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

摘要 这个K23指导的以病人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，在行为的行为， 干预研究，以减少年轻人的酒精使用和酒精相关的后果， 到急诊科（艾德）接受治疗。在这5年的奖励中，重点培训将 致力于获得专业知识：1）酒精使用和行为改变的心理学理论; 2） 行为干预，以防止危险的酒精使用; 3）计算机化的方法，以提供 行为干预; 4）混合方法分析。候选人将进行三项研究 在获奖过程中，应用这些获得的技能，并优化互动， 电脑化，短信（SMS）传递，行为干预，以防止危险的酒精 在年轻人中使用。这种干预建立在候选人的经验发展和 测试SMS提供的行为干预措施，并结合策略，以提高年轻人的 在计划饮酒场合之前设定饮酒限制的动机， 饮酒事件，并在饮酒事件发生后的第二天帮助反思。沟通将在 每周周四至周日，将根据基线数据量身定制，并适应生态 酒精认知和使用模式的瞬时评估（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讨论，以确定可接受性， 结合这些特征的SMS干预的偏好。在研究#2中，候选人将测试 在40名年轻人中进行为期12周的用户知情短信干预的可行性 在艾德医院被确诊为危险饮酒将通过EMA在基线时完成评估 第12周通过网络随访。主要结局包括对EMA的忠诚度（包括 在12个周末和研究结束时对程序可用性进行评级。在研究#3中， 候选人将对90名在艾德中被确定为危险的年轻人进行一项3组随机对照试验， 饮酒，以比较SMS干预的疗效估计，包括前，内和后， 饮酒支持对话到短信干预，包括饮酒前和饮酒后支持对话 (no内饮酒支持）和SMS评估对照组。主要结果包括周末 重度饮酒事件和每次饮酒事件的平均饮酒量，通过EMA报告测量。 其他结果将包括每月总饮酒量，酒精相关后果和干预 通过基于网络的后续评估衡量满意度。结果将用于修改 并为更大规模的III期RCT做准备。该项目的重点符合NIAAA的 对酒精使用的寿命观点。培训方案和研究计划符合NIAAA的要求 减少大学和未成年人饮酒的举措。我们计划研究的艾德人群符合 NIAAA的战略目标是重点减少少数群体和非少数群体之间的健康差距。 学生群体。

Abstract 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.