Web Intervention for Concerned Partners to Prevent Service Member Alcohol Abuse

描述(由申请者提供)：美国军人酗酒是一个需求高度未得到满足的弱势群体。酒精滥用是问题饮酒的一个阶段，发生在滥用和依赖之前，将服役人员的伴侣和家人置于严重后果的风险中。不幸的是，现有的军事报道政策可能会阻止服役人员寻求帮助，因为他们担心对职业造成负面影响。服务人员报告说，他们的伴侣的鼓励是寻求护理的最普遍的促进者，改变饮酒模式的人最常提到伴侣的支持，认为这是支持改变的最有帮助的机制。因此，以服务人员的伴侣为目标，采取预防性干预措施，可以成为防止滥用和依赖的重要手段。我们提议进行一项为期3年的研究，以适应和试行基于网络的干预(WBI)，旨在帮助相关合作伙伴(CP)向酗酒的服务成员提供支持，并根据服务成员的意见开始开发服务成员模块。我们将首先将一种被称为社区加强和家庭培训(CREAT)干预的循证干预措施应用于网络，以帮助克服与保密问题和访问有关的障碍。我们的建议有三个具体目标。目标1：开发4次基于网络的干预(WBI)原型，并根据15-20个CP的反馈进行迭代修订。目的2：对已完成的WBI(n=50)和延迟的WBI(n=50)进行随机对照预试，评估WBI对CP在干预三个月后关于服务成员求助(如咨询、自助、初级保健、治疗)和饮酒以及CP幸福感和关系满意度的报告的影响。目标3：根据服务成员的输入和内容评估，开始为服务成员开发后续WBI模块。我们将探索服务成员的干预偏好，并获取他们对建议的WBI的反馈。我们的项目意义重大，因为它有可能惠及大批服兵役人员，他们可能受到当前OEF/OIF/OND冲突的不成比例的影响，否则他们滥用饮酒将得不到发现和治疗。它还开发了一种新的预防模式，不依赖服务人员或合作伙伴到医院或临床设施获得护理。这项拟议的研究具有创新性，因为没有针对滥用的基于CP的预防性干预措施。这项先导性研究将为R01试验的发展提供信息，该试验评估对CPS的WBI进行更大规模的随机研究，并对服役人员进行后续干预。

DESCRIPTION (provided by applicant): U.S. military service members engaged in alcohol misuse are a vulnerable population with high unmet need. Alcohol misuse is a stage of problem drinking that occurs before abuse and dependence, placing service members' partners and families at risk for serious consequences. Unfortunately, existing military reporting policies may discourage service members from seeking help for fear of negative career consequences. Service members report encouragement from their partners as the most prevalent facilitator of seeking care and individuals who change their drinking patterns most often cite partner support as the most helpful mechanism in supporting change. Thus, targeting service members' partners using preventive interventions can be an important vehicle for preventing the progression to abuse and dependence. We propose a 3-year study to adapt and pilot-test a web-based intervention (WBI) intended to help concerned partners (CPs) provide support to service members with alcohol misuse and to begin development of a service member module based on service member's input. We will first adapt an evidence-based intervention known as Community Reinforcement and Family Training (CRAFT) intervention to the web to help overcome barriers related to confidentiality concerns and access. Our proposal has three specific aims. Aim 1: Develop a 4-session web- based intervention (WBI) prototype and make iterative revisions based on feedback from 15-20 CPs. Aim 2: Conduct a randomized controlled pilot-test of the finalized WBI (n=50) compared to delayed WBI (n=50), and evaluate the impact of the WBI on CP's reports of service member help-seeking (e.g., counseling, self-help, primary care, treatment) and drinking, and CP well-being and relationship satisfaction three months after the intervention. Aim 3: Begin development of a follow-on WBI module for service members based on service member input and content evaluation. We will explore the service member's intervention preferences and obtain their feedback on a proposed WBI for them. Our project is significant because it has the potential to benefit a large population of military service members who may be disproportionately affected by the current OEF/OIF/OND conflicts and whose drinking misuse would otherwise go undetected and untreated. It also develops a new prevention model that does not rely on service members or partners attending a hospital or clinical facility to access care. The proposed study is innovative because there are no CP-based preventive interventions addressing misuse. This pilot study will inform the development of an R01 trial that evaluates a larger randomized study of a WBI for CPs with a follow-on intervention for service members.