Family-focused vs. Drinker-focused Smartphone Interventions to Reduce Drinking-related Consequences of COVID-19

以家庭为中心与以饮酒者为中心的智能手机干预措施可减少与饮酒相关的 COVID-19 后果

• 批准号: 10700053
• 负责人: DAVID H GUSTAFSON
• 金额: $ 112.52万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-25 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10700053
• 关键词: Address; Adult; Adult Children; Al-Anon; Alcohol consumption; Alcoholic beverage heavy drinker; Alcohols; American; Behavior Therapy; Behavioral; COVID-19; COVID-19 impact; Cellular Phone; Communication; Competence; Conflict (Psychology); Contracts; Control Groups; Couples Therapy; Data; Disease; Drug usage; Evidence based intervention; Family; Family member; Feedback; Funding; Health; Health Insurance; Healthcare; Heavy Drinking; Hybrids; Inequity; Interpersonal Violence; Intervention; Job loss; Measures; Mediating; Mediation; Mediator; Modeling; Motivation; Names; National Institute on Alcohol Abuse and Alcoholism; Outcome; Perception; Personal Satisfaction; Persons; Pharmaceutical Preparations; Phase; Quality of life; Randomized; Recovery; Resources; Risk; Service delivery model; Services; Severities; Spouses; Stress; Stress and Coping; Substance Use Disorder; Support System; Technology; Telephone; Testing; Time; United States National Institutes of Health; Vaccination; Vaccines; addiction; alcohol intervention; arm; behavior change; comorbidity; coronavirus disease; design; digital health; digital intervention; drinking; effectiveness testing; evidence base; follow up assessment; follow-up; formative assessment; health care availability; health disparity; high risk drinking; implementation science; implementation study; improved; member; pandemic impact; pandemic stress; primary outcome; psychoeducation; psychoeducational; psychologic; randomized trial; recruit; relapse prevention; response; risk mitigation; satisfaction; secondary outcome; sex; smartphone application; social; substance use; theories; tool; usability

PROJECT SUMMARY / ABSTRACT The combination of COVID-19 and alcohol/substance use disorders exacerbates a wide range of existing problems, including the likelihood of contracting COVID and severity of consequences, pandemic-related stresses that trigger alcohol and substance use, loss of jobs and healthcare access, increased interpersonal violence, and overarching systemic inequities. Interventions are needed to address these serious problems, which are likely to persist even after widespread availability of COVID vaccines. In response to PAR 20-243, this R01 project is a Hybrid II RCT/implementation study modifying and testing two of our alcohol smartphone interventions to address the fallout from COVID. We propose a 3-arm RCT comparing a control vs. a drinker-focused intervention vs. a family-focused intervention. The drinker-focused intervention (ACHESS-C) is an extension of our evidence-based Addiction–Comprehensive Health Enhancement Support system (ACHESS), augmented with COVID resources. The family-focused intervention (FamCHESS-C) combines ACHESS-C services with evidence-based Alcohol Behavioral Couple Therapy services to help both drinker and partner with behavior change, relationship problems, and general well-being. In the proposed 8-month trial plus 4-month follow-up, 198 dyads (drinker + family member) will be randomly assigned to: 1) Smartphone control: both receive a smartphone with standard support and crisis numbers; 2) ACHESS-C: drinker receives a phone with ACHESS-C, partner receives a phone with support and crisis numbers; 3) Fam-CHESS-C: both receive phone with FamCHESS-C. The project has the following aims: Aim 1: Complete refinements to the FamCHESS-C app. Aim 2: Conduct a balanced RCT to test the following outcomes: Primary: 1) drinker % heavy drinking days, 2) dyad quality of life. Secondary: 3) dyad relationship satisfaction, 4) dyad psychological/physical conflict, 5) drinker no heavy drinking days, 6) drinker % days alcohol/drug use, 7) dyad COVID vaccination rates, 8) drinker alcohol- and drug-related problems. Exploratory: 9) partner % days alcohol/drug use, 10) dyad crisis healthcare use, 11) dyad technology satisfaction. We hypothesize that outcomes will be more favorable in FamCHESS-C relative to ACHESS-C, and both will be more favorable relative to smartphone control. Aim 3: Examine mediation effects of dyad's competence, relatedness, and motivation; drinker's interim change in % days of alcohol and drug use, and extent of app use for comparisons of ACHESS-C and FamCHESS-C. Examine moderation of effects of condition by drinker sex, severity of drinker’s baseline alcohol use, drinker engagement in treatment for AUD/SUD, and dyad’s baseline relationship satisfaction. Aim 4: Conduct a small-scale (20 dyads) formative evaluation using an implementation science model to collect qualitative data on perceptions of difficulties and benefits of ACHESS-C and FamCHESS-C use.

项目摘要 /摘要 Covid-19和酒精/药物使用障碍的结合加剧了广泛的现有 问题，包括收缩共证和后果的严重性，与大流行有关的问题 触发酒精和吸毒，工作丧失和医疗保健的压力，人际关系增加 暴力和总体的系统性不平等。需要采取干预措施来解决这些严重的问题， 即使在宽度供疫苗的宽度可用性之后，它们也可能会持续。 为了响应20-243杆，这个R01项目是一个混合II RCT/实施研究，正在修改和测试两个 我们的酒精智能手机干预措施解决了Covid的影响。我们提出了3臂RCT 比较控制对照与以饮酒者为中心的干预措施与以家庭为中心的干预措施进行比较。以饮酒者为中心 干预（ACHESS-C）是我们基于证据的成瘾的扩展 增强支持系统（ACHESS），增强了共同资源。以家庭为中心的干预措施 （Famchess-C）将Achess-C服务与循证酒精行为夫妇疗法结合在一起 帮助饮酒者和合作，以改变行为改变，关系问题和一般福祉。 在拟议的为期8个月的试验加4个月的随访中，198个二元组（Drinker +家庭成员）将是随机的 分配给：1）智能手机控制：两者都会收到具有标准支持和危机号码的智能手机； 2） Achess-C：饮酒者接收带有Achess-C的手机，伴侣接收一部带有支持和危机的电话 数字3）FAM-CHESS-C：两者都接收带有Famchess-C的电话。该项目具有以下目的： AIM 1：完整对FamChess-C应用程序的改进。 AIM 2：进行平衡的RCT测试以下结果：主要：1）饮酒者％大量饮酒日，2） 二元生活质量。次要：3）二元关系满意度，4）二元心理/身体冲突，5） 饮酒者没有大量饮酒天，6）饮酒者％饮酒/吸毒，7）Dyad Covid疫苗接种率，8） 饮酒者酒精和与毒品有关的问题。探索：9）伴侣％饮酒/吸毒，10）二元危机 医疗保健使用，11）二元技术满意度。我们假设结果在 Famchess-C相对于Achess-C，相对于智能手机控制，两者都将更有利。 目标3：检查二元组能力，相关性和动机的调解效应；饮酒者的临时变化 在饮酒和吸毒的百分比中，以及用于比较Achess-C和Famchess-C的应用程序使用范围。 检查饮酒者性别，饮酒者的基线酒精的严重程度，饮酒者的严重性，饮酒者 参与AUD/SUD的治疗，以及Dyad的基线关系满意度。 AIM 4：使用实施科学模型进行小规模（20个二元组）形成性评估 收集有关Achess-C和Famchess-C使用困难和益处的定性数据。