滋病毒在男男性行为者中的持续蔓延仍然十分重要。尽管针对男男性行为者存在一些降低性风险的干预措施，但重要的局限性限制了它们的影响。 这些障碍包括传播和/或实施方面的障碍，如冗长的治疗方案，对训练有素的干预人员的需求，以及仅限于医疗保健服务 设置.干预措施也未能解决导致高风险行为的关键因素，特别是大量饮酒。测试干预措施对减少男男性行为者大量饮酒的有效性的研究很少，而且大多只探索了持续数周或数月的更有效的治疗方案。基于动机访谈（MI）原则的减少大量饮酒的单次接触干预方法，通常被称为“个性化反馈干预”，已在其他人群中成功开发和测试。类似的基于变化阶段和MI原则的减少艾滋病毒风险的简短干预措施，如个性化认知咨询，也已被证明在这些人中产生有意义的减少无保护性行为。这些平行的研究强调了开发一种简短的综合干预措施以减少MSM中的酒精使用和性风险的机会。通过基于技术或移动健康的形式调整和提供这些干预措施，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计划的基础，重点是开发技术辅助工具，可以很容易地交付给高风险的个人。这个为期三年的项目旨在根据MI的原则，开发和试点测试一种简短的综合干预措施，以减少男男性行为者的酗酒和无保护性行为。这一综合干预措施将适用于平板电脑形式，专门用于社区环境中的高危MSM。该研究包括两个阶段：第一阶段涉及进行定性研究，以（1）整合酒精使用和性风险干预组件，（2）使其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。第二阶段是在社区寻求艾滋病毒检测的男男性行为者中进行随机对照的干预试验，以探索其对酒精和艾滋病毒相关行为结果的潜在影响。这项研究将最终产生一个综合的，以理论为基础的，技术交付的干预大量饮酒和性风险，是完全便携式的，并已初步测试的有效性，在社区环境中，高风险的男男性接触者从事预防服务。