Applying Construal Level Theory to Develop and Test an Interactive Text Messaging Adjunct Intervention to Reduce Heavy Drinking and HIV Risk

应用解释水平理论开发和测试交互式短信辅助干预措施，以减少酗酒和艾滋病毒风险

• 批准号: 10838056
• 负责人: Nioud Mulugeta Gebru
• 金额: $ 15.11万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-25 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10838056
• 关键词: HIV risk; Heavy Drinking; Intervention; Testing; live text; theories

Project Summary/Abstract Heavy drinking is common among young adult men who have sex with men (MSM), which increases likelihood of engaging in sexual behaviors with risk for HIV. Text messaging - a ubiquitous technology- is starting to be used to address alcohol/HIV risk, but more theory-based work is needed to rigorously develop and test the content of text messages to optimize behavior change. Thus, in this MOSAIC K99/R00, the applicant will, in the K99 phase, develop and refine, and then, in the R00 phase, test the efficacy of an interactive text messaging program to reduce heavy drinking and HIV risk utilizing construal level theory (CL T) to define intervention targets. Both prior evidence and theory inform this proposal. Specifically, CL T suggests that individuals can think about a behavior or behavior change (e.g., drinking less) abstractly (e.g., why the person wants to drink less) or concretely (e.g., how the person will limit their drinking). Interventions and experimental manipulations based on CL T use the why/how paradigm to ask participants a series of why/how questions intended to induce abstract or concrete thinking, respectively. Evidence suggests that abstract thinking may enhance motivation to change whereas concrete thinking may facilitate effective implementation of behavior change; however, CL T has largely been applied to facilitate weight loss and reduced smoking. Despite its applicability and potential, CL T has yet to be applied to alcohol and HIV research. In this proposal, the applicant seeks to develop and test CL T-based why/how text messages to induce abstract/concrete thinking, respectively, about alcohol and HIV risk and in turn reduce alcohol use, risky sexual behaviors, and negative consequences of drinking, at the day-level. During the K99 phase, the applicant, working with an advisory panel of young adult heavy drinking MSM, will develop and refine the text messaging protocol (Aim 1; months 1-9). We will then conduct a series of pilot tests and exit interviews (2 rounds of n=12 participants) to iteratively assess and improve feasibility and acceptability of the intervention (Aim 2; months 10-24). During the R00 phase, participants (N=240) will first complete baseline assessment and GamePlan - an existing brief alcohol/HIV intervention to enhance motivation to change with demonstrated promise. Participants will then be micro-randomized at the day-level (i.e., randomized every day) for 8 weeks to receive (1) CLT-concrete messages; (2) CLT-abstract messages; (3) control messages; or (4) no messages. Participants will complete assessments daily and at the end of the intervention. These aims are in line with the applicant's goals to acquire training in (1) developing and testing behavioral interventions (Dr. Christopher Kahler); (2) conducting micro-randomized trials (Dr. Stephanie Goldstein), and (3) analyzing intensive longitudinal data (Dr. Jennifer Merrill}, and to facilitate a successful transition to independence. This project will enable the applicant to work with a highly skilled, experienced team, and provide data for a future R01 to test the effectiveness of the intervention on a larger scale, as well as provide critical theoretical information regarding potentially novel mechanisms of behavior change in alcohol/HIV research.

项目摘要/摘要 酗酒在男男性行为(MSM)的年轻成年男性中很常见，这增加了可能性 从事有感染艾滋病毒风险的性行为。短信--一种无处不在的技术--正开始 用于解决酒精/艾滋病毒风险，但需要更多基于理论的工作来严格开发和测试 短信内容优化行为改变。因此，在这张马赛克K99/R00中，申请人将在 K99阶段，开发和改进，然后在R00阶段，测试交互式文本消息的效果 减少大量饮酒和艾滋病毒风险的计划利用解释水平理论(CL T)来确定干预目标。 先前的证据和理论都支持这一建议。具体地说，CL T建议个人可以考虑 抽象或具体的行为或行为改变(例如，饮酒减少)(例如，为什么人们想要减少饮酒) (例如，这个人将如何限制他们的饮酒)。干预和实验操作基于 CL T使用为什么/如何范式来询问参与者一系列为什么/如何旨在诱导抽象或 分别是具体的思考。有证据表明，抽象思维可能会增强改变的动力 虽然具体的思维可能有助于有效地实施行为改变，但CL T在很大程度上 已被用于促进减肥和减少吸烟。尽管它的适用性和潜力，CL T还没有 应用于酒精和艾滋病毒研究。在本提案中，申请人寻求开发和测试基于CL-T的 为什么/如何通过短信分别引发对酒精和艾滋病毒风险的抽象/具体思考，进而 减少饮酒，减少危险的性行为，减少饮酒的负面后果。 在K99阶段，申请人将与青少年酗酒男男性接触者顾问小组合作， 制定和完善短信协议(目标1；1-9月)。然后，我们将进行一系列的试验测试 和离职面谈(两轮n=12名参与者)，反复评估和改进可行性和可接受性 干预(目标2；10-24个月)。在R00阶段，参与者(N=240)将首先完成基线 评估和游戏计划-现有的短暂酒精/艾滋病毒干预措施，以增强改变的动机 展示了自己的承诺。然后，参与者将在日一级被微随机化(即每天随机) 在8周内接收(1)CLT-具体消息；(2)CLT-抽象消息；(3)控制消息；或(4)否 留言。参与者将每天完成评估，并在干预结束时完成。 这些目标与申请者在(1)开发和测试行为方面获得培训的目标是一致的 干预措施(克里斯托弗·卡勒博士)；(2)进行微型随机试验(斯蒂芬妮·戈尔茨坦博士)；以及(3) 分析密集的纵向数据(Jennifer Merrill博士)，并促进向独立的成功过渡。 该项目将使申请者能够与高技能、有经验的团队合作，并为 未来的R01将在更大范围内测试干预的有效性，并提供关键的理论 关于酒精/艾滋病毒研究中潜在的新的行为改变机制的信息。