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 大量饮酒在与男性发生性关系（MSM）的年轻人中很常见，这增加了可能性 从事艾滋病毒风险的性行为。文本消息传递 - 无处不在的技术开始 用于应对酒精/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 文本消息的内容以优化行为更改。因此，在此镶嵌K99/r00中，申请人将在 K99阶段，开发和完善，然后在R00阶段测试交互式文本消息的功效 利用约束水平理论（CL T）来定义干预目标的计划，以减少大量饮酒和艾滋病毒风险。 先前的证据和理论都为这一提议提供了信息。具体而言，Cl T建议个人可以考虑 行为或行为改变（例如，少喝酒）（例如，为什么要少喝酒）或具体 （例如，该人将如何限制他们的饮酒）。基于干预措施和实验操作 cl t使用为什么/如何范式向参与者询问一系列原因/旨在诱导抽象或 具体思维分别。证据表明，抽象思维可能会增强改变的动力 而具体思维可能有助于有效实施行为改变；但是，Cl t很大 用于促进减肥和减少吸烟。尽管具有适用性和潜力，但Cl t尚未 应用于酒精和艾滋病毒研究。在此提案中，申请人试图开发和测试基于Cl t的 为什么/如何分别诱导摘要/具体思维的文本信息有关酒精和艾滋病毒的风险 减少饮酒，有风险的性行为以及饮酒的负面影响。 在K99阶段，申请人与年轻成人大量饮酒MSM的咨询小组合作，将 制定和完善文本消息传递协议（AIM 1; 1-9个月）。然后，我们将进行一系列试验测试 和退出访谈（2轮n = 12参与者），以迭代评估和提高可行性和可接受性 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 - 现有的简短酒精/艾滋病毒干预措施，以增强改变的动机 表现出希望。然后，参与者将在一天级别（即每天随机分组）进行微型助长 在8周内接收（1）CLT混凝土消息； （2）CLT-ABSTRACT消息； （3）控制消息；或（4）否 消息。参与者将每天和干预结束时完成评估。 这些目标符合申请人在（1）制定和测试行为方面培训的目标 干预措施（Christopher Kahler博士）； （2）进行微随机试验（Stephanie Goldstein博士）和（3） 分析密集的纵向数据（Jennifer Merrill博士}，并促进成功过渡到独立性。 该项目将使申请人与高技能，经验丰富的团队合作，并为 未来的R01，以大规模测试干预措施的有效性，并提供关键的理论 有关酒精/艾滋病毒研究中行为变化的潜在新机制的信息。