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.

抽象的 成年初期是心理健康问题的常见时期，尤其是情感问题 焦虑和抑郁等疾病，以及有问题的饮酒模式。大量饮酒可以 导致负面的心理健康、学业、身体健康和认知功能结果。尤其， 饮酒的人更有可能患有精神共病并且临床结果较差。 与单独的精神症状或饮酒相比，合并症的风险更大，但 很少针对心理健康环境。使用物质来应对负面情绪 复合风险，因为那些习惯于应对的人遇到的问题最多。因此，确定目标很重要 饮酒，尤其是患有情感障碍的 EA 人士用来应对。 典型的酒精治疗是简短的、基于动机的，并提供规范的反馈。我们建议 加强我们现有的 EA 干预措施，用于患有情感障碍的精神科护理，这些患者使用酒精来治疗 应对，利用技术。技术可以实时评估高风险情况 通过生态瞬时评估（EMA）和生态提供干预内容 瞬时干预 (EMI)。交付定制的、及时的风险降低消息，并与 个性化规范反馈可能会通过减少问题使用和抑郁/焦虑结果来影响 使用的可能性和使用的负面结果。我们建议通过以下方式加强现有的试点干预： 整合参与者反馈和协议细化。在第一阶段，我们将 (1) 对试点进行更改 PFCope+EMI，基于参与者和研究人员的经验； (2) 通过评估精细化干预 系列焦点小组。在第 2 阶段，我们将测试我们的精细干预措施 (PFCope+EMI)，并以随机、 对照治疗试验与仅在基线时提供的个性化规范反馈（PNF）相比。 PFCope+EMI 包括：1) 面对面的个性化反馈会议，以呈现规范性的意见 信息，讨论个人的使用情况，并生成用于 EMI 的风险降低信息； 2) EMA 至 监测情感、使用意图、实际饮酒情况、应对动机和替代应对技能的运用；和 3) 基于 EMA 的定制消息 (EMI)（即规范反馈加上个性化风险降低消息 当个人报告负面影响和使用意图时）。 PNF 条件将收到 1) 亲自 个性化反馈会议，呈现规范信息，讨论个人的使用情况，交付于 基线。我们预计该项目将导致开发一种明确的、新颖的技术—— 对患有酒精和抑郁/焦虑症的 EA 进行支持性实时干预，并可在以后进行测试 在多站点全功率 RCT 中。