Web Intervention for Concerned Partners to Prevent Service Member Alcohol Abuse

描述（由申请人提供）：从事酒精滥用的美国军人是一个易受伤害的群体，有很高的未满足需求。酒精滥用是酗酒问题的一个阶段，发生在滥用和依赖之前，使服役人员的伴侣和家庭面临严重后果的风险。不幸的是，现有的军事报告政策可能会阻碍服务人员寻求帮助，因为他们害怕对职业造成负面影响。服务人员报告说，伴侣的鼓励是寻求治疗的最普遍的促进因素，而改变饮酒模式的个人最常将伴侣的支持作为支持改变的最有帮助的机制。因此，针对服役人员的伴侣使用预防性干预措施可以成为防止发展为滥用和依赖的重要手段。我们提议进行一项为期3年的研究，以调整和试点一项基于网络的干预措施，旨在帮助有关合作伙伴向酗酒的服务人员提供支持，并开始根据服务人员的意见开发一个服务人员模块。我们将首先采用一种基于证据的干预措施，即社区强化和家庭培训（CRAFT）干预措施，以帮助克服与保密问题和访问有关的障碍。我们的建议有三个具体目标。目标1：开发一个4阶段的基于网络的干预（WBI）原型，并根据15-20个CPs的反馈进行迭代修订。目的2：对最终完成的WBI （n=50）与延迟完成的WBI （n=50）进行随机对照试验，并在干预后三个月评估WBI对CP的服务人员求助（如咨询、自助、初级保健、治疗）和饮酒报告以及CP的幸福感和关系满意度的影响。目标3：开始基于服务成员输入和内容评估为服务成员开发后续WBI模块。我们将探索服务成员的干预偏好，并获得他们对建议的WBI的反馈。我们的项目意义重大，因为它有可能使大批军人受益，他们可能受到目前OEF/OIF/OND冲突的不成比例的影响，否则他们的酗酒行为将不会被发现和治疗。它还开发了一种新的预防模式，不依赖于在医院或临床机构就诊的服务人员或合作伙伴获得护理。拟议的研究是创新的，因为没有基于cp的预防干预措施来解决滥用问题。该试点研究将为R01试验的发展提供信息，该试验将对CPs的WBI进行更大的随机研究，并对服务人员进行后续干预。

DESCRIPTION (provided by applicant): U.S. military service members engaged in alcohol misuse are a vulnerable population with high unmet need. Alcohol misuse is a stage of problem drinking that occurs before abuse and dependence, placing service members' partners and families at risk for serious consequences. Unfortunately, existing military reporting policies may discourage service members from seeking help for fear of negative career consequences. Service members report encouragement from their partners as the most prevalent facilitator of seeking care and individuals who change their drinking patterns most often cite partner support as the most helpful mechanism in supporting change. Thus, targeting service members' partners using preventive interventions can be an important vehicle for preventing the progression to abuse and dependence. We propose a 3-year study to adapt and pilot-test a web-based intervention (WBI) intended to help concerned partners (CPs) provide support to service members with alcohol misuse and to begin development of a service member module based on service member's input. We will first adapt an evidence-based intervention known as Community Reinforcement and Family Training (CRAFT) intervention to the web to help overcome barriers related to confidentiality concerns and access. Our proposal has three specific aims. Aim 1: Develop a 4-session web- based intervention (WBI) prototype and make iterative revisions based on feedback from 15-20 CPs. Aim 2: Conduct a randomized controlled pilot-test of the finalized WBI (n=50) compared to delayed WBI (n=50), and evaluate the impact of the WBI on CP's reports of service member help-seeking (e.g., counseling, self-help, primary care, treatment) and drinking, and CP well-being and relationship satisfaction three months after the intervention. Aim 3: Begin development of a follow-on WBI module for service members based on service member input and content evaluation. We will explore the service member's intervention preferences and obtain their feedback on a proposed WBI for them. Our project is significant because it has the potential to benefit a large population of military service members who may be disproportionately affected by the current OEF/OIF/OND conflicts and whose drinking misuse would otherwise go undetected and untreated. It also develops a new prevention model that does not rely on service members or partners attending a hospital or clinical facility to access care. The proposed study is innovative because there are no CP-based preventive interventions addressing misuse. This pilot study will inform the development of an R01 trial that evaluates a larger randomized study of a WBI for CPs with a follow-on intervention for service members.