Mobile Health Intervention to Increase Substance-Free Activities During Alcohol Treatment

项目总结/摘要 酒精使用障碍（AUD）是一个非常普遍和重要的公共卫生问题。行为治疗 基于社会学习理论和认知行为疗法的原则， 虽然对AUD进行了测试，但效果大小相对较小，治疗后复发率较高。 理论上知情的预防性干预可能有助于增强现有AUD治疗的效果。在 特别是，有证据表明，缺乏无物质活动的环境有助于 开发和维护AUD，以及奖励SF活动的可用性可能是可行的 与酒精竞争的替代品。利用无障碍和低成本选项的优势 通过使用移动的技术，这个K23指导以患者为导向的研究职业发展 奖项提案概述了一个良好的综合研究和培训计划，以调查移动的健康干预 在AUD治疗患者中增加参与奖励SF活动。这项拟议的研究 旨在开发和评估一个移动的手机生态瞬时评估加上生态瞬时 干预（EMA+EMI;标题：移动的-奖励活动中心治疗（m-ReACT））应用程序， 加强现有AUD治疗。m-ReACT应用程序将监测自我报告的奖励SF活动 实时参与并提供个性化反馈，鼓励参与者高度参与 奖励以目标为导向并支持积极治疗结果的活动。这一拟议干预措施 将分两个阶段开发。第一阶段将通过一系列焦点小组开发m-ReACT应用程序， 可用性研究和II期将在随机对照初步试验中评价其有效性，样本量为50 AUD 最近开始接受门诊AUD治疗的患者。试点RCT的参与者将被随机 分配给m-ReACT条件或主动控制条件。假设m-ReACT将 导致戒酒天数百分比的增加和SF活动的强化。 该研究计划为PI提供了必要的实践学习和指导培训， 提供技术增强的干预措施，设计和实施EMA+EMI平台，定性 先进的统计方法。成功完成此K23奖项将提供PI 必要的培训，以便能够过渡到独立的研究者角色，检查新的干预措施， 加强AUD治疗。这一提议与NIAAA目前的筹资优先事项高度一致 使用移动的技术来提高有效性、可访问性和使用行为 对AUD的干预。

PROJECT SUMMARY/ ABSTRACT Alcohol Use Disorder (AUD) is a highly prevalent and significant public health problem. Behavioral treatments based in the principles of social learning theory and cognitive behavior therapy have been developed and tested for AUD, yet effect sizes are relatively small and rates of relapse following treatment are high. Theoretically informed adjunctive interventions may help to enhance the effects of extant AUD treatments. In particular, evidence suggests that environments lacking in substance-free (SF) activities contribute to the development and maintenance of AUD and that the availability of rewarding SF activities may serve as viable alternatives to compete with alcohol use. Building on the advantages of accessibility and low-cost option afforded by the use of mobile technology, this K23 Mentored Patient-Oriented Research Career Development Award proposal outlines a well-integrated research and training plan to investigate a mobile health intervention to increase engagement in rewarding SF activities among patients in AUD treatment. This proposed research aims to develop and evaluate a mobile phone ecological momentary assessment plus ecological momentary intervention (EMA+EMI; entitled: mobile – Rewarding Activity Centered Treatment (m-ReACT)) app to augment existing AUD treatment. The m-ReACT app will monitor self-reported rewarding SF activity engagement in real-time and deliver personalized feedback that encourages participants to engage in highly rewarding activities that are goal-oriented and support positive treatment outcomes. This proposed intervention will be developed in two phases. Phase 1 will develop the m-ReACT app through a series of focus groups and usability studies and Phase 2 will evaluate its efficacy in randomized control pilot trial with a sample of 50 AUD patients who have recently initiated outpatient AUD treatment. Participants in the pilot RCT will be randomly assigned to either the m-ReACT condition or an active control condition. It is hypothesized that m-ReACT will result in increased rates of percent days of alcohol abstinence and increased reinforcement from SF activities. This research plan provides the PI the essential hands-on learning and mentored training in development and delivery of technology enhanced interventions, design and implementation of EMA+EMI platforms, qualitative methodology, and advanced statistical approaches. Successful completion of this K23 award will provide the PI essential training to be able to transition to an independent investigator role examining novel interventions to enhance AUD treatment. This proposal is highly consistent with NIAAA’s current funding priorities of funding projects that use mobile technology to improve the effectiveness, accessibility, and use of behavioral interventions for AUD.