Technology-Supported Physical Activity Intervention for Depressed Alcoholic Women

 描述(申请人提供)：酒精使用障碍(AUD)是美国第三大可预防的死亡原因，与巨大的经济负担和与健康相关的负面后果有关。虽然女性患AUDS的可能性较小，但她们因饮酒而经历的负面健康后果比男性更严重。由于耻辱、羞耻和育儿问题，女性不太可能接受专门的成瘾治疗。抑郁症和AUDS在女性中的共患率要高得多，与男性相比，女性抑郁症通常在AUD之前有短暂的发病。男性和女性的复发率都很高，但在复发的预测因素上出现了显着的性别差异。女性更有可能在令人不快的负面情绪状态和抑郁症状下复发，负面情绪在这些压力源和饮酒结果之间的关系中起中介作用。与男性相比，患有AUDS的女性报告称，饮酒是为了应对负面情绪。因此，帮助女性制定替代应对策略的干预方法在减少患有AUDS的抑郁女性的酒精复发方面可以发挥重要作用。鉴于运动对减少抑郁、负面情绪和饮酒冲动的已被证明的好处，帮助女性参与灵活和可接受的生活方式体力活动(LPA)干预可能为她们提供一种工具，她们可以在复发风险最高的早期康复期间利用这一工具来应对负面情绪状态和饮酒欲望。近年来出现了令人兴奋的新数字健身技术(例如，带有网络和移动应用程序的Fitbit活动监测器)，这些技术包括能够进一步增强增加体力活动的关键组件-目标设置和自我监控-的功能。我们建议开发为期12周的LPA+Fitbit干预措施，用于抑郁症女性的酒精治疗。这将包括：1)面对面的身体活动(PA)咨询指导会议2)4个简短的电话PA咨询会议，重点是增加PA并战略性地使用PA来应对情绪和酒精渴望；3)使用Fitbit健身跟踪器设定体育活动目标和进行日常自我监控；以及4)每周通过电子邮件发送支持性信息。此应用程序的总体目标是开发LPA+Fitbit干预，根据初始开放试点(n=20)和反馈对其进行修改，以确保其可行性 以及对患有AUDS的抑郁症妇女早期康复的可接受性，提出潜在的机制，并在一项小型随机临床试验(n=50)中获得其疗效的初步数据。在本申请中提出的LPA+Fitbit干预方法简单、低成本，并易于移植到患有AUDS的妇女接受治疗的各种临床环境中。如果患有AUDS的女性认为LPA+Fitbit干预在早期康复期间可行、可接受和有帮助，则可以为她们提供亟需的替代应对策略，以降低复发风险，并减少饮酒对她们健康和福祉的总体负面影响。

 DESCRIPTION (provided by applicant): Alcohol use disorders (AUDs) are the 3rd leading preventable cause of death in the U.S. and are associated with significant economic burden and health-related negative consequences. While women may be less likely to develop AUDs, they experience more significant negative health consequences of alcohol use than men. Due to stigma, shame, and child care issues; women are less likely to receive specialty addiction treatment. The comorbidity of depression and AUDs is much higher in women, and compared to men, women depression often has a temporal onset prior to an AUD. Relapse rates are very high in both men and women but significant gender differences emerge in the predictors of relapse. Women are more likely to relapse in unpleasant, negative emotional states and depressive symptoms and negative affect mediate the relationship between these stressors and drinking outcomes. More so than men, women with AUDs report drinking to cope with negative emotions. Therefore, intervention approaches that help women develop alternate coping strategies can have an important role in decreasing alcohol relapse among depressed women with AUDs. Given the demonstrated benefits of exercise for decreasing depression, negative affect, and urges to drink, helping women engage in a flexible and acceptable lifestyle physical activity (LPA) intervention may provide them a tool they can utilizing "in the moment" to cope with negative emotional states and alcohol craving during early recovery when relapse risk is highest. Exciting new digital fitness technologies (e.g., Fitbit activity monitor with web and mobile applications) have emerged in recent years that include features able to further enhance critical components for increasing physical activity - goal setting and self-monitoring. We propose to develop a 12-week LPA+Fitbit intervention for depressed women in alcohol treatment. This will include: 1) an in-person physical activity (PA) counseling orientation session 2) 4 brief, phone-based PA counseling sessions focused on increasing PA and strategically using bouts of PA to cope with affect and alcohol cravings; 3) use of the Fitbit fitness tracker fo physical activity goal-setting and daily self-monitoring; and 4) weekly supportive messages delivered by email. The overall objective of this application is to develop this LPA+Fitbit intervention, modify it based on a initial open pilot (n=20) and feedback to ensure its feasibility and acceptability for depressed women with AUDs in early recovery, propose potential mechanisms, and to obtain preliminary data on its efficacy in a small randomized clinical trial (n=50). The LPA+Fitbit intervention proposed in this application is simple, low-cost, and easily transportable to the varied clinical settings women with AUDs receive treatment. If women with AUDs find the LPA+Fitbit intervention feasible, acceptable, and helpful during early recovery, they could be afforded with a much needed alternate coping strategy that would reduce relapse risk and decrease the overall negative impact of alcohol use on their health and well-being.