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

项目总结 年轻成年男女实施亲密伴侣暴力(IPV)的比率很高。30多年的总结 多年来的研究得出结论，酒精是IPV的一个原因，特别是急性酒精中毒， 强调迫切需要在饮酒后近距离提供干预措施--这是一段增加的时期 对IPV的风险。然而，尽管大量饮酒和IPV以及 酒精促进的IPV的高流行率，缺乏经验支持的干预措施，特别是那些 资源少，易于扩展，便于广泛传播。交付准时送货服务的可能性越来越大 通过移动技术进行的时间(JIT)干预，特别是那些随着时间推移而适应个人需求的干预 不断变化的需求需要提供基于实时、真实世界环境的适当干预策略 时间适应性干预(JITAI)。JITAI已经在一系列行为健康问题上进行了评估 包括酒精使用；然而，对于酒精促成的IPV行为，没有经验支持的JITAI。 为了开发JITAI，JIT干预通过创新的微随机试验(MRT)进行优化，其中 个体被微随机化以在关键时间点接受不同的干预策略以确定 什么时候消息传递最好，哪种类型的消息对谁最有影响力，在什么情况下 条件。因此，本申请将结合传统的随机对照试验来评估交付的效果 减少酒精的JIT消息促进了IPV的实施，MRT优化了选择和 为未来的吉泰改编消息。拟议的干预措施侧重于理论上和经验上的 与i3模式一致的知识产权实施的支持目标--主流的知识产权统一理论 实施--包括承受痛苦的技能、情绪调节技能和戒酒策略。一个 PI的RCT(K08AA021745)支持这些减少酒精使用和IPV的干预目标 在有性侵历史的妇女中实施，最近的一项试点研究支持了可行性和 使用MRT设计将这些JIT信息传递给有良好风险的男性和女性的接受度 干预对关键酒精和IPV结局的影响。因此，我们建议评估 这是对400名最近有IPV行为的酗酒年轻人进行的JIT信息干预。参与者 将随机分为JIT消息传递干预或仅评估对照(RCT设计)。全 参与者将完成一项基线调查，每天两次，为期30天，并在1、3和6个月内进行跟踪- 向上的调查。在干预臂(MRT设计)内，每天早上之后将对个体进行微随机分组 以及在30天的监测期间的晚间报告，以(1)是否收到JIT消息，以及(2)如果是，给一个 三种类型的信息(承受痛苦技能、ER技能、减少酒精策略)。这一创新的设计将 优化JIT消息的选择和改编，以适应未来的JITAI，以减少酒精促进的IPV。

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.