A Text-Message Intervention to Reduce Alcohol Use Among Young Adult ED Patients

描述（由申请人提供）：这个K23指导以患者为导向的职业发展奖的目的是加快候选人的发展成为一个独立的调查员，在行为干预研究的专业知识，以减少酒精的使用和酒精相关的后果之间的年轻人谁目前到急诊科（艾德）的照顾。在这个为期5年的奖项中，重点培训将致力于获得以下方面的专业知识：1）酒精使用和行为改变的心理学理论; 2）预防危险酒精使用的行为干预; 3）提供行为干预的计算机化方法;以及4）混合方法分析。候选人将在获奖过程中进行三项研究，以应用这些获得的技能，并优化交互式，计算机化，短信（SMS）传递，行为干预，以防止年轻人危险的酒精使用。这种干预建立在候选人的经验开发和测试短信提供的行为干预措施，并纳入战略，以增加年轻人的动机，以设定饮酒限制之前，计划饮酒场合，加强目标限制在饮酒事件，并协助反射后的一天饮酒事件。沟通将于每周周四至周日进行，将根据基线数据进行调整，并适应对酒精认知和使用模式的生态瞬时评估（EMA）。在研究#1中，候选人将与40名危险饮酒的年轻人进行焦点小组，以确定结合这些功能的SMS干预的可接受性和偏好。在研究#2中，候选人将在12周的时间内与40名在艾德中发现的危险饮酒的年轻人一起测试用户知情的SMS干预的可行性。评估将在基线时通过EMA报告完成，并在第12周通过基于网络的随访完成。主要结果包括12个周末对EMA的忠诚度（包括饮酒对话）和研究结束时对程序可用性的评级。在研究#3中，候选人将对艾德中确定的90名危险饮酒的年轻人进行3组RCT，以比较包含饮酒前、饮酒中和饮酒后支持对话的SMS干预与包含饮酒前和饮酒后支持对话（无饮酒中支持）的SMS干预以及SMS评估对照组的疗效估计值。主要结果包括周末大量饮酒事件和通过EMA报告测量的每次饮酒事件的平均饮酒量。其他结果将包括每月总饮酒量，酒精相关后果以及通过基于网络的随访评估测量的干预满意度。结果将用于修改干预措施，并为更大规模的III期RCT做准备。该项目的重点符合NIAAA对酒精使用的寿命观点。培训建议和研究计划符合NIAAA减少大学和未成年人饮酒的倡议。我们计划研究的艾德人群符合NIAAA的战略目标，即专注于减少少数群体和非学生人群之间的健康差距。

DESCRIPTION (provided by applicant): This purpose of this K23 Mentored Patient-Oriented Career Development Award is to expedite the candidate's development into an independent investigator with expertise in the conduct of behavioral intervention studies to reduce alcohol use and alcohol-related consequences among young adults who present to the Emergency Department (ED) for care. Within this 5 year award, focused training will be dedicated to gain expertise in: 1) psychological theories of alcohol use and behavior change; 2) behavioral interventions to prevent hazardous alcohol use; 3) computerized approaches to deliver behavioral interventions; and 4) mixed methodology analyses. The candidate will perform three studies over the course of the award to apply these acquired skills and to optimize an interactive, computerized, text-messaging (SMS) delivered, behavioral intervention to prevent hazardous alcohol use among young adults. This intervention builds upon the candidate's experience developing and testing SMS-delivered behavioral interventions and incorporates strategies to increase young adult motivations to set drinking limits prior to planned drinking occasions, reinforce goal limits during drinking episodes and assist reflection the day after drinking episodes. Communication will take place Thursday through Sunday every week, will be tailored to baseline data, and adaptive to ecological momentary assessments (EMA) of alcohol cognitions and use patterns. In Study #1, the candidate will perform focus groups with 40 young adults with hazardous drinking to identify acceptability and preferences for an SMS intervention incorporating these features. In Study #2, the candidate will test the feasibility of a user-informed SMS intervention over a 12-week period with 40 young adults identified in the ED with hazardous drinking. Assessments will be completed at baseline, through EMA reports and at week 12 via a web-based follow-up. Primary outcomes include fidelity to EMA (including intra-drinking dialogue) over 12 weekends and end-of-study ratings of program usability. In Study #3, the candidate will conduct a 3-arm RCT with 90 young adults identified in the ED with hazardous drinking to compare estimates of efficacy of an SMS intervention incorporating pre-, intra-and post- drinking support dialogue to an SMS intervention incorporating pre-and post-drinking support dialogue (no intra-drinking support) and an SMS assessment control group. Primary outcomes include weekend heavy drinking episodes and average drinks per drinking episode as measured through EMA reports. Additional outcomes will include total drinks per month, alcohol-related consequences, and intervention satisfaction as measured through web-based follow-up assessments. Outcomes will be used to modify the intervention and to prepare for a larger Phase III RCT. The focus of this project fits with the NIAAA's Lifespan perspective on alcohol use. The training proposal and research plan fits with the NIAAA initiatives to reduce college and underage drinking. The ED population we plan to study fits with the NIAAA strategic objectives to focus on reducing health disparities among minority groups and non- student populations.