Piloting Signs of Safety: A Deaf-Accessible Therapy Toolkit for Alcohol Use Disorder and Trauma

安全试点：针对酒精使用障碍和创伤的聋人无障碍治疗工具包

• 批准号: 9761412
• 负责人: Melissa Lee Anderson
• 金额: $ 24.08万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-10 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9761412
• 关键词: Address; Adherence; Adult; Aftercare; Alcohol abuse; Alcohol consumption; American; American Sign Language; Behavior Therapy; Client; Clinical; Cognitive; Communities; Comorbidity; Companions; Compassion; Coping Skills; Data; Educational process of instructing; Employment; Enrollment; Evidence based treatment; Family; Feedback; Film; Frequencies; Future; General Population; Health; Health Personnel; Hearing; Impairment; Individual; Integrative Therapy; Language Development; Learning; Linguistics; Mediator of activation protein; Modeling; Motivation; National Institute on Alcohol Abuse and Alcoholism; Outcome; Parents; Participant; Pilot Projects; Population; Post-Traumatic Stress Disorders; Problem Solving; Process Assessment; Program Development; Protocols documentation; Psychotherapy; Radio; Randomized; Randomized Controlled Trials; Reading; Recovery; Reporting; Research Personnel; Research Training; Safety; Services; Severities; Socialization; Symptoms; Text; Therapeutic Studies; Time; Training; Training Programs; Translations; Trauma; Visual; Work; addiction; alcohol abuse therapy; alcohol comorbidity; alcohol craving; alcohol related problem; alcohol use disorder; arm; artist; base; behavioral health; cultural competence; deaf; design; digital; disorder risk; drinking behavior; efficacy testing; evidence base; experience; falls; follow up assessment; follow-up; fourth grade; health literacy; high risk; improved; peer; physical conditioning; primary outcome; programs; prototype; recruit; response; satisfaction; screening; social norm; trauma exposure

PROJECT SUMMARY/ABSTRACT The U.S. Deaf community – a group of more than 500,000 Americans who communicate using American Sign Language (ASL) – experiences nearly three times the rate of lifetime problem drinking and twice the rate of trauma exposure compared to the general population. Although there are validated treatments for alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) in hearing populations, there are no evidence-based treatments for any behavioral health condition for use with Deaf clients. Current evidence-based treatments fail to meet Deaf clients’ unique linguistic and cultural needs. To address these barriers, the PI led a team of Deaf and hearing researchers, clinicians, filmmakers, actors, artists, and Deaf people with AUD to develop a prototype of “Signs of Safety,” a Deaf-accessible toolkit to be used with an existing, widely-disseminated protocol for AUD/trauma – Seeking Safety. The Signs of Safety toolkit, as designed thus far, includes a therapist guide and population-specific client materials (e.g., visual handouts; ASL teaching stories on digital video, which present key learning points). It is designed for use by clinicians who are Deaf themselves, hearing signers, or hearing non-signers working with ASL interpreters. The aims of the proposed study are: (1) to generate a final, professional version of Signs of Safety to be used in future research and train three study clinicians in Signs of Safety and Seeking Safety; (2) to conduct a two- arm pilot randomized controlled trial (RCT) of Seeking Safety + Signs of Safety toolkit versus unsupplemented Seeking Safety, collecting data on feasibility outcomes (screening, recruitment, retention, satisfaction, fidelity, adherence, assessment process) and preliminary clinical outcomes (i.e., reduction in alcohol use frequency and quantity, alcohol craving, alcohol-related problems, severity of PTSD symptoms); and, (3) to examine potential mediators and moderators of outcome (e.g., motivation for treatment, provider cultural competency, coping skills, self-compassion, understanding of health information). The proposed aims will provide feasibility and preliminary efficacy data necessary to support a NIAAA R01 for a full-scale RCT to test the efficacy of Signs of Safety, as well as a participatory action model for conducting RCTs within the Deaf community.

项目摘要/摘要 美国聋人社区 - 一群使用美国标志进行交流的超过50万美国人 语言（ASL） - 经历终生问题的速度几乎是饮酒率的三倍 与普通人群相比，创伤暴露。虽然有经过验证的饮酒治疗方法 障碍（AUD）和创伤后应激障碍（PTSD）在听力人群中，没有证据 与聋人使用的任何行为健康状况的治疗。当前基于证据的治疗失败 满足聋哑客户独特的语言和文化需求。 为了解决这些障碍，PI领导了一支聋哑和听力的研究人员，临床医生，电影制片人，演员， 艺术家和聋哑人有AUD来开发“安全迹象”的原型，这是一个聋哑的工具包 与现有的，广泛释放的AUD/创伤协议一起使用 - 寻求安全。安全的迹象 迄今为止设计的工具包包括治疗师指南和特定人群的客户材料（例如，视觉 讲义； ASL在数字视频上教授故事，其中提出了关键学习点）。它设计用于使用 聋哑人，听力签名者或与ASL口译员一起工作的非签名者的临床医生。 拟议的研究的目的是：（1）生成最终的专业版本的安全迹象 在未来的研究和培训三位研究临床医生的安全迹象和寻求安全的迹象中； （2）进行两种 ARM PILOT随机对照试验（RCT）寻求安全 +安全工具包的迹象 寻求安全，收集有关可行性结果的数据（筛查，招聘，保留，满意度，忠诚， 依从性，评估过程）和初步临床结果（即降低酒精使用频率 和数量，渴望酒精相关的问题，PTSD症状的严重程度）； （3）检查 结果的潜在调解人和主持人（例如，治疗动机，提供者文化能力， 应对技能，自我同情，对健康信息的理解）。 拟议的目标将提供可行性和初步效率数据，以支持NIAAA R01 全面的RCT测试安全迹象的效率，以及进行的参与行动模型 聋人社区中的RCT。