A Technology-based Intervention to Reduce Alcohol Use after Bariatric Surgery

减肥手术后减少饮酒的基于技术的干预措施

• 批准号: 10055199
• 负责人: Jordan Michel Braciszewski
• 金额: $ 21.63万
• 依托单位: HENRY FORD HEALTH SYSTEM
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-20 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10055199
• 关键词: Abstinence; Address; Adoption; Aftercare; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Behavior; Behavioral; Blood alcohol level measurement; Body Weight decreased; Caring; Cellular Phone; Clinical Trials; Control Groups; Coping Skills; Data; Development; Ecological momentary assessment; Education; Enrollment; Ethanol Metabolism; Evidence based intervention; Feedback; Food; Freezing; Gastrectomy; Gastric Bypass; Goals; Grant; Guidelines; Hormones; Hour; Incidence; Individual; Intervention; Intervention Trial; Interview; Length; Low Prevalence; Mental Health; Metabolic hormone; Metabolism; Methods; Mission; Modeling; Morbid Obesity; Observational Study; Operative Surgical Procedures; Outcome; Participant; Patient Preferences; Patients; Persons; Phase; Physiological; Pilot Projects; Plant Roots; Population; Population Intervention; Populations at Risk; Prevalence; Prevention; Preventive Intervention; Procedures; Public Health; Questionnaires; Randomized; Readiness; Recommendation; Reporting; Research; Rewards; Risk; Surveys; System; Techniques; Technology; Testing; Text Messaging; Time; Treatment Efficacy; United States; United States National Institutes of Health; absorption; alcohol abstinence; alcohol effect; alcohol prevention; alcohol use disorder; alcohol use initiation; bariatric surgery; base; brief intervention; clinical practice; clinically significant; computerized; coping mechanism; cost; cost effective; deter alcohol use; disorder later incidence prevention; drinking; evidence base; experience; food consumption; group intervention; hazard; hazardous drinking; innovation; mHealth; meetings; motivational enhancement therapy; novel; patient population; physical conditioning; post intervention; preference; prevent; primary outcome; programs; psychoeducation; recruit; reduced alcohol use; response; retention rate; satisfaction; service delivery; skills; smoking cessation; surgical risk; therapy design; traditional therapy; treatment as usual; weight loss intervention

Despite bariatric surgery being the most effective weight loss intervention for patients who are severely obese, as many as 1 in 5 patients will develop an alcohol use disorder after their surgery. Changes in metabolism, hormone levels, and behavior as a result of bariatric surgery alter the rewarding effects of alcohol while concurrently changing its absorption rate, putting patients at significantly elevated risk of hazardous drinking. Simply providing education to this vulnerable patient population about post-surgical risks has not been sufficient to reduce alcohol use, yet comprehensive in-person interventions are met with significant challenges, including hours-long distances between patients and their bariatric surgery programs. Thus, our long-term goal is to increase access to an empirically-supported intervention for reducing alcohol use among patients who undergo bariatric surgery by leveraging technology. Our intervention, rooted in motivational interviewing and the transtheoretical model, is a two-session computerized brief intervention (CBI), supplemented by six months of tailored text messaging based on participants’ CBI results and subsequent fluctuations in their readiness to change. The purpose of the proposed study is to optimize this technology-based intervention for patients who undergo bariatric surgery and to examine feasibility and acceptability of the intervention. In the first phase, patient interviews (n= 20) will be utilized to identify preferences for intervention content and treatment delivery. Ten patients will then participate in an open trial of the intervention, which will be subsequently revised based on feedback from these patients. In Phase 2, patients (N = 60) will be recruited between 3 and 6 months following bariatric surgery and randomized to the intervention or treatment as usual control group. All patients will complete baseline questionnaires and at 1, 3, 6, and 9 month post-assessments. We expect that this intervention will be both feasible and acceptable to patients. Results will be used as preliminary data to inform a large, fully-powered clinical trial to test the larger efficacy of this intervention. Although primary outcomes focus on feasibility and acceptability, we also expect that patients assigned to the intervention will have a longer time to their first post-surgical drink, report more days of abstinence, fewer drinks per drinking day, and a lower prevalence of alcohol use disorder after bariatric surgery compared to controls. This project is innovative because it expands upon existing interventions for bariatric surgery patients by implementing evidence-based strategies for alcohol use. By utilizing a technology-based approach, we can also reach a larger number of patients to prevent initiation of drinking, reduce current alcohol use, and facilitate better engagement in care, should individuals opt into traditional treatment approaches. The proposed line of research is significant and relevant to NIH’s mission because the intervention is expected to reduce the likelihood that patients will develop an alcohol use disorder following bariatric surgery. Given the potential of wide dissemination at low cost, the proposed study has high potential public health and clinical significance.

尽管减肥手术是严重肥胖的患者最有效的减肥干预措施，但 手术后，多达5分之一的患者将患有酒精饮用障碍。新陈代谢的变化， 马酮水平和由于减肥手术而导致的行为改变了酒精的有益影响 同时改变其滥用率，使患者的危险饮酒风险显着升高。 仅向这位脆弱的患者人群提供有关手术后风险的教育 足以减少饮酒，但全面的面对面干预遇到了重大挑战， 包括患者及其减肥手术计划之间的长时间距离。那，我们的长期目标 是增加获得经验支持的干预措施，以减少患者的饮酒 通过利用技术进行减肥手术。我们的干预措施源于动机面试和 跨理论模型是两次计算机简短干预（CBI），补充了六个月 根据参与者的CBI结果和随后的波动，量身定制的文本消息传递的准备 改变。拟议研究的目的是为患者优化这种基于技术的干预措施 进行减肥手术并检查干预的可行性和可接受性。在第一阶段， 患者访谈（n = 20）将用于确定干预内容和治疗交付的偏好。 然后，十名患者将参加干预措施的公开试验，随后将基于修订 这些患者的反馈。在第2阶段，将在3到6个月之间招募患者（n = 60） 减肥手术后，并像往常一样将干预或治疗随机分配。所有患者 将在评估后1、3、6和9个月完成基线问卷。我们期望这 干预既可以是可行的，也是患者可接受的。结果将用作初步数据以告知 一项大型，全功能的临床试验，以测试此干预效率的较高效率。虽然主要结果 专注于可行性和可接受性，我们还希望分配给干预措施的患者 较长的时间到他们的第一次外科饮料，报告更多节制的日子，每天饮料少的饮料和 与对照组相比，减肥手术后酒精使用障碍的患病率较低。这个项目是 创新的，因为它通过实施来扩展对减肥手术患者的现有干预措施 基于证据的饮酒策略。通过使用基于技术的方法，我们还可以达到 大量患者以防止饮酒，减少当前的酒精饮酒并促进更好 参与护理，如果个人选择采用传统的治疗方法。提议的线 研究很重要，并且与NIH的使命相关，因为预计干预措施将减少 减肥手术后，患者会发展出一种酒精疾病的可能性。鉴于潜力 拟议的研究以低成本的广泛传播具有很高的潜在公共卫生和临床意义。