Tailored Adaptive Mobile Messaging to Reduce Problem Drinking

项目摘要 提交了名为《定制的自适应移动消息传递以减少问题饮酒》的建议R01 要扩展我们最近完成的R34赠款，名为定制的移动消息传递以减少问题 饮酒(R34AA021502)。尽管后果严重，但酗酒不戒酒的人 目标很少寻求治疗。互联网筛查和移动应用程序等较新的方法提供 接触和治疗这一难以接触到的人群的机会。我们最近完成了一项R34研究 在那里我们开发了第一个自动化的全面定制自适应(TA)短信干预 针对有问题的饮酒(PD)。我们将TA与不同类型的每天一次的自动化消息进行了比较 包括：仅基线定制消息(TO)、丢帧消息(LF)、增益帧消息(GF)、 以及仅限每周移动评估(MA)。这是在超过12周的171个问题的样本中完成的 在美国各地的互联网上招募了饮酒者。在大多数饮酒问题上，所有消息群的表现都好于MA 结果，TA组对每一次饮酒结果的影响最大，平均每周 在第12周减少9种标准饮料和每周2天大量饮酒。超过8- 在一个月的时间里，1149人参加了基于网络的筛查调查，突出了对 在这群人中传递信息。这项研究提供了发送消息的有效性的初步证据 减少全国寻求帮助的成年人的帕金森病。需要大规模的随机对照试验 提供必要的实证证据，以验证短信干预措施并了解 寻求酗酒者帮助的结果。在一项大规模的R01试验中，我们建议将定制的 自适应消息组(TA；N=300)到仅基线定制组(TO；N=300)和周刊 仅移动评估组(MA；N=300)。所有小组都将在六个月内收到消息。 参与者将在基线、1个月、3个月、6个月、 12个月和18个月。不同条件的参与者将获得为期26周的每周MA。我们 假设TA在所有饮酒措施上都优于MA，并且TA将 除了一个月的跟踪外，在所有时间段都表现优异。其他目标包括测试基准 主持人，如酒精严重程度和调解人，如消息相关性。总体而言，如果研究目标是 实现后，我们将：1)有经验支持TA是对帕金森病有效的干预措施，其效果是 经久耐用；2)了解仅接收基线剪裁是否足够，或者自适应剪裁是否足够 是长期行为改变所必需的；3)了解结果的调节者和调解者 对帕金森病的消息干预；以及4)能够向消费者传播有经验支持的直接 为帕金森病提供移动干预，任何有手机的人都不准备寻求面对面的护理。

Project Summary The proposed R01, entitled, Tailored Adaptive Mobile Messaging to Reduce Problem Drinking, is submitted to expand on our recently completed R34 grant entitled, Tailored Mobile Messaging to Reduce Problem Drinking (R34AA021502). Despite significant consequences, heavy drinking individuals with non abstinence goals rarely seek treatment. Newer methods such as internet screening and mobile apps provide opportunities to engage and treat this difficult to reach population. We recently completed an R34 study where we developed the first automated comprehensive tailored adaptive (TA) text messaging intervention for problem drinking (PD). We compared TA to different types of automated once a day messaging including: baseline tailored only messaging (TO), loss framed messaging (LF), gain frame messaging (GF), and weekly mobile assessment only (MA). This was done over 12 weeks in a sample of 171 problem drinkers recruited on the internet across the US. All messaging groups outperformed MA on most drinking outcomes, and the TA group had the largest effect sizes on every drinking outcome with an average weekly drink reduction of 9 standard drinks and a reduction of 2 heavy drinking days a week at week 12. Over an 8- month period, 1149 individuals took the web-based screening survey, highlighting the demand for messaging in this population. This study provides initial evidence of the effectiveness of messaging to reduce PD in help-seeking adults across the country. Large scale randomized controlled trials are needed to provide the necessary empirical evidence to validate SMS interventions and to understand moderators of outcome for help seeking heavy drinkers. In a large scale R01 trial, we propose to compare the Tailored Adaptive messaging group (TA; N=300) to the baseline Tailored Only group (TO; N=300) and the weekly Mobile Assessment only group (MA; N=300). All groups will receive messages for a six month period. Participants will complete self-report web-based assessments at Baseline, 1-Month, 3-Months, 6-Months, 12-Months and 18-Months. Participants across conditions will receive weekly MA for 26 weeks. We hypothesize that TA will be superior to MA on all drinking measures at all time periods and TA will outperform TO at all time periods except one month follow-up. Other aims include testing baseline moderators such as alcohol severity and mediators such as message relevance. Overall, if study aims are achieved, we will: 1) have empirical support that TA is an effective intervention for PD and its effects are durable over time; 2) understand whether receiving baseline only tailoring is sufficient or if adaptive tailoring is needed for long-term behavior change; 3) understand the moderators and mediators of outcome in messaging interventions for PD; and 4) be able to disseminate an empirically-supported direct to consumer mobile intervention for PD to anyone with a mobile phone who is not ready to seek in-person care.