Project CHOICE: Choosing Healthy Options in Coping with Emotions, a Personalized-Feedback EMA/EMI Study for Emerging Adults Leaving Psychiatric Partial Hospitalization

项目 CHOICE：选择健康的应对情绪的选择，一项针对摆脱精神病部分住院治疗的新兴成年人的个性化反馈 EMA/EMI 研究

• 批准号: 10445037
• 负责人: Ana M Abrantes
• 金额: $ 21.28万
• 依托单位: BUTLER HOSPITAL (PROVIDENCE, RI)
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-05 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10445037
• 关键词: Address; Affect; Alcohol abuse; Alcohol consumption; Alcohols; Anxiety; Caring; Clinical; Coping Skills; Data; Day Care; Development; Ecological momentary assessment; Effectiveness of Interventions; Emotions; Feedback; Focus Groups; Future; Heavy Drinking; Hospitalization; Individual; Intention; Intervention; Intervention Studies; Knowledge; Lead; Mental Depression; Mental Health; Methods; Modification; Monitor; Mood Disorders; Moods; Motivation; Outcome; Participant; Pattern; Perception; Persons; Phase; Pilot Projects; Protocols documentation; Psychiatric therapeutic procedure; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Recurrence; Reporting; Research Personnel; Risk; Risk Reduction; Series; Site; Specific qualifier value; Study Subject; Suggestion; Suicide; Technology; Testing; Time; Treatment Efficacy; alcohol abuse therapy; alcohol comorbidity; alcohol intervention; alcohol related problem; base; cognitive function; comorbidity; coping; drinking; effective intervention; emerging adult; emerging adulthood; experience; group intervention; high risk; interest; intervention delivery; multi-site trial; negative affect; new technology; normative feedback; personalized normative feedback; physical conditioning; pilot test; programs; psychiatric comorbidity; response; satisfaction; substance use; symptomatology; tailored messaging; treatment arm; treatment trial; usability

ABSTRACT Emerging adulthood represents a common time for problematic mental health issues, particularly affective disorders such as anxiety and depression, and problematic patterns of alcohol use. Heavy alcohol use can lead to negative mental health, academic, physical health, and cognitive functioning outcomes. In particular, individuals who use alcohol are more likely to have psychiatric comorbidity and have poorer clinical outcomes. Comorbidity is associated with more risk than psychiatric symptomatology or alcohol use alone, yet is rarely targeted in mental health settings. Using substances for the motive of coping with negative affect compounds risks, as those who use to cope experience the most problems. As such, it is important to target alcohol use, particularly in EA with affective disorders who use to cope. Typical treatment for alcohol is brief, motivationally-based, and provides normative feedback. We propose to enhance our existing interventions with EA in psychiatric care with affective disorders who use alcohol to cope, which capitalized on technology. Technology allows for assessment of high-risk situations in real time through Ecological Momentary Assessment (EMA) and delivery of interventional content by Ecological Momentary Intervention (EMI). The delivery of tailored, just-in-time risk reduction message paired with personalized normative feedback may impact problematic use and depression/anxiety outcomes by reducing the likelihood of use and negative outcomes of use. We propose to enhance our existing pilot intervention by integrating participant feedback and protocol refinement. In Phase 1, we will (1) make changes to the pilot PFIcope+EMI, based on participant and researcher experience; (2) evaluate the refined intervention through a series of focus groups. In Phase 2, we will test our refined intervention (PFIcope+EMI) and in a randomized, controlled treatment trial as compared to personalized normative feedback only, delivered at baseline (PNF). The PFIcope+EMI consists of: 1) an in-person personalized feedback session to present normative information, discuss the individual's use, and generate risk reduction messages to be used in EMI; 2) EMA to monitor affect, use intention, actual alcohol use, coping motives, and alternate coping skills utilization; and 3) tailored messages (EMI) based on EMA (i.e., normative feedback plus individualized risk reduction messages when individuals report negative affect and use intention). The PNF condition will receive 1) an in-person personalized feedback session to present normative information, discuss the individual's use, delivered at baseline. We anticipate that this project will lead to the development of a well-specified, novel, technology- supported, real-time intervention for EA with comorbid alcohol and depression/anxiety that can be later tested in a multi-site fully-powered RCT.

摘要