BASICS-ED: A Momentary Intervention for Concurrent Smoking and Heavy Drinking

描述(申请人提供)：大学生大量饮酒(HED)是一个持续存在的公共卫生问题，具有严重的后果，包括发展成物质使用障碍、心理社会问题、健康风险、意外伤害和死亡。美国全国调查数据显示，超过80%的大学生报告在过去一年中饮酒，其中44%的人报告称在过去两周内至少有一次重度饮酒(男性/女性每次5/4杯)。此外，据报道，几乎所有的大学吸烟者都饮酒，而且通常吸烟和HED同时发生。美国一项全国性的调查发现，目前98%的吸烟者饮酒，44%-59%的饮酒者吸烟。此外，在报告饮酒(OR=4.21，p&lt；.0001)、有饮酒问题(OR=3.31，p&lt；.0001)和报告使用饮酒来应对问题(OR=2.19，p&lt；.05)的学生中，共同发生的风险最大。为了更好地了解这些危险行为并确定潜在的干预点，本研究的总体目标是开发针对大学生吸烟者的HED的个性化、计算机化的干预措施。本研究的第一个目的是利用生态瞬时评估(EMA)来更好地理解这些过程。从EMA每日饮酒和吸烟报告中获得的信息将被用来模拟近端对HED的影响的动态。因此，这些模型的结果将确定参与HED的大学生吸烟者的干预点。在这项基础研究之后，我们计划将这些模型转化为干预措施，通过安装在电子设备上的互动程序进行实时管理。这项拟议研究的最终目的将是在一项随机对照试验中评估基于经验的干预的有效性，比较计算机干预和只接受电子评估的控制组在参与HED的大学生吸烟者样本(n=126)中的有效性。更具体地说，计算机化干预将包括成功干预、大学生简短酒精筛查和干预(基础)的组成部分，以及最近为未寻求治疗的大学生吸烟者开发的简短吸烟干预。这项名为BASICS-ED的干预将在电子设备上实时实施。该计划将使用分支算法开发，以便对个人环境中的瞬时变化进行持续评估，以确定模块的选择和排序，提供个性化的基本信息和实时吸烟干预。 与公共健康相关：大量饮酒和吸烟是美国各地大学校园的重大公共健康问题。这项拟议的研究最显著的好处将是开发一种针对大学生同时饮酒和吸烟的干预措施。如果有效，那么该计划可能会在大学生中广泛传播，并有可能减少大学校园内高风险酗酒和吸烟的发生率。

DESCRIPTION (provided by applicant): Heavy episodic drinking (HED) among college students is a persistent public health problem with severe consequences, including development of substance-use disorders, psychosocial problems, health risks, accidental injuries, and death. National US survey data indicate more than 80% of college students report consuming alcohol in the past year, with 44% reporting heavy episodic drinking (HED; 5/4 drinks per occasion for men/women) at least once in the previous 2 weeks. In addition, it has been reported that nearly all college smokers drink alcohol and usually smoking and HED co-occur. One National US survey found 98% of current smokers drank alcohol and 44-59% of drinkers smoked cigarettes. Furthermore, the co-occurrence risk was greatest among students who reported greater alcohol consumption (OR=4.21, p< .0001), having a drinking problem (OR = 3.31, p< .0001), and those who reported using drinking to cope with their problems (OR=2.19, p< .05). In order to achieve a better understanding of these risk behaviors and identify potential points for intervention, the overall aim of the proposed study is to develop an individually-tailored, computerized intervention targeting HED among college student smokers. The first aim of this research is to gain a better understanding of these processes using ecological momentary assessment (EMA). The information obtained from EMA daily reports of drinking and smoking will be used to model the dynamics of proximal influences on HED. The results from these models will thereby identify points of intervention for college student smokers who engage in HED. Following from this basic research, we plan to translate the models into an intervention that would be administered in real-time via an interactive program installed on an electronic device. The final aim of the proposed study will be to evaluate the efficacy of the empirically-based intervention in a randomized controlled trial comparing the computerized intervention to an electronic assessment-only control groups in a sample (n=126) of college student smokers who engage in HED. More specifically, the computerized intervention will incorporate components of the successful intervention, Brief Alcohol Screening and Intervention for College Students (BASICS), as well as a recently developed brief smoking intervention for non- treatment seeking college student smokers. The intervention, BASICS-ED, will be administered in real-time on an electronic device. The program will be developed using branching algorithms, such that ongoing assessment of momentary changes in an individual's environment will determine the selection and ordering of modules, providing individually-tailored BASICS messages and the smoking intervention in real-time. PUBLIC HEALTH RELEVANCE: Heavy episodic drinking and smoking are significant public health problems on college campuses across the United States. The most salient benefit of the proposed research will be the development of an intervention designed to target concurrent drinking and smoking among college students. If effective, then the program could be widely distributed to college students and potentially reduce the incidence of high-risk heavy drinking and smoking on college campuses.