A social media intervention for high-intensity drinking in a national sample of emerging adults

项目摘要 预防高强度饮酒事件（HID;女性消费8+标准饮料，男性消费10+） 在新兴成人（EA）中是重要的公共健康问题; HID增加了两者的风险（例如， 长期饮酒的后果。发育方面，EA报告的最高患病率为 酒精使用和滥用。大约11%的EA报告过去2周的HID，1/3的酗酒者（5+） 在过去的两周内，有七分之一的高中生在过去的两周内报告了HID， 成年初显期HID增加了停电的风险，可能导致进一步的健康后果， 作为伤害。虽然有一些有希望的干预措施可以减少EA的酒精消费，但干预措施 效果通常是适度的，随着时间的推移没有持续的效果，迄今为止的干预措施还没有 这一点可能不太可能因以前的干预措施而改变。接合 社交媒体（SM）现在是EA的日常规范，他们经常使用私人移动消息应用程序， Snapchat在约80%的EA中。25岁以下的用户每天在Snapchat上花费M= 40分钟。这些高水平的 与SM内容的互动提供了一个动态平台，使EA参与干预， 与传统的干预措施相比，同行式健康教练在日常生活中更接近实时地解决HID问题。 本研究的具体目标是：1）迭代开发和重点测试一个同伴促进的8周 基于SM的干预对EA中HID的影响，2）测试干预与 对HID和酒精后果的控制条件。我们将反复开发一个同行便利的私人SM 通过Snapchat提供的消息干预。与之前的工作一样，我们将首先开发具有吸引力的用户- 通过与环境机构和国家众包的参与性方法生成内容，然后进行迭代 重点测试与国家招募的EA参与者与HID。干预措施将利用同龄人作为健康 教练，以促进融洽和联系（这是可扩展的，以获得学生学员在卫生领域） 并将侧重于“为什么，如何”的动机性访谈模式，内容的剪裁解决“为什么” 改变（例如，（了解变更的原因，审查不良后果，对HID的规范性反馈等） 以及“如何”改变（例如，引出保护策略的好处，解决期望和动机，使用 动机、目标设定等的认知行为应对策略）。我们将测试开发的干预措施， 一项在100名18-25岁的EA中进行的试点随机对照试验， 躲了起来只有将在试验后2个月和4个月随访（基线后）时测量结局。的 制定一项适应性强、可扩展和有效的干预措施，专门针对环境机构之间的严重工业污染，这是一个关键步骤 在公共卫生工作中，高风险饮酒和相关后果。这项研究可能会产生重大影响 通过改变东亚地区的HID轨迹，防止健康和社会后果， 酒精使用障碍，以及为未来的SM行为健康干预提供信息。

Project Summary Preventing high intensity drinking episodes (HID; consuming 8+ standard drinks for women and 10+ for men) among emerging adults (EAs) is an important public health concern; HID increases risk for both short (e.g., injury) and long-term consequences of alcohol use. Developmentally, EAs report the highest prevalence of alcohol use and misuse. Approximately 11% of EAs report past 2-week HID, 1/3 of those who binge drink (5+ drinks) report HID in the past 2 weeks, and 1 in 7 high school seniors follow a sustained HID pattern through emerging adulthood. HID increases risk for blackouts, potentially leading to further health consequences such as injury. Although there are promising interventions that reduce alcohol consumption among EAs, intervention effects are typically modest in size without sustained effects over time, and interventions to date have not addressed HID specifically, which may be less likely to change as a result of previous interventions. Engaging with social media (SM) is now a daily norm for EAs with regular use of private mobile-messaging apps like Snapchat among ~80% of EAs. Users under age 25 spend an M=40min/day on Snapchat. These high levels of engagement with SM content provide a dynamic platform to engage EAs in interventions providing access to peer-like health coaches to address HID in their daily lives closer to in real-time than traditional interventions. The specific aims of the proposed study are to: 1) iteratively develop and focus test a peer-facilitated 8-week SM-based intervention for HID among EAs, and 2) test the preliminary efficacy of the intervention versus a control condition on HID and alcohol consequences. We will iteratively develop a peer-facilitated private SM messaging intervention delivered via Snapchat. As in prior work, we will initially develop engaging, user- generated content via a participatory approach with EAs and national crowdsourcing, followed by iterative focus testing with nationally recruited EA participants with HID. The intervention will leverage peers as health coaches to promote rapport and connection (which is scalable given access to student trainees in health fields) and will focus on the “Why, How” model of motivational interviewing with tailoring of content addressing “why” change (e.g., elicit reasons for change, review of negative consequences, normative feedback on HID, etc.) and “how” change (e.g., elicit benefits of protective strategies, addressing expectancies and motives, use of cognitive behavioral coping strategies for motives, goal setting, etc.). We will test the developed intervention in a pilot randomized controlled trial versus a control condition among 100 18-25 year-old EAs with past-month HID. Outcomes will be measured at a 2-month post-test and 4-month follow-up (post-baseline). The development of an adaptable, scalable and efficacious intervention tailored for HID among EAs is a critical step in public health efforts to high-risk drinking and related consequences. This study could have significant impact by altering HID trajectories among EAs, preventing health and social consequences and the development of alcohol use disorders, as well as informing future SM interventions for behavioral health.