Evaluation and Optimization of a Just-in-Time Messaging Intervention to Reduce Alcohol-Facilitated Intimate Partner Violence Perpetration Among At-Risk Young Adult Men and Women

点击翻译按钮获取中文摘要

PROJECT SUMMARY Young adult men and women perpetrate intimate partner violence (IPV) at high rates. A summary of over 30 years of research concludes that alcohol is a causal factor of IPV, particularly acute alcohol intoxication, highlighting the critical need for interventions delivered proximally to drinking episodes – a period of increased risk for IPV. Yet despite the high societal and personal costs associated with heavy drinking and IPV and the high prevalence of alcohol facilitated IPV, empirically supported interventions are lacking, particularly those that are low resource and easily scalable for wide dissemination. It is increasingly feasible to deliver Just-In- Time (JIT) interventions via mobile technology, particularly those that adapt over time to an individual's changing needs to provide appropriate intervention strategies based on real time, real world context – Just-In- Time Adaptive Interventions (JITAIs). JITAIs have been evaluated for a range of behavioral health issues including alcohol use; however, no empirically supported JITAIs for alcohol-facilitated IPV perpetration exist. To develop JITAIs, JIT interventions are optimized through innovative micro-randomized trials (MRTs) in which individuals are micro-randomized to receive different intervention strategies at critical time points to determine when a message is best delivered, which type of message is most impactful for whom, and under what conditions. Thus, the present application will combine a traditional RCT to evaluate the efficacy of delivering JIT messages to reduce alcohol facilitated IPV perpetration with a MRT to optimize the selection and adaptation of messages for a future JITAI. The proposed intervention focuses on theoretically and empirically supported targets for IPV perpetration consistent with the I3 Model – the prevailing unifying theory of IPV perpetration – including distress tolerance skills, emotion regulation skills, and alcohol reduction strategies. An RCT by the PI (K08AA021745) supports these intervention targets for reducing alcohol use and IPV perpetration among women with sexual assault histories, and a recent pilot study supports the feasibility and acceptability of delivering these JIT messages using a MRT design to at-risk men and women with good effects of the intervention on key alcohol and IPV outcomes. As such, we propose to evaluate the efficacy of this JIT messaging intervention in 400 heavy drinking young adults with recent IPV perpetration. Participants will be randomized to the JIT messaging intervention or an assessment only control (RCT design). All participants will complete a baseline survey, 30-days of twice daily monitoring, and 1-, 3-, and 6-month follow- up surveys. Within the intervention arm (MRT design), individuals will be micro-randomized after each morning and evening report during the 30 days of monitoring to (1) receive a JIT message or not, and (2) if yes, to one of three message types (distress tolerance skill, ER skill, alcohol reduction strategy). This innovative design will optimize the selection and adaptation of JIT messages for a future JITAI to reduce alcohol facilitated IPV.