Development of a Mobile Mindfulness Intervention for Alcohol Use Disorder and PTSD among OEF/OIF Veterans

开发针对 OEF/OIF 退伍军人酒精使用障碍和 PTSD 的移动正念干预措施

• 批准号: 10263953
• 负责人: Jordan P Davis
• 金额: $ 25.98万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10263953
• 关键词: Address; Affect; Afghanistan; Alcohol consumption; Alcohols; American; Awareness; Behavioral; Caring; Communities; Conflict (Psychology); Development; Diagnosis; Disease; Distress; Eligibility Determination; Ethnic Origin; Evidence based intervention; Face; Feedback; Freedom; Gender; Goals; Health Services Accessibility; Healthcare; Healthcare Systems; Heavy Drinking; Impulsivity; Individual; Informal Social Control; Intervention; Intervention Studies; Iraq; Knowledge; Methods; Occupational; Outcome; Patient Recruitments; Persons; Pharmaceutical Preparations; Phase; Population; Post-Traumatic Stress Disorders; Public Health; Race; Randomized Controlled Trials; Reporting; Research; Resistance; Risk; Sampling; Services; Stress; Substance Use Disorder; Symptoms; Technology; Testing; Trauma; Treatment outcome; Underserved Population; United States Department of Veterans Affairs; Veterans; Work; acceptability and feasibility; alcohol consequences; alcohol misuse; alcohol use disorder; base; behavioral health; care seeking; comparison intervention; craving; disorder later incidence prevention; efficacy testing; emotion regulation; evidence base; experience; feasibility testing; high risk; high risk drinking; improved; innovation; intervention effect; male; meetings; mindfulness; mindfulness intervention; mobile application; mobile computing; novel; operation; physical conditioning; post intervention; post-traumatic symptoms; preventive intervention; programs; recruit; reduce symptoms; skills; social media; social stigma; stress reduction; substance use; substance use treatment; success; symptom treatment; traumatic event; treatment as usual; usability

PROJECT SUMMARY/ABSTRACT The long-term goal of this proposal is to improve treatment outcomes for OEF/OIF veterans with alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) who are not currently accessing care through the Veterans Affairs Healthcare System (VA) or other settings. Many OEF/OIF veterans struggle with heavy drinking and related consequences and this can be especially pronounced with the co-occurrence of PTSD. Prior research has found aspects of self-regulation (emotion regulation, impulse control), stress, and craving to be important putative targets in AUD and PTSD symptom reduction. However, with upwards of 50% of veterans who have behavioral health needs not seeking treatment, it is imperative to utilize advances in technology to develop and test interventions that can reach non-treatment seeking veterans and target both symptoms of PTSD and AUD. As the proposed mechanisms (e.g., self-regulation) are becoming better understood regarding how they affect PTSD and AUD outcomes, approaches should focus on targeting these mechanisms and evaluating if they are essential facilitators of change. Mindfulness-based interventions (MBI) can target such mechanisms, but a gap in the knowledge persists regarding the utility of MBIs with veterans who screen positive for PTSD and AUD. Therefore, we propose to improve treatment outcomes for OEF/OIF veterans with PTSD and AUD by targeting self-regulation, stress, and cravings. We will develop and test a novel mobile MBI, Mobile Mindfulness Based Relapse Prevention (mMBRP), that will improve upon evidence- based in-person and group MBRP by reaching veterans outside of treatment settings. The engaging and easy- to-use mobile MBI integrates relapse prevention, stress reduction, and self-regulation skills and is relevant to issues surrounding stigma and barriers that veterans face when seeking services. The central hypothesis will be tested through a focus on three specific aims: (1) refine and add MBRP content to the popular VA- developed Mindfulness Coach mobile application through a beta testing phase where we test for feasibility and acceptability of the app, (2) pilot test the efficacy of the mMBRP mobile app on alcohol use and PTSD outcomes compared to control, and (3) assess mechanisms of change such as self-regulation, stress, and cravings, as well as exploratory moderators of gender, race/ethnicity, and recency of discharge, on mMBRP effects. The unique strengths of this proposal are its focus on an underserved population, utilization of mobile technology for intervention delivery, and use of a novel intervention known to effectively target self-regulation and stress. The expected results will define a viable and easy-to-access treatment that can improve both AUD and PTSD symptoms. Results of this study will have a positive impact on substance use outcomes for those who have experienced traumatic events and will identify mechanism of action for treatment success. The app can be disseminated through our partners in the VA and through targeted sharing on social media.

项目总结/文摘