Behavioral Mechanism Mediating Enhanced Online Intervention for College Drinkers

描述（由申请人提供）：大学生群体中的酒精使用既普遍又有问题。频繁饮酒会带来许多负面后果，从轻微（如宿醉、缺课）到严重（如酒后驾车、袭击、死亡）4,5。针对大学生酒精使用的流行在线干预减少了酒精消费和相关问题6,7。然而，在线干预不如面对面干预有效。拟议的项目将在随机对照试验中使用电子邮件助推器，以努力提高现有的、流行的、免费的在线干预措施——酒精101 PlusTM9的功效，同时保持低成本和易于传播。助推器已成功用于在紧急医疗环境中寻求伤害治疗的酒精使用干预措施10,11,12。尽管取得了这些成功，但之前的研究并没有支持对大学生酒精干预的增强效果。本项目旨在通过改进促进剂的设计，开发和评估促进剂对广泛使用的大学生酒精干预的有效性。具体来说，本项目将通过提供方便的电子邮件访问来改善助推器，以尽量减少负担；提供简洁、个性化的反馈；并提供保护行为策略（PBS）的提醒。美国公共广播公司一直预测，与酒精有关的问题会减少1,14,15,16。拟议的研究将严格审查这个问题，包括PBS使用的可操纵性。在线干预包括PBS作为教育的一个组成部分，并提出了专门针对这些行为的助推器。目标1：通过增加个性化的随访助推器，提高易于传播的计算机化干预的效果，其中效果可以通过减少饮酒和相关问题来证明。目标2：通过使用这些个性化的后续助推器，延长减少饮酒和相关问题的持续时间。目的3：检查保护行为策略强调的干预作为中介行为机制的变化。实验方案：对参与者进行关键构念评估，然后随机选择是否接受干预。为了测试添加助推器的有效性，随机分配到酒精干预助推器组的参与者将在干预后4周收到电子邮件，并根据他们在干预后报告的酒精摄入量量身定制反馈。参与者最初将每两周接受一次评估，然后每三个月一次，直到九个月。意义：这项拟议的研究将是启动程序化研究路线的关键第一步，以适应现有的在线干预措施，并开发包括PBS作为主要项目组成部分的未来干预措施。这项研究的结果将用于确定修改方案或助推器的影响。这些将推动本研究项目后续研究的假设。

DESCRIPTION (provided by applicant): Alcohol use within the college student population is both widespread and problematic1,2,3. There are many negative consequences associated with frequent alcohol use, ranging from mild (e.g., hangovers, missed classes) to severe (e.g., DUIs, assault, death)4,5. Popular online interventions targeting alcohol use among college students reduce alcohol consumption and associated problems6,7. However, online interventions are not as efficacious as face-to-face interventions8. The proposed project will employ emailed boosters in a randomized, controlled trial in an effort to improve the efficacy an existing, popular, free online intervention, Alcohol 101 PlusTM9, while at the same time maintaining low cost and easy dissemination. Boosters have been used successfully for alcohol use interventions among those seeking injury treatment in emergency medical settings10,11,12. Despite these successes, prior research has not supported booster efficacy for college student alcohol interventions6,13. The proposed project seeks to develop and evaluate the effectiveness of boosters for a widely-used college student alcohol intervention by improving on the design of boosters. Specifically, the present project will improve boosters by providing easy access via email to minimize burden; providing succinct, personalized feedback; and providing reminders of protective behavioral strategies (PBS). PBS have consistently predicted reductions in alcohol-related problems1,14,15,16. The proposed study will critically examine the issue, including the manipulability of PBS use. The online intervention includes PBS as one component of education, and proposed boosters target these behaviors specifically. The proposed research will address the following specific aims: Aim 1: Improve the efficacy of an easily-disseminated computerized intervention by adding personalized follow-up boosters, where efficacy is evidenced by reduced drinking and related problems. Aim 2: Extend the duration of the reduction in drinking and associated problems through the use of these personalized follow-up boosters. Aim 3: Examine protective behavioral strategies highlighted by the intervention as mediating behavioral mechanisms of change. Experimental Protocols: Participants will be assessed on key constructs, then will be randomized to receive the intervention or not. To test the effectiveness of adding boosters, participants randomized to alcohol intervention boosters will receive emails 4 weeks after the intervention with tailored feedback based upon their reported alcohol consumption after the intervention. Participants will initially be assessed biweekly, then every three months up to nine months. Significance: The proposed study will be a critical first step in launching a programmatic line of research to adapt existing online interventions and develop future interventions that include PBS as a major program component. The findings from this study will be used to identify implications for modifying the protocol or booster. These will drive the hypotheses for subsequent studies in this program of research. PUBLIC HEALTH RELEVANCE: The goal of the proposed research is to examine whether an innovative booster can strengthen and extend the effects of a computerized intervention targeting college drinking. The booster is low-cost and easy to disseminate, thus implementable on a large scale. Consequently, the public health impact may be far-reaching.