Latinx Hazardous Drinkers with Clinical Anxiety: Effectiveness Trial of a Personalized Normative Feedback Intervention

项目概要/摘要 尽管是美国最大和增长最快的人口统计数据之一，拉丁裔人 经历了惊人的健康差距，特别是在危险饮酒和同时发生的临床 焦虑到目前为止，还没有干预措施针对临床焦虑背景下的危险饮酒， 拉丁人。目前的R 01提案建立在我们过去的工作基础上，制定了一个简短的单一会议， 基于计算机的个性化反馈干预（PFI），旨在提高对不良反应的认识。 焦虑-酒精相互关系，增加减少危险饮酒的动机和意图， 对使用酒精治疗焦虑症的积极态度和意图。具体而言，我们建议制定一个 低成本，高传播性，综合PFI为Latinx危险饮酒者与临床焦虑（AA-PFI 1.0） 将在社区卫生诊所实施并检验其有效性。我们的方法将 遵循与美国国立卫生研究院（NIH）指导方针一致的阶段性模型， 规范行为干预。第一阶段行动将包括收集定性和定量资料， 来自三个迭代焦点小组（N = 21）的反馈，以完善干预内容并评估治疗 可接受性和可行性。IB期活动将包括一项严格的随机临床试验， 在250个Latinx危险品样本中比较AA-PFI 2.0与对照PFI（C-PFI）的有效性 患有临床焦虑症的饮酒者，他们在社区健康诊所接受治疗。这项研究代表了一个 在将基础研究转化为更有效的战略的更大范围内迈出了重要和关键的一步 用于减少患有生物行为共病的服务不足人群的危险饮酒。拟议 研究项目支持国家酒精滥用研究所的2017-2021年战略计划， 酒精中毒（NIAAA）通过推进两个关键领域的研究。首先，目前的提案有最终目标， 改善策略，以防止酒精滥用，酒精使用障碍和酒精相关的后果 在这些疾病的“高危”人群中开展宣传（目标3）。第二，它增强了公共卫生的影响， NIAAA支持的研究，重点关注美国增长最快和最大的人口统计数据之一， 显示危险饮酒方面的差距（目标5）。当前的应用程序符合RFA的目标- AA-21-001，建议检查低成本，高度传播，个性化， 文化适应PFI为拉丁裔危险饮酒者与临床焦虑在社区为基础的健康诊所。 考虑到同时焦虑和饮酒对公共卫生的影响，我们认为这项研究的目的是为了提高人们的健康水平。 将产生的发现，增强科学知识，推进我们对焦虑机制的理解， 酒精使用的关系，并告知新的治疗危险饮酒者的发展与临床 焦虑，适应性强，易于在各种医疗保健环境中实施。

Project Summary/Abstract Despite being one of the largest and fastest-growing demographics in the United States (US), Latinx persons experience striking health disparities, particularly in terms of hazardous drinking and co-occurring clinical anxiety. No interventions to date have targeted hazardous drinking in the context of clinical anxiety among Latinx persons. The current R01 proposal builds upon our past work by developing a brief, single-session, computer-based, personalized feedback intervention (PFI) designed to enhance knowledge regarding adverse anxiety-alcohol interrelations, increase motivation and intention to reduce hazardous drinking, and reduce positive attitudes and intentions regarding the use of alcohol for anxiety. Specifically, we propose to develop a low-cost, highly disseminatable, integrated PFI for Latinx hazardous drinkers with clinical anxiety (AA-PFI 1.0) that will be implemented and tested for effectiveness in community-based health clinics. Our approach will follow a staged model consistent with National Institutes of Health (NIH) guidelines for developing and standardizing behavioral interventions. Phase IA activities will involve collecting qualitative and quantitative feedback from three iterative focus groups (N = 21) to refine intervention content and evaluate treatment acceptability and feasibility. Phase IB activities will include a rigorous randomized clinical trial designed to compare the effectiveness of AA-PFI 2.0 to a control PFI (C-PFI) among a sample of 250 Latinx hazardous drinkers with clinical anxiety who receive care within community-based health clinics. This study represents an important and pivotal step in the larger landscape of translating basic research to more efficacious strategies for reducing hazardous drinking in underserved populations with biobehavioral comorbidities. The proposed research project supports the 2017-2021 strategic plan of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) by advancing research in two of the key areas. First, the current proposal has the end goal of improving strategies to prevent alcohol misuse, alcohol use disorder, and alcohol-related consequences among an ‘at-risk’ population for these conditions (goal 3). Second, it enhances the public health impact of NIAAA-supported research by focusing on one of the fastest-growing and largest demographics in the US who demonstrate disparities in hazardous drinking (goal 5). The current application aligns with the goals of RFA- AA-21-001 by proposing to examine the effectiveness of a low cost, highly disseminatable, personalized, culturally adapted PFI for Latinx hazardous drinkers with clinical anxiety within community-based health clinics. Given the collective public health impact of concurrent anxiety and alcohol use, we believe the proposed study will yield findings that enhance scientific knowledge, advance our understanding of mechanisms in anxiety- alcohol use relations, and inform the development of novel treatments for hazardous drinkers with clinical anxiety that are adaptable and easily implemented across a variety of healthcare settings.