Pilot test of an mHealth Intervention for Reducing Alcohol Use among Rural Adolescent and Young Adult Cancer Survivors

减少农村青少年和年轻成年癌症幸存者饮酒的移动医疗干预试点试验

• 批准号: 10273171
• 负责人: Carolyn Lauckner
• 金额: $ 37.87万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-14 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10273171
• 关键词: AIDS/HIV problem; Address; Adherence; Adolescent and Young Adult; Advocate; Aftercare; Alcohol consumption; Alcohols; Area; Behavior; Bluetooth; Cancer Center; Cancer Survivor; Cancer Survivorship; Caring; Cellular Phone; Clinic; Clinical Trials; Communities; Counseling; Country; Data; Development; Diagnosis; Education; Enrollment; Evidence based intervention; Frequencies; Health; Health Promotion; High Prevalence; Incidence; Intervention; Intervention Trial; Interview; Kentucky; Literature; Malignant Neoplasms; Mental Health; Meta-Analysis; Monitor; Moods; Oncology; Outcome; Ownership; Persons; Physical activity; Population; Primary Health Care; Procedures; Provider; Randomized Controlled Trials; Reporting; Research; Research Personnel; Risk; Risk Behaviors; Risk Factors; Rural; Sampling; Services; Sleep; Structure; Surveys; Survivors; Technology; Telephone; Testing; Transportation; Travel; United States; Veterans; Visit; Youth; acceptability and feasibility; aged; alcohol behavior; alcohol intervention; alcohol monitoring; barrier to care; base; binge drinker; binge drinking; cancer recurrence; cancer risk; comorbidity; comparison group; digital; digital health; drinking; efficacy testing; experience; feasibility testing; follow-up; health literacy; improved outcome; informant; innovation; literacy; mHealth; mortality; motivational enhancement therapy; nutrition; peer; physical conditioning; pilot trial; psychologic; reduced alcohol use; rural area; rural dwellers; social stigma; substance use; survivorship; tool; underage drinking

ABSTRACT Adolescent and young adult (AYA) survivors of cancer have poorer health than their peers who have not been diagnosed with cancer and are more likely to die from non-cancer related causes. Researchers have called for health promotion interventions to improve outcomes and reduce risk behaviors among this population; however, one key risk factor—alcohol consumption—has been largely unstudied. Most AYA survivors are current drinkers, and over a third report engaging in binge drinking. Survivors living in rural areas may be even more at risk, as they have limited access to health and psychological care and many youth in these areas report more frequent alcohol consumption than their urban counterparts. Given that alcohol use is associated with increased risk of cancer recurrence, poorer survival, and other comorbidities, it is important to explore interventions for reducing this behavior among rural AYA survivors. The proposed research will test a mobile health (mHealth) intervention for reducing alcohol use, called TRAC: Tracking and Reducing Alcohol Consumption. This intervention, which is currently being implemented among a sample of people living with HIV/AIDS, is based on principles of motivational interviewing. It utilizes weekly phone conversations with an interventionist over an 8-week period and twice-daily self-monitoring of alcohol consumption using mobile surveys and Bluetooth breathalyzers. The intervention has strong potential for acceptability among rural AYAs given this populations’ high digital literacy, and will also reduce barriers to care experienced by those in rural areas, who often have to travel long distances to see providers in-person. Through key informant interviews, the TRAC intervention will be adapted and refined for rural AYA survivors. Then, it will be tested through a pilot randomized controlled trial with a monitoring and education comparison group. This pilot trial will assess intervention retention, adherence, and acceptability, and provide preliminary data regarding impact on alcohol use. Overall, the proposed research will yield valuable feasibility data to inform a definitive randomized controlled trial of this intervention to test efficacy among a larger sample of rural AYA survivors. If TRAC is shown to be successful in this population, it could be implemented in rural cancer clinics across the country and reduce risky alcohol consumption among the over 2 million AYAs in the United States.

摘要 青少年和年轻成年人（AYA）癌症幸存者的健康状况比他们的同龄人更差， 被诊断患有癌症，更有可能死于非癌症相关的原因。研究人员呼吁， 健康促进干预措施，以改善结果，减少这一人群的危险行为; 然而，一个关键的危险因素--饮酒--在很大程度上还没有得到研究。大多数AYA幸存者 目前的饮酒者，超过三分之一的人报告参与酗酒。生活在农村地区的幸存者甚至可能 风险更大，因为他们获得保健和心理护理的机会有限， 他们比城市居民更经常饮酒。考虑到饮酒与 随着癌症复发风险的增加、生存率降低和其他合并症， 在农村AYA幸存者中减少这种行为的干预措施。拟议中的研究将测试一个移动的 减少酒精使用的移动健康干预措施，称为TRAC：跟踪和减少酒精 消费这项干预措施目前正在一批患有艾滋病的人中实施， 艾滋病毒/艾滋病问题的调查是基于动机访谈的原则。它利用每周电话交谈， 干预者在8周的时间内使用移动的每天两次自我监测酒精消费 调查和蓝牙呼气测醉器干预措施在农村AYAs中具有很强的可接受性 考虑到这些人群的高数字素养， 这些人往往需要长途跋涉才能亲自见到医疗服务提供者。通过对关键线人的采访， TRAC干预措施将针对农村AYA幸存者进行调整和完善。然后，它将通过试点进行测试 随机对照试验，有监测和教育对照组。该试验将评估 干预措施的保留、依从性和可接受性，并提供有关对酒精影响的初步数据 使用.总的来说，拟议的研究将产生有价值的可行性数据，为确定的随机 这项干预的对照试验，以测试农村AYA幸存者的更大样本的疗效。如果TRAC是 在这一人群中显示出成功，它可以在全国各地的农村癌症诊所实施。 并减少美国200多万AYA中的危险酒精消费。