Translating Behavioral Economics Strategies to Culturally Tailor a Mobile Health Mindfulness Intervention to Reduce Risky Drinking Behaviors in Black College Student Men

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Abstract Black emerging adult college men (BCM; 18−29 years) in the U.S. experience more alcohol-related health disparities than same-aged White men and Black women. However, BCM are hesitant to engage in interventions shown to alleviate stress and alcohol consumption in college students. Using mobile health (mHealth) interventions tailored for BCM may address these disproportionalities. Hence, the long-term goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to launch Dr. Laura Reid Marks’s program of research as an independent clinical scientist with a focus on reducing alcohol-related health disparities in Black emerging adults. This goal will be achieved through a 5-year parallel training and research plan. Training goals include: (1) developing expertise in the theory and practice of T1 translation of the ORBIT model (an NIH model of phased behavioral intervention development); (2) cultivating skills in behavioral economics theory to develop engagement strategies for a behavioral mHealth intervention; (3) implementing novel experimental approaches (i.e., micro-randomized trials; MRTs), to increase mHealth engagement; and (4) building skills to successfully direct a research lab and mentor a diverse lab of students. Training objectives will be met through a comprehensive training plan involving: (1) ongoing individual meetings with mentors (Drs. Naar, Murphy, Nahum-Shani, and Li), to learn from their combined expertise in T1 translation of health intervention, behavioral economics, mHealth, MRT research design, and statistical analyses; (2) courses, workshops, and seminars; (3) conferences and professional development. Skills gained through the training plan will be applied to a project capitalizing on Phases I and II of the ORBIT model in preparation for Phase III. To address Aim 1 (Phase 1), in Years 1−2, we will analyze focus group data collected from BCM drinkers at a predominantly White institution to develop and refine strategies drawn from behavioral economics (i.e., episodic future thinking, reciprocity) to increase engagement in a mindfulness application (app) for binge and heavy drinking BCM. To address Aim 2 (Phase I and II), across Years 2−4, we will use a pilot-MRT to test the feasibility, acceptability, and preliminary effect of the Aim 1 engagement strategies to engage binge and heaving drinking BCM (N = 40) in a mindfulness app. Participants will be randomized to one of three conditions (episodic future thinking, reciprocity, or no prompt conditions). A baseline survey, ecological momentary assessments, paradata, and a post-pilot MRT individual exit interview will assess feasibility, acceptability, and the preliminary effect of the engagement strategies delivered as text-based prompts in a smartphone to increase engagement in mHealth mindfulness, reduce stress, and ultimately alcohol consumption in BCM. The proposed studies will provide pilot data for Dr. Marks’ first R01 submission to NIAAA, to be submitted in Year 5. The proposal is aligned with the NIH Research Career Development’s goal of ensuring the training of a diverse pool of scientists to address U.S. behavioral and biomedical needs.