Feasibility and Effectiveness of Gamified Digital Intervention to Prevent Alcohol and Mental Health Risks

项目摘要 性少数女性饮酒，经历与酒精有关的问题，并患有精神疾病。 健康问题的发生率高于异性恋同龄人。尽管一些临床项目正在 为寻求治疗这些问题的性少数女性（SMW）而开发的，只有一小部分 SMW需要它曾经寻求治疗。与此同时，预防性干预措施能够避免这些问题， 在不寻求治疗的法定最低工资者中，减少饮酒和改善心理健康的工作进展缓慢 出现。拟议的研究建立在R21AA025767的基础上，该研究建立了初步的可行性， 向法定最低工资提供有关饮酒和应对行为的个性化规范反馈的有效性 更广泛的基于应用程序的社会竞争，旨在挑战对这一人群的有害刻板印象， 建立一个支持性的虚拟社区。在我们的试点试验中，性少数女性热情地参与了 在没有参与激励的情况下，这样做。此外，相对于接收到PNF的子样本， 在比赛中的控制主题，那些接受PNF的饮酒和应对大大减少 他们的消费和负面影响超过4个月的时间。此外，定性反馈 建议否定PNF和社交媒体的负面刻板印象激发了社区功能（目前 在不同的条件下）可能也提供了超越酒精和应对PNF的心理益处 评估。为了建立在这些有希望的发现和补救的局限性，这项研究提出，首先优化 该应用程序基于试点试验（AIM 1）参与者的反馈，然后进行大型，复杂， I型实施有效性试验，同时检查功能齐全的应用程序对 饮酒，酒精相关问题，心理健康相对于有限的功能心理教育 控制版本的应用程序（AIM2），确定与完全解释相关的心理机制， 特色应用程序的有效性（AIM3），阐明人口统计和性少数污名相关的主持人 （目标4），并检查在真实的世界条件下使用的参与度、可接受性和可持续性， 未受激励、功能齐全的应用程序用户的子样本（AIM 5）。

Project Abstract Sexual minority women consume alcohol, experience alcohol-related problems, and suffer from mental health problems at higher rates than do their heterosexual peers. Although several clinical programs are being developed for sexual minority women (SMW) seeking treatment for these problems, only a small proportion of SMW needing it ever seek treatment. Meanwhile, preventive interventions able to avoid these problems by reducing drinking and improving psychological well-being among non-treatment seeking SMW have been slow to emerge. The proposed research builds on R21AA025767, which established the preliminary feasibility and effectiveness of delivering personalized normative feedback on drinking and coping behaviors to SMW within a broader app-based social competition designed to challenge harmful stereotypes about this population and foster a supportive virtual community. In our pilot trial, sexual minority women enthusiastically engaged with the app in the absence of participation incentives for doing so. Further, relative to a sub-sample that received PNF on control topics within the competition, those who received PNF on drinking and coping substantially reduced their consumption and negative consequences over a 4-month period. Moreover, qualitative feedback suggested that negative stereotype disconfirming PNF and social media inspired community features (present across conditions) may have also provided psychological benefits beyond the alcohol and coping PNF evaluated. To build on these promising findings and remedy limitations, this research proposes to first optimize the app based on feedback from participants in the pilot trial (AIM1) and then conduct a large, sophisticated, Type I implementation-effectiveness trial to simultaneously examine the effects of the fully featured app on drinking, alcohol-related problems, and psychological well-being relative to a limited feature psychoeducational control version of the app (AIM2), identify explanatory psychological mechanisms associated with the fully featured app’s effectiveness (AIM3), elucidate demographic and sexual minority stigma-related moderators (AIM4), and examine engagement, acceptability, and sustainability of use under real world conditions among a sub-sample of unincentivized, fully featured app users (AIM 5).