Personalized mobile app intervention: Challenging alcohol expectancies to reduce high-risk alcohol use and consequences

项目摘要/摘要 酒精是学生在高等教育中使用的最普遍的精神活性物质， 与各种短期和长期负面后果有关。尽管许多学生经历了 负面后果，一些人继续以有问题的水平饮酒。本提案延长了一项 研究计划侧重于了解酒精预期、酒精使用和酒精使用的日常过程模型 对社区大学和四年制大学开展手机干预的相关后果 学生们。我们之前的工作(R01AA016979，Pi Lee)研究了预期如何影响饮酒和 当天晚些时候的结果；当检查结果对 对酒精影响的未来预期；以及这些关系对谁存在。我们每年收集三次数据 在一年中的四个季度中的每一个季度中持续两周的一天。我们发现日常饮酒之间存在重要联系 预期和第二天高风险饮酒之间，以及每日后果和第二天预期之间。 总体而言，研究结果对以每日预期为目标的干预措施的实施时间具有重要影响。这个 目前的研究基于这些发现测试了一种干预措施，并使用个人的日常生活进行实时反馈 预期、使用和后果，并建立在NIAAA认可的两个应对高风险的战略基础上 大学生饮酒：挑战与酒精相关的预期，传统上是通过体内完成的 实验设计和电子个性化反馈。体内酒精预期的局限性 挑战(AEC)干预措施包括由于缺乏广泛实施的可行性而导致利用率低。 因此，目前竞争激烈的续费应用程序将为数据设计一个手机应用程序(APP 收集和干预。这种电子、移动AEC(MAEC)干预旨在挑战日常- 降低饮酒预期，减少高风险饮酒和负面后果。我们将把 开发mAEC的方法和结果，它将在14天内每天实施 随访至12个月。MAEC将根据学生的反馈提供个性化的日常反馈 饮酒意图、饮酒预期和后果。450名高危大学生饮酒者的样本 社区大学和四年制大学都将被录取，并被随机分配到两个条件中的一个，以比较 MAEC的有效性和仅评估对照(AOC)条件。具体目标是检查(1) MAEC干预相对于AOC的有效性，(2)作为干预中介的全球期望值 有效性，以及(3)干预是否削弱了积极预期和日常生活之间的联系 并加强负面预期与后果之间的日常联系。MAEC 干预措施有可能对该领域产生重大影响，因为它是可扩展的，而且很容易 散播的。以个人日常饮酒为目标的经验性干预的发展 预期和饮酒意图可能会被证明特别有效。

PROJECT SUMMARY / ABSTRACT Alcohol is the most prevalent psychoactive substance used by students in post-secondary education and is associated with a variety of short- and long-term negative consequences. Although many students experience negative consequences, some continue to drink at problematic levels. The present proposal extends a program of research focused on understanding daily process models of alcohol expectancies, alcohol use, and related consequences by developing a mobile phone intervention for community college and 4-year college students. Our prior work (R01AA016979, PI Lee) examined how expectancies influence drinking and consequences later that day; how learning might take place when examining the influence of consequences on future expectations of alcohol's effects; and for whom these relationships exist. We collected data three times a day for 2 weeks in each of four quarters across 1 year. We found important links between daily alcohol expectancies and next-day high-risk alcohol use and between daily consequences and next-day expectancies. Overall, findings have important implications for timing of intervention delivery to target daily expectancies. The present study tests an intervention based on these findings, with real-time feedback using individuals' daily expectancies, use, and consequences, and builds on two NIAAA-endorsed strategies for addressing high-risk college student drinking: challenging alcohol-related expectancies, traditionally done through in-vivo experimental designs, and electronic personalized feedback. Limitations of in-vivo alcohol expectancy challenge (AEC) interventions include low utilization due to lack of feasibility for widespread implementation. Therefore, the present competing renewal application will design a mobile phone application (app) for data collection and intervention. This electronic, mobile AEC (mAEC) intervention is designed to challenge daily- level alcohol expectancies and reduce high-risk drinking and negative consequences. We will incorporate methods and results from our prior R01 to develop mAEC, which will be implemented daily across 14 days with follow-ups through 12 months. The mAEC will provide personalized, daily feedback based on students' drinking intentions, alcohol expectancies, and consequences. A sample of 450 high-risk college drinkers from both community and 4-year colleges will be recruited and randomized to one of two conditions to compare the efficacy of the mAEC and an assessment-only control (AOC) condition. Specific aims are to examine (1) the efficacy of the mAEC intervention relative to AOC, (2) global expectancies as mediators of intervention efficacy, and (3) whether the intervention weakens the daily link between positive expectancies and consequences and strengthens the daily link between negative expectancies and consequences. The mAEC intervention has the potential to have a major impact on the field because it will be scalable and easily disseminated. The development of an empirically-supported intervention that targets individuals' daily alcohol expectancies and drinking intentions may prove particularly efficacious.