Developing a mobile-health intervention to reduce problematic alcohol use in young adults with ADHD

点击翻译按钮获取中文摘要

PROJECT SUMMARY/ABSTRACT Dr. Traci Kennedy, PI of the proposed K23, is a clinical scientist whose long-term goal is to lead a program of research on developing and testing interventions to reduce problematic alcohol use among vulnerable young people, especially young adults with Attention Deficit/Hyperactivity Disorder (ADHD). Problematic alcohol use among young adults (ages 18-25) has severe individual and societal consequences, yet most go untreated. ADHD significantly elevates risk and limits the effectiveness of existing treatments. Inhibitory control is a key transdiagnostic and modifiable risk factor underlying both ADHD and problematic alcohol use. This K23 project aims to develop and test the feasibility and preliminary efficacy of a novel, accessible mobile-health (mHealth) intervention that targets in-the-moment inhibitory control to reduce problematic drinking among young adults with ADHD. Text messages will prompt the use of behavioral strategies to enhance inhibitory control throughout the day and in high-risk moments. To motivate behavioral strategy use, ecological momentary assessment (EMA) of ADHD symptoms and personalized, adaptive feedback will boost self-awareness of inhibitory control deficits. Aim 1 is to develop feasible and acceptable behavioral strategy prompts. First, strategy content will be developed in a subsample (n=10) of young adult drinkers with ADHD from an in-progress pilot study (Study 1a). Next, strategy prompt content and delivery timing and frequency will be refined in a new pilot sample (n=16) of young adults with ADHD who consume 4+/5+ drinks/occasion (female/male) weekly (i.e., heavy episodic drinkers) with input from a panel of key stakeholders (Study 1b). Aim 2 is to examine the feasibility and acceptability of the resulting intervention among heavy episodic drinkers (N=70) with ADHD, half randomly assigned to the intervention and half to an alcohol monitoring control condition for 3 weeks (Study 2). The utility of passively sensed smartphone indices of inhibitory control (e.g., screen unlock rate) will be explored to inform future personalization. Aim 3 is to test preliminary intervention effects, including dynamic transactions among alcohol use, inhibitory control, and life impairments. This innovative, scalable intervention addresses a critical need to help young adults with ADHD curb problematic alcohol use. Outcomes will lead to a future fully-powered efficacy trial. The proposed research and training (didactics, conferences, mentor-directed training) will equip the PI with the requisite skills to launch an independent research career in alcohol interventions: competence in momentary drinking capture; expertise in intervention science focused on mHealth; and in-depth knowledge of inhibitory control. Dr. Sarah Pedersen (mentor), expert in momentary drinking processes, EMA, and inhibitory control, and Dr. Brooke Molina (co-mentor), expert in intervention science with emphasis on ADHD and addictions, will guide the PI’s training and research. A team of consultants will complement training (statistical analysis, alcohol mHealth interventions development and evaluation, and passive sensing). This K23 has direct public health implications and addresses NIAAA priorities on developing alcohol treatments for comorbid conditions.