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.

项目概要/摘要 COVID-19 和酒精/药物滥用障碍的结合加剧了一系列现有的问题 问题，包括感染新冠病毒的可能性以及与流行病相关的后果的严重性 导致酒精和药物滥用、失业和医疗保健机会减少、人际关系增加的压力 暴力和普遍的系统性不平等。需要采取干预措施来解决这些严重问题， 即使在新冠疫苗广泛使用之后，这种情况也可能持续存在。 为了响应 PAR 20-243，该 R01 项目是 Hybrid II RCT/实施研究，修改和测试了两个 我们通过智能手机对酒精进行干预，以解决新冠疫情的影响。我们提出了 3 组随机对照试验 比较对照、以饮酒者为中心的干预措施和以家庭为中心的干预措施。以饮酒者为中心 干预 (ACHESS-C) 是我们基于证据的成瘾综合健康的延伸 增强支持系统 (ACHESS)，通过新冠病毒资源进行了增强。以家庭为中心的干预 (FamCHESS-C) 将 ACHESS-C 服务与循证酒精行为夫妻疗法相结合 帮助饮酒者和伴侣改变行为、解决关系问题和总体健康的服务。 在拟议的 8 个月试验加上 4 个月随访中，将随机抽取 198 名二人组（饮酒者 + 家庭成员） 分配给： 1) 智能手机控制：两人都收到一部带有标准支持和危机号码的智能手机； 2） ACHESS-C：饮酒者收到带有 ACHESS-C 的电话，伴侣收到带有支持和危机的电话 数字； 3) Fam-CHESS-C：均用FamCHESS-C 接收电话。该项目有以下目标： 目标 1：完成 FamCHESS-C 应用程序的改进。 目标 2：进行平衡随机对照试验来测试以下结果：主要：1) 饮酒者重度饮酒天数百分比，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） 饮酒者无大量饮酒天数，6) 饮酒者饮酒/吸毒天数百分比，7) 双重新冠疫苗接种率，8) 饮酒者酒精和毒品相关的问题。探索性：9) 伴侣酗酒/吸毒的天数百分比，10) 夫妻危机 医疗保健用途，11）二元技术满意度。我们假设结果会更有利 FamCHESS-C相对于ACHESS-C，两者相对于智能手机控制来说都会更有利。 目标 3：检验二人能力、关联性和动机的中介效应；饮酒者的临时改变 以饮酒和吸毒天数百分比以及应用程序使用程度来比较 ACHESS-C 和 FamCHESS-C。 检查饮酒者性别、饮酒者基线饮酒严重程度、饮酒者对病情影响的调节程度 参与 AUD/SUD 治疗，以及二人的基线关系满意度。 目标 4：使用实施科学模型进行小规模（20 对）形成性评估 收集有关 ACHESS-C 和 FamCHESS-C 使用的困难和好处的定性数据。