Building and pilot testing a couples-based smartphone systems to address alcohol use disorder

构建并试点测试基于情侣的智能手机系统以解决酒精使用障碍问题

• 批准号: 9770732
• 负责人: DAVID H GUSTAFSON
• 金额: $ 28.27万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2021-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9770732
• 关键词: Abstinence; Acute; Address; Adopted; Adult; Aging; Alcohol abuse; Alcohols; Asthma; Behavior Therapy; Behavioral; Caring; Cellular Phone; Chronic; Clinical; Clinical Trials; Colon Carcinoma; Computers; Conflict (Psychology); Control Groups; Counseling; Couples; Couples Therapy; Data; Diagnosis; Education; Effectiveness; Elements; Emotional; Family; Family Caregiver; Feedback; Grant; HIV; Health; Individual; Integrative Therapy; Lead; Malignant neoplasm of prostate; Manuals; Massachusetts; Measurement; Mediation; Mediator of activation protein; Methods; Nature; Outcome; Patients; Persons; Play; Prevalence; Procedures; Program Development; Protocols documentation; Public Health; Race; Randomized; Randomized Clinical Trials; Recovery; Relapse; Reporting; Research; Risk; Role; Sample Size; Services; Stress; Substance Use Disorder; Support System; Symptoms; System; Technology; Testing; Time; Withdrawal; Woman; Work; addiction; alcohol use disorder; base; behavior change; communication device; cost; craving; data management; data sharing; design; disorder later incidence prevention; efficacy study; efficacy trial; high risk drinking; improved; improved outcome; malignant breast neoplasm; medical specialties; member; men; operation; power analysis; prevent; programs; prototype; public health relevance; randomized trial; recruit; relapse risk; response; treatment as usual; treatment center; treatment program

PROJECT SUMMARY Alcohol use disorder (AUD) is the most common substance use disorder. Yet only a small fraction of people who need treatment receive it, and most of them get only short-term support even though continuing care has been shown to be much more effective. More consistent and available continuing care could greatly improve patient recovery. Partner support can also be critical to recovery, but many partners do not know how to support their partners' recovery or manage their own responses to it. Clinicians also lack evidence of the efforts patients are making toward recovery. Treating couples in which one member is recovering from AUD has been shown to be efficacious; in particular, Alcohol Behavioral Couples Therapy (ABCT) has shown positive outcomes. Still, ABCT has not been widely adopted, in part because of practical problems. A-CHESS is a smartphone-based system proven to substantially reduce relapse, but A-CHESS serves only the patient. Relapse prevention and recovery support for both patient and partner could be built into smartphones, which could make these services available almost anywhere and anytime. A majority of adults own a smartphone, regardless of race, education, and financial status. This project would develop and pilot test a new smartphone-based system for AUD patients, their partners, and clinicians called PartnerCHESS. PartnerCHESS would integrate key features of ABCT and A-CHESS. This R34 planning grant would pilot test PartnerCHESS and prepare for a large randomized trial to test the new system. PartnerCHESS will also include a Clinician Report that will automatically alert clinicians of patients at risk of relapse, along with other information on how recovery is proceeding. The project has three specific aims: 1. Integrate A-CHESS with key features of ABCT to create PartnerCHESS to serve patients, partners, and clinicians. 2. Conduct a pilot test (a small randomized clinical trial) of PartnerCHESS to estimate effect size and refine the protocol, procedures, recruitment strategy, measurements, and operations we would use in a large RCT. 3a. Decide whether to pursue an R01 application. 3b. Possibly plan for the R01. The project would develop PartnerCHESS with 6 recruited couples who test the system and give feedback. Once ready, the system would be tested by 34 other couples randomized to receive either PartnerCHESS + treatment as usual (TAU) or A-CHESS + TAU for a 6-month trial. Data will be collected at baseline and 2, 4, and 6 months and analyzed to see if a large clinical trial holds promise and, if so, lead to an application for support of a full-scale trial based on the elements developed and results obtained in this pilot test. The study is important to public health because of the scope of the alcohol abuse and the potential of technology to improve the lives of both patients and partners. If successful, such technology could greatly broaden the reach and impact of AUD treatment in general and couples therapy in particular.

项目摘要 酒精使用障碍（AUD）是最常见的物质使用障碍。然而只有一小部分人 需要治疗的人得到了治疗，他们中的大多数人只得到了短期的支持，尽管持续的护理已经 被证明是更有效的。更一致和可用的持续护理可以大大改善 病人康复合作伙伴的支持对于恢复也至关重要，但许多合作伙伴不知道如何 支持他们的伴侣的恢复或管理自己的反应。临床医生也缺乏证据表明， 患者为康复所做的努力。治疗其中一名成员正在从AUD中恢复的夫妇 已被证明是有效的;特别是，酒精行为夫妇治疗（ABCT）已显示 积极的成果。然而，ABCT还没有被广泛采用，部分原因是实际问题。国际象棋 是一种基于智能手机的系统，被证明可以大大减少复发，但A-CHESS只为患者服务。 对患者和伴侣的复发预防和恢复支持可以内置于智能手机中， 可以使这些服务几乎随时随地可用。大多数成年人拥有智能手机， 不分种族教育和经济状况该项目将开发和试点测试一种新的 这是一个基于智能手机的系统，面向AUD患者、他们的伴侣和临床医生，名为PartnerCHESS。 PartnerCHESS将集成ABCT和A-CHESS的关键功能。这项R34规划赠款将试点测试 合作伙伴CHESS和准备一个大的随机试验，以测试新系统。合作伙伴CHESS还将 包括临床医生报告，该报告将自动提醒临床医生有复发风险患者，沿着其他 关于如何恢复的信息。该项目有三个具体目标： 1.将A-CHESS与ABCT的关键功能集成，创建PartnerCHESS，为患者、合作伙伴和 临床医生 2.对PartnerCHESS进行试点测试（一项小型随机临床试验），以估计效应量并完善 我们将在大型RCT中使用的方案、程序、招募策略、测量和操作。 3a.决定是否继续进行R 01申请。3b.可能是R 01。 该项目将开发PartnerCHESS，招募6对夫妇测试该系统并提供反馈。 准备好后，该系统将由随机接受PartnerCHESS +的其他34对夫妇进行测试 常规治疗（TAU）或A-CHESS + TAU，为期6个月。将在基线和第2、4、 和6个月，并进行分析，看看一个大型临床试验是否有希望，如果有，导致申请 支持在该试点测试中开发的要素和获得的结果的基础上进行全面试验。 这项研究对公众健康很重要，因为酒精滥用的范围和潜在的 改善患者和伴侣生活的技术。如果成功，这种技术将大大 扩大AUD治疗的范围和影响，特别是夫妻治疗。