Refining and piloting a text messaging intervention to delay alcohol initiation and reduce alcohol use escalation among abstainer and lighter drinker college students

项目摘要/摘要 虽然对美国大学饮酒的研究主要集中在饮酒的流行率和问题上 与大量饮酒有关的研究要少得多，研究对象主要是那些 要么是戒酒者(即不喝酒)，要么是饮酒量较少的人(即男性，饮酒量不超过4杯 每周饮酒14次或更少；女性在两小时内饮酒3次或更少，每周饮酒7次或更少 每周饮酒量)。根据一项全国性调查，在18-22岁的大学生中，超过40%的人没有 报告称，在过去的一个月里饮酒(SAMSHA，2014)，只有一半的人经常酗酒 喝酒(NIAAA情况说明书)。研究进一步表明，相当大比例的学生是 在进入大学之前和之后禁酒或少量饮酒的人确实会开始饮酒，而且通常会进展到 成为酗酒者(McCabe等人，2005；O‘Malley&Johnston，2002；Schulenberg等人， 2005)。这证明了大学的第一年，特别是头几个月，是一种高风险 同时开始饮酒和重度饮酒的时间以及推迟重度饮酒的开始 在整个大学里，饮酒者和戒酒者之间的饮酒应该会导致更大的相关伤害 年岁和青壮年。此外，基于移动电话的干预是一种创新的方法 接触到年轻人，并已被确立为一种以证据为基础的、推荐的方法 解决健康问题(Free等人，2011年)，包括饮酒(Suffoletto等人，2012年)。因此， 这项建议的最终目标是开发、完善和试点针对戒酒者和 减少一年级大学生饮酒，最终目标是推迟饮酒和/或减少饮酒 酒精使用升级。焦点小组、干预内容开发和用户的迭代过程 针对戒酒者和饮酒量较少的人的独特体验的反馈将成为TM干预的依据 将在先导研究中提供6周的TMS、6周的干预后评估以及3、6和9 在100名戒酒和饮酒较少的大学生中进行了一个月的跟踪调查。这个 拟议中的研究具有对公共健康产生巨大影响的潜力。尽管已经使用了TM干预措施 对于高风险的年轻成年饮酒者，这是第一个针对戒酒或较轻饮酒的TM干预措施 饮酒者，这在文献中是一个著名的缺口(Bock等人，2016年)。推迟酒精使用的开始或升级 从长远来看，大量饮酒将节省与高风险饮酒相关的金钱和精力。 鉴于减少年轻人和大学生过度饮酒已被列为 作为2020年健康人的主要目标(USDHHS，2015)和NIAAA的关键优先事项，这一干预措施 重点是在戒酒者和较轻者中延迟饮酒开始和升级为高风险饮酒 饮酒者可以在实现这一目标方面取得重要进展。

PROJECT SUMMARY/ABSTRACT While a large focus of research on U.S. college drinking has focused on the prevalence of and problems related to heavy-episodic drinking, a much smaller amount of research has focused on college students who are either abstainers (i.e., do not drink any alcohol) or lighter drinkers (i.e., for men, drinking 4 or fewer drinks in two hours and 14 or fewer drinks per week; and for women drinking 3 or fewer in two hours and 7 or fewer drinks per week). According to a national survey, over 40% percent of college students ages 18–22 do not report drinking in the past month (SAMSHA, 2014) with only half of those engaging in regular heavy-episodic drinking (NIAAA factsheet). Research further suggests that a significant proportion of students who were abstinent or light drinkers prior to and upon entering college do initiate drinking, and often progress to becoming heavy-episodic drinkers (McCabe et al., 2005; O'Malley & Johnston, 2002; Schulenberg et al., 2005). This provides evidence that the first year of college, and specifically the first few months, is a high-risk time for initiating both drinking and heavy-episodic drinking and that delaying the onset of heavy-episodic drinking among light drinkers and abstainers should lead to greater related harms throughout both the college years and young adulthood. Additionally, mobile phone-based interventions are an innovative method for reaching young people and have been established as an evidence-based, recommended approach towards addressing health issues (Free et al., 2011), including alcohol use (Suffoletto et al., 2012). As such, the ultimate goal of this proposal is to develop, refine and pilot a text message (TM) intervention for abstainer and lighter drinking first year college students with the ultimate goal of delaying alcohol initiation and/or reducing alcohol use escalation. An iterative process of focus groups, intervention content development, and user feedback focused on the unique experiences of abstainers and lighter drinkers will inform the TM Intervention to be delivered in a pilot study with 6 weeks of TMs, a 6 week post-intervention assessment, and 3, 6, and 9 month follow-ups and among 100 incoming first year abstainer and lighter drinker college students. The proposed research has great potential for impact on public health. Although TM interventions have been used with high-risk young adult drinkers, this is the first TM intervention to be developed for abstaining or lighter drinkers, which is a noted gap in the literature (Bock et al., 2016). Delaying alcohol use initiation or escalation to heavy alcohol use will, in the longer-term, save money and effort associated with higher-risk alcohol use. Given that reducing young adults' and college students' engagement in excessive alcohol use has been listed as a major objective of Healthy People 2020 (USDHHS, 2015) and a key priority of NIAAA, an intervention that focuses on delaying alcohol initiation and escalation into higher-risk alcohol use among abstainer and lighter drinkers could make important strides to achieving this goal.