Tailored Adaptive Mobile Messaging to Reduce Problem Drinking

项目摘要 建议的R 01，标题为，定制的自适应移动的消息，以减少问题饮酒，提交 扩展我们最近完成的R34补助金，题为“定制移动的消息传递以减少问题” 饮酒（R34 AA 021502）。尽管有显著的后果，酗酒的人与非禁欲 目标很少寻求治疗。互联网筛选和移动的应用程序等较新的方法提供了 有机会接触和治疗这一难以接触的人群。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综合定制自适应（TA）短信干预， 问题饮酒（PD）我们将TA与不同类型的自动化每日一次消息传递进行了比较 包括：仅基线定制的消息传送（TO），丢失帧消息传送（LF），增益帧消息传送（GF）， 每周仅进行移动的评估（MA）。这是在12周内完成的171个问题的样本 在美国各地的互联网上招募的饮酒者。在大多数饮酒方面，所有消息组的表现都优于MA 结果，TA组对每个饮酒结果的影响最大，平均每周 在第12周时，每周减少9次标准饮酒，减少2天重度饮酒。超过8- 一个月期间，1149人参加了基于网络的筛选调查，强调了对 在这个人群中传递信息。这项研究提供了初步证据的有效性，消息， 减少全国寻求帮助的成年人的PD。需要大规模的随机对照试验 提供必要的经验证据，以验证SMS干预措施，并了解 寻求重度饮酒者的帮助。在一项大规模R 01试验中，我们建议比较定制的 自适应消息组（TA; N=300）至基线仅定制组（TO; N=300）和每周一次 仅移动的评估组（MA; N=300）。所有小组将收到为期六个月的信息。 受试者将在基线、1个月、3个月、6个月、 12-月和18个月。不同条件的参与者将每周接受MA，持续26周。我们 假设TA在所有时间段的所有饮酒指标上都上级MA，TA将 在除1个月随访外的所有时间段均优于TO。其他目标包括测试基线 调节因子如酒精严重程度和调节因子如信息相关性。总的来说，如果研究目的是 实现，我们将：1）有经验支持，TA是一种有效的干预PD和其效果是 2）了解仅接受基线定制是否足够，或者自适应定制是否足够 是长期行为改变所需要的; 3）了解结果的调节者和调解者， 针对PD的消息传递干预;以及4）能够向消费者直接传播药物支持 对任何拥有移动的电话但尚未准备好寻求面对面护理的人进行移动的PD干预。

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.