Behavioral economic and wellness-based approaches for reducing alcohol use and consequences among diverse non-student emerging adults

基于行为经济学和健康的方法，用于减少不同非学生新兴成年人的饮酒及其后果

• 批准号: 10339445
• 负责人: JAMES G. MURPHY
• 金额: $ 35.02万
• 依托单位: UNIVERSITY OF MEMPHIS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-05 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10339445
• 关键词: Address; Affective Symptoms; African American; Age; Alcohol abuse; Alcohol consumption; Arousal; Behavioral; Behavioral Mechanisms; Belief; Black race; COVID-19 pandemic effects; Clinical Research; Communities; Coping Skills; Development; Drug usage; Education; Educational Intervention; Elements; Ethnic group; Evaluation; Feedback; Future; Goals; Health; Healthcare; Heavy Drinking; Income; Informal Social Control; Institute of Medicine (U.S.); Intervention; Laboratory Research; Marketing; Measures; Mediating; Mental Depression; Mental Health; Modality; Moods; National Institute on Alcohol Abuse and Alcoholism; Outcome; Participant; Physiological; Population; Poverty; Preventive care; Psychological reinforcement; Race; Randomized; Randomized Clinical Trials; Relaxation Therapy; Reporting; Research; Rewards; Risk; Risk Factors; Site; Stress; Stress and Coping; Suggestion; Symptoms; Testing; Woman; Workplace; active method; age group; alcohol consequences; alcohol demand; alcohol measurement; alcohol misuse; alcohol related consequences; alcohol related problem; alcohol use disorder; base; behavior change; behavioral economics; brief alcohol intervention; chronic alcohol ingestion; college; community center; comorbidity; control trial; cost effective; depressive symptoms; discounting; dissemination research; dissemination trial; drinking; economic impact; efficacy evaluation; emerging adult; experience; follow-up; heavy drinking college student; help-seeking behavior; high risk; member; negative affect; novel; post intervention; preference; psychiatric comorbidity; racial and ethnic; reduced alcohol use; reduced substance use; secondary outcome; sex; social; stress management; telehealth; tool; treatment response; university student

Brief alcohol interventions (BAI) are among the most cost-effective preventive care measures available and the evaluation of these interventions with high-risk and difficult-to-reach populations is an NIAAA priority. Although emerging adults (EAs) who attend college often have access to brief alcohol interventions (BAIs), there is a critical need to enhance both the efficacy and potential for dissemination of these approaches with high-risk non-student EAs. EAs who are not 4-year college students or graduates report higher levels of alcohol-related problems, greater levels of comorbid drug use and mental health symptoms, and higher risk for chronic alcohol use disorder compared to college graduates. Most BAIs include a single session focused explicitly on discussing risks associated with drinking and correcting normative beliefs about drinking rates without addressing the reasons why EAs may drink, including stress and limited behavioral alternatives to drinking. Because many EAs who do not graduate from college are socially and economically marginalized, an approach that encourages them to drink less without providing the tools to reduce stress and develop mood- enhancing behavioral substitutes to drinking or drug use is unlikely to be successful. The Substance-Free Activity Session (SFAS) attempts to increase engagement goal-directed activities that might provide alternatives to alcohol use and also includes strategies for coping with stress/depression. The two-session (plus booster) BAI+SFAS approach has demonstrated efficacy for reducing both alcohol use/problems and depressive symptoms in two randomized clinical trials with college EAs and may be a more promising approach than single-session BAIs for higher-risk non-student EAs. Two critical next steps are to: 1) evaluate the BAI+SFAS with non-student EAs, and 2) determine if a two-session Relaxation Training (RT) +SFAS approach, which would enhance wellness and address two synergistic risk factors for alcohol misuse, demonstrates similar efficacy as the BAI+SFAS intervention. If so, this wellness-based approach may have greater potential for dissemination than approaches that include a BAI because the session content may be more appealing to EAs (managing stress and increasing positive activities). Thus, the primary goal of the proposed study is to establish the efficacy of these novel BAI approaches with high-risk community dwelling EAs, and a secondary goal is to identify factors that may increase potential for dissemination. We will conduct a randomized 3-group (BAI+SFAS vs. RT+SFAS vs. education control) trial with 525 EAs (175 per group; estimated 50% women & 50% African American) who report recent heavy drinking and who are not students or graduates of 4-year colleges. Outcomes will be assessed at 1, 3, 6, and 12 months post-intervention. We hypothesize that at follow-up both BAI+SFAS and RT+SFAS participants will report significantly greater reductions in alcohol use and problems relative to education control participants, with no differences in outcomes between the two active treatment conditions.

短期酒精干预措施（BAI）是现有的最具成本效益的预防保健措施之一