eHealth Coping Skills Training and Coach Support for Women Whose Partner Has a Drinking Problem

为伴侣有饮酒问题的女性提供电子健康应对技能培训和教练支持

• 批准号: 9102659
• 负责人: Brian G. Danaher
• 金额: $ 65.48万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9102659
• 关键词: Accounting; Address; Adult; Alcohol abuse; Anger; Behavioral; Buffers; Caring; Cellular Phone; Child; Coping Skills; Development; Distress; Exhibits; Funding; Future Generations; Health; Health Care Costs; Individual; Internet; Intervention; Life; Measures; Mediating; Mediation; Mediator of activation protein; Mental Depression; Mental Health; Modeling; Monitor; Online Systems; Outcome; Parents; Participant; Pilot Projects; Play; Population; Prevalence; Process; Public Health; Randomized; Reporting; Research; Research Personnel; Role; Sampling; Secondary to; Services; Site; Spouses; Staging; Target Populations; Testing; Thinking; Time; Training Programs; Update; Violence; Woman; Work; alcohol use disorder; causal model; cost; depressive symptoms; design; drinking; eHealth; experience; follow-up; health care service; help-seeking behavior; improved; intervention effect; mHealth; meetings; negative affect; non-alcoholic; novel; physical conditioning; prevent; problem drinker; programs; psychologic; psychological distress; public health relevance; skill acquisition; skills; skills training; socioeconomics; therapy development; treatment program; usability; violence perpetration; violence victimization; web portal; web site

 DESCRIPTION (provided by applicant): Estimates suggest that nearly 1 in 20 adult women in the U.S. are married to or living with a partner with an alcohol use disorder (AUD). These women often experience significant psychological and physical distress, utilize substantially more health care services than spouses of those without an AUD, and incur overall higher healthcare costs. Improving their own physical and psychological health is important in its own right, but also may help facilitate partner drinking reduction, and buffer the negative effects of the partner's drinking on their children. Despite their prevalence, distress, importance, and cost, this population remains largely hidden and underserved. Institutional, psychological and socioeconomic barriers discourage these women from seeking help, and when they do seek help, the newer, empirically tested services are not within their reach. Novel, alternate delivery models are needed to overcome the barriers, and provide easy access to empirically evaluated services. To begin to meet this need, the investigators, in a prior Stage I effort, adapted an empirically tested face-to-face coping skills training program to a self-paced, Web version (StopSpinningMyWheels; SSMW). SSMW was well-received, had high participation, and, relative to no intervention, improved short-term coping skills and negative affect. The increase in skills partially mediated improvements in distress. This proposal builds on the pilot study by (a) updating and reprogramming SSMW to add responsive web-design, greater content personalization, and increased transportability; (b) adding a complementary mHealth app so women can use their smartphones to access SSMW content and interactivity; (c) developing a SSMW coach web portal to facilitate their tracking of participant engagement; and (d) developing a Usual Web Comparison (UWC) site that provides access to a compilation of free Web information. We then propose a large-scale RCT in which 450 women with an AUD partner will be randomized to one of three conditions: SSMW with coach support calls (SSMW+COACH), SSMW without coach support (SSMW ONLY), or the UWC. Assessments will occur at baseline, a 6-week interim, a 12-week post, and at subsequent 6 and 12-month followups. We hypothesize that, in reducing negative affect, both SSMW conditions will be more effective than UWC, and, in considering the role of coach support, SSMW+COACH will be more effective than SSMW ONLY in engaging participants, and reducing negative affect. We (a) test whether differential skill acquisition, behavioral activation, and negative thinking mediate these effects, (b) study the role of differential program engagement in this mediation model, and (c) explore the moderating role of baseline negative affect. The work expands our understanding of interventions for this underserved group, fills a major public health gap in how best to reach and improve their lives, and may, indirectly, facilitate a reduction in their partner's problem, and protect their children from its negative effects.

 描述（由申请人提供）：据估计，美国近二十分之一的成年女性与患有酒精使用障碍 (AUD) 的伴侣结婚或同居。这些女性经常经历严重的心理和身体困扰，比没有澳元的女性的配偶使用更多的医疗保健服务，并且总体上承担更高的医疗费用。改善自己的身心健康本身很重要，但也可能有助于促进伴侣减少饮酒，并缓冲伴侣饮酒对孩子的负面影响。尽管它们普遍存在、痛苦、重要性和代价， 这一人群在很大程度上仍处于隐蔽状态且得不到充分服务。体制、心理和社会经济障碍阻碍了这些妇女寻求帮助，而当她们寻求帮助时，最新的、经过经验检验的服务却不在她们的能力范围之内。需要新颖的替代交付模式来克服障碍，并提供轻松获得经经验评估的服务的机会。为了满足这一需求，研究人员在第一阶段的前期工作中，将经过实证检验的面对面应对技能培训计划改编为自定进度的网络版本（StopSpinningMyWheels；SSMW）。 SSMW 反响良好，参与度高，并且相对于不干预，提高了短期应对技能和负面影响。增加的 技能在一定程度上调节了痛苦的改善。该提案以试点研究为基础，通过 (a) 更新和重新编程 SSMW，以添加响应式网页设计、更强的内容个性化和更高的可移植性； (b) 添加补充性移动医疗应用程序，以便妇女可以使用智能手机访问 SSMW 内容和互动； (c) 开发一个 SSMW 教练门户网站，以方便他们跟踪参与者的参与情况； (d) 开发一个常用网络比较 (UWC) 站点，提供对免费网络信息汇编的访问。然后，我们提出一项大规模随机对照试验，其中 450 名有 AUD 伴侣的女性将被随机分配到以下三种情况之一：有教练支持电话的 SSMW（SSMW+COACH）、没有教练支持的 SSMW（仅限 SSMW）或 UWC。评估将在基线、6 周中期、12 周后以及随后的 6 个月和 12 个月的随访中进行。我们假设，在减少负面影响方面，两种 SSMW 条件都将比 UWC 更有效，并且在考虑教练支持的作用时，SSMW+COACH 在吸引参与者和减少负面影响方面将比仅 SSMW 更有效。我们（a）测试差异性技能获取、行为激活和消极思维是否介导这些影响，（b）研究差异性项目参与在此中介模型中的作用，以及（c）探索基线负面情绪的调节作用。这项工作扩大了我们对针对这一服务不足群体的干预措施的理解，填补了在如何最好地达到和改善他们的生活方面的重大公共卫生空白，并且可能间接地促进减少他们伴侣的问题，并保护他们的孩子免受其负面影响。