A Technology-based Intervention to Reduce Alcohol Use after Bariatric Surgery

减肥手术后减少饮酒的基于技术的干预措施

• 批准号: 10470842
• 负责人: Jordan Michel Braciszewski
• 金额: $ 21.63万
• 依托单位: HENRY FORD HEALTH SYSTEM
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-20 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10470842
• 关键词: Abstinence; Address; Adoption; Aftercare; Alcohol abuse; Alcohol consumption; Alcohols; Behavior; Behavioral; Blood alcohol level measurement; Body Weight decreased; Caring; Cellular Phone; Clinical Trials; Control Groups; Coping Skills; Data; Development; Ecological momentary assessment; Education; Enrollment; Ethanol Metabolism; Evidence based intervention; Feedback; Food; Freezing; Gastrectomy; Gastric Bypass; Goals; Grant; Guidelines; Hormones; Hour; Incidence; Individual; Intervention; Intervention Trial; Interview; Length; Low Prevalence; Mental Health; Metabolic hormone; Metabolism; Methods; Mission; Modeling; Morbid Obesity; Observational Study; Operative Surgical Procedures; Outcome; Participant; Patient Preferences; Patients; Persons; Phase; Physiological; Pilot Projects; Plant Roots; Population; Population Intervention; Populations at Risk; Prevalence; Prevention; Procedures; Public Health; Questionnaires; Randomized; Readiness; Recommendation; Reporting; Research; Rewards; Risk; Surveys; System; Techniques; Technology; Testing; Text Messaging; Time; Treatment Efficacy; United States; United States National Institutes of Health; absorption; acceptability and feasibility; alcohol abstinence; alcohol effect; alcohol prevention; alcohol use disorder; alcohol use initiation; bariatric surgery; base; brief intervention; clinical practice; clinically significant; computerized; coping mechanism; cost; cost effective; deter alcohol use; disorder later incidence prevention; drinking; evidence base; experience; feasibility testing; food consumption; group intervention; hazard; hazardous drinking; innovation; intervention delivery; mHealth; meetings; motivational enhancement therapy; novel; patient population; physical conditioning; post intervention; preference; prevent; preventive intervention; primary outcome; programs; psychoeducation; recruit; reduced alcohol use; response; retention rate; satisfaction; service delivery; skills; smoking cessation; substance use; surgical risk; tailored messaging; therapy design; traditional therapy; treatment as usual; weight loss intervention

Despite bariatric surgery being the most effective weight loss intervention for patients who are severely obese, as many as 1 in 5 patients will develop an alcohol use disorder after their surgery. Changes in metabolism, hormone levels, and behavior as a result of bariatric surgery alter the rewarding effects of alcohol while concurrently changing its absorption rate, putting patients at significantly elevated risk of hazardous drinking. Simply providing education to this vulnerable patient population about post-surgical risks has not been sufficient to reduce alcohol use, yet comprehensive in-person interventions are met with significant challenges, including hours-long distances between patients and their bariatric surgery programs. Thus, our long-term goal is to increase access to an empirically-supported intervention for reducing alcohol use among patients who undergo bariatric surgery by leveraging technology. Our intervention, rooted in motivational interviewing and the transtheoretical model, is a two-session computerized brief intervention (CBI), supplemented by six months of tailored text messaging based on participants’ CBI results and subsequent fluctuations in their readiness to change. The purpose of the proposed study is to optimize this technology-based intervention for patients who undergo bariatric surgery and to examine feasibility and acceptability of the intervention. In the first phase, patient interviews (n= 20) will be utilized to identify preferences for intervention content and treatment delivery. Ten patients will then participate in an open trial of the intervention, which will be subsequently revised based on feedback from these patients. In Phase 2, patients (N = 60) will be recruited between 3 and 6 months following bariatric surgery and randomized to the intervention or treatment as usual control group. All patients will complete baseline questionnaires and at 1, 3, 6, and 9 month post-assessments. We expect that this intervention will be both feasible and acceptable to patients. Results will be used as preliminary data to inform a large, fully-powered clinical trial to test the larger efficacy of this intervention. Although primary outcomes focus on feasibility and acceptability, we also expect that patients assigned to the intervention will have a longer time to their first post-surgical drink, report more days of abstinence, fewer drinks per drinking day, and a lower prevalence of alcohol use disorder after bariatric surgery compared to controls. This project is innovative because it expands upon existing interventions for bariatric surgery patients by implementing evidence-based strategies for alcohol use. By utilizing a technology-based approach, we can also reach a larger number of patients to prevent initiation of drinking, reduce current alcohol use, and facilitate better engagement in care, should individuals opt into traditional treatment approaches. The proposed line of research is significant and relevant to NIH’s mission because the intervention is expected to reduce the likelihood that patients will develop an alcohol use disorder following bariatric surgery. Given the potential of wide dissemination at low cost, the proposed study has high potential public health and clinical significance.

尽管减肥手术是对严重肥胖患者最有效的减肥干预措施，