Targeting High Risk Drinking Days with Mobile Treatment for Spanish-Speaking Patients

通过针对西班牙语患者的移动治疗来瞄准高风险饮酒日

• 批准号: 10722095
• 负责人: Bryan Benitez
• 金额: $ 17.56万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10722095
• 关键词: Adult; Alcohol consumption; Alcoholic Liver Diseases; Alcohols; Award; Cellular Phone; Clinical Research; Clinical Trials; Cognitive Therapy; Conduct Clinical Trials; Coping Skills; Data; Development; Development Plans; Disparity; Drug usage; E-learning; Educational process of instructing; Evidence based treatment; Face; Feedback; Focus Groups; Fostering; Future; Goals; Grant; Health Personnel; Health Services Accessibility; Hispanic Populations; Holidays; Home; Incidence; Individual; Intervention; Leadership; Life; Linguistics; Measures; Mentors; Methods; Modification; Morbidity - disease rate; Motivation; Not Hispanic or Latino; Parameter Estimation; Participant; Patients; Population Heterogeneity; Process; Provider; Publishing; Qualitative Research; Questionnaires; Reporting; Research; Social Processes; Substance Use Disorder; Symptoms; System; Testing; Time; Training; Training Programs; Treatment Protocols; United States; United States National Institutes of Health; Universities; Writing; acceptability and feasibility; alcohol abuse therapy; alcohol use disorder; barrier to care; binge drinking; career; career development; cohort; computerized; cost effective; cost effectiveness; craving; design; digital delivery; digital technology; drinking; efficacy evaluation; efficacy research; experience; feasibility testing; high risk; high risk drinking; improved; minority health; mobile computing; mood symptom; mortality; multilevel analysis; power analysis; programs; prospective; psychiatric symptom; randomized, clinical trials; recruit; reduced substance use; satisfaction; secondary outcome; simulation; skills; skills training; socioeconomics; stakeholder perspectives; statistics; sustained attention; usability; user centered design

Project Abstract Each year in the U.S., millions of Spanish-speaking Hispanics experience negative consequences from harmful alcohol use. Hispanics suffer from alcohol use disorder (AUD) and alcohol-related liver disease at rates similar to non-Hispanic Whites. However, Hispanics with AUD are less likely to receive treatment than non- Hispanic Whites. Hispanics also face greater socioeconomic, cultural, and linguistic barriers to treatment for AUD than non-Hispanic Whites. These barriers include limited access to Spanish-speaking providers and culturally adapted evidence-based treatments. Computerized treatments and mobile technology have significant potential to increase access to evidence-based treatments in a cost-effective manner for Spanish speakers. A culturally adapted computerized treatment for Spanish-speaking Hispanics with substance use disorders has demonstrated efficacy at reducing rates of alcohol and drug use in a randomized clinical trial (Computer-Based Training for Cognitive Behavioral Therapy; Spanish CBT4CBT). Several other clinical trials have supported the efficacy and cost-effectiveness of English versions of CBT4CBT. Rapid, mobile delivery of CBT skills would facilitate treatment feasibility during risky periods for drinking in daily life (e.g. weekend evenings). But, CBT4CBT modules each require 35-40 minutes of sustained attention to complete and cannot be used quickly during high- risk drinking periods. This project proposes to develop a concentrated mobile version of Spanish CBT4CBT to rapidly deliver treatment content on high-risk drinking days: Aim 1) Identify Spanish CBT4CBT module topics associated with greater reductions in daily alcohol use and psychiatric symptoms. Aim 2) Develop a concentrated version of Spanish CBT4CBT consisting of a subset of content from the current modules. Aim 3) Test the feasibility and acceptability of using smartphones to deliver a concentrated version of Spanish CBT4CBT on high-risk drinking days. To complete these aims, my career development plan includes mentored training in the following domains: 1) conducting clinical trials of treatments for AUD; 2) designing culturally adapted treatments for Hispanics; 3) delivering treatment components through smartphones; 4) using mixed methods to explore stakeholders’ perspectives on treatments for AUD; 5) fostering professional development through grant writing, publishing, leadership, and networking. This award will provide me with hands-on experience in ongoing clinical trials of computerized treatments for Spanish speakers with AUD. I will participate in NIH training programs on digital technologies, minority health, and professional development, including the MOSAIC UE5 leadership forums. I will complete Yale University courses on clinical trial methods, qualitative research, and grant writing. These activities will build on my prior expertise with using mobile technology and advanced statistics to study the temporal dynamics of motivation for drinking and social processes. This award will support my transition to an independent research career developing mobile treatments for Hispanics to target drinking in real-time.

项目摘要 在美国，每年有数百万讲西班牙语的西班牙裔人遭受以下负面后果： 有害的酒精使用。西班牙裔美国人患酒精使用障碍 (AUD) 和酒精相关肝病的比例很高 与非西班牙裔白人相似。然而，与非 AUD 患者相比，西班牙裔患者接受治疗的可能性较小 西班牙裔白人。西班牙裔人在接受 AUD 治疗时还面临更大的社会经济、文化和语言障碍 高于非西班牙裔白人。这些障碍包括与讲西班牙语的提供者的接触有限以及文化上的障碍。 适应循证治疗。计算机化治疗和移动技术具有巨大潜力 以具有成本效益的方式增加西班牙语使用者获得循证治疗的机会。一个文化上 针对患有药物滥用障碍的讲西班牙语的西班牙裔人进行了计算机化治疗 在一项随机临床试验（基于计算机的 认知行为治疗培训；西班牙语 CBT4CBT)。其他几项临床试验也支持了 英文版 CBT4CBT 的功效和成本效益。快速、移动地提供 CBT 技能将 促进日常生活中饮酒危险时期（例如周末晚上）的治疗可行性。但是，CBT4CBT 每个模块都需要 35-40 分钟的持续关注才能完成，并且无法在高强度学习期间快速使用。 饮酒期间的风险。该项目建议开发西班牙语的集中移动版本 CBT4CBT 在高风险饮酒日快速提供治疗内容：目标 1) 识别西班牙语 CBT4CBT 模块主题与进一步减少日常饮酒和精神症状相关。目的 2) 开发西班牙语 CBT4CBT 的集中版本，其中包含当前内容的子集 模块。目标 3) 测试使用智能手机提供集中版本的可行性和可接受性 西班牙 CBT4CBT 在高风险饮酒日。 为了实现这些目标，我的职业发展计划包括以下领域的指导培训： 1) 进行AUD治疗的临床试验； 2) 为西班牙裔设计适合文化的治疗方法； 3） 通过智能手机提供治疗成分； 4）采用混合方法探索利益相关者的 对 AUD 治疗的看法； 5）通过资助写作、出版来促进专业发展， 领导力和网络。该奖项将为我提供正在进行的临床试验的实践经验 为讲西班牙语的人提供澳元的计算机化治疗。我将参加 NIH 数字化培训项目 技术、少数民族健康和专业发展，包括 MOSAIC UE5 领导力论坛。我 将完成耶鲁大学有关临床试验方法、定性研究和资助写作的课程。这些 活动将建立在我之前使用移动技术和高级统计研究的专业知识的基础上 饮酒动机和社会过程的时间动态。该奖项将支持我过渡到 独立研究事业，为西班牙裔人开发移动治疗方法，以实时控制饮酒情况。