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: 9976408
• 负责人: Melissa Lee Anderson
• 金额: $ 41.93万
• 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 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9976408
• 关键词: Address; Adherence; Adult; Aftercare; Alcohol abuse; Alcohol consumption; American; American Sign Language; Behavior Therapy; Client; Clinical; Cognitive; Communities; 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; comorbidity; 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.

项目总结/摘要 美国聋人社区-一个由50多万使用美国手语交流的美国人组成的团体 语言（ASL）-经历了近三倍的终身问题饮酒率和两倍的速度， 与普通人群相比，创伤暴露。虽然有有效的治疗酒精使用 听力障碍（AUD）和创伤后应激障碍（PTSD），目前还没有基于证据的 治疗任何行为健康状况，用于聋人客户。目前的循证治疗失败 满足聋人客户独特的语言和文化需求。 为了解决这些障碍，PI领导了一个由聋人和听力研究人员、临床医生、电影制片人、演员组成的团队， 艺术家和聋人与AUD开发一个原型的“安全标志”，一个聋人访问的工具包， 与现有的广泛传播的AUD/创伤寻求安全方案一起使用。安全的标志 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;数字视频上的美国手语教学故事，其中提出了关键的学习点）。它的设计目的是 聋人临床医生，听力签名者，或听力非签名者与ASL口译员一起工作。 本研究的目的是：（1）生成一个最终的、专业的安全标志版本 在未来研究中，对三名临床医生进行安全迹象和寻求安全方面的培训;（2）进行两项- 寻找安全性+安全性体征工具包与未补充的对照组初探性随机对照试验（RCT） 寻求安全性，收集可行性结果数据（筛选、招募、保留、满意度、忠诚度， 依从性、评估过程）和初步临床结果（即，减少酒精使用频率 和数量，酒精渴望，酒精相关的问题，PTSD症状的严重程度）;和，（3）检查 结果的潜在中介者和调节者（例如，治疗的动机，提供者的文化能力， 应对技能、自我同情、对健康信息的理解）。 拟议目标将提供必要的可行性和初步疗效数据，以支持NIAAA R 01， 一个全面的随机对照试验，以测试安全标志的有效性，以及一个参与性的行动模式， 聋人社区内的RCT。