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

项目摘要/摘要 尽管拉丁裔人口是美国最大、增长最快的人口之一，但 经历显著的健康差距，特别是在危险饮酒和临床共生方面 焦虑。到目前为止，还没有干预措施针对危险饮酒在临床焦虑的背景下 拉丁裔人。目前的R01提案建立在我们过去工作的基础上，制定了一个简短的、单一的会议、 基于计算机的个性化反馈干预(PFI)旨在增强有关不良反应的知识 焦虑与酒精的相互关系，增加减少危险饮酒的动机和意图，并减少 关于使用酒精治疗焦虑的积极态度和意图。具体地说，我们建议制定一项 为临床焦虑的Latinx危险饮酒者提供低成本、高传播性的综合PFI(AA-PFI 1.0) 这将在以社区为基础的卫生诊所实施并测试有效性。我们的方法将 遵循与美国国立卫生研究院(NIH)指南一致的阶段性模式，以开发和 规范行为干预。IA阶段的活动将包括收集定性和定量的 来自三个迭代焦点小组(N=21)的反馈，以完善干预内容和评估治疗 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，旨在 在250例Latinx危险样本中比较AA-PFI 2.0和对照PFI(C-PFI)的有效性 有临床焦虑症的饮酒者在社区卫生诊所接受治疗。这项研究代表了一个 在将基础研究转化为更有效的战略这一大背景下，迈出了重要和关键的一步 用于减少有生物行为并存的未得到充分服务的人群的危险饮酒。建议数 研究项目支持国家酗酒问题研究所2017-2021年战略计划 通过推进两个关键领域的研究来防治酗酒(NIAAA)。首先，当前的提案有最终目标 改进预防酒精滥用、酒精使用障碍和酒精相关后果的战略 在这些情况下的“高危”人群中(目标3)。第二，它加强了对公众健康的影响 NIAAA-通过关注美国增长最快、人口规模最大的人群之一来支持研究 显示危险饮酒方面的差异(目标5)。当前的应用与RFA的目标一致- AA-21-001通过建议检查低成本、高度可传播性、个性化 为社区卫生诊所内临床焦虑的拉丁裔危险饮酒者提供文化适应的PFI。 鉴于同时存在的焦虑和饮酒对公共健康的影响，我们认为拟议的研究 将产生增强科学知识的发现，促进我们对焦虑机制的理解- 酒精使用关系，并为临床危险饮酒者提供新的治疗方法 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.