Web Intervention for Concerned Partners to Prevent Service Member Alcohol Abuse

描述（由申请人提供）：从事酒精滥用的美国军人是一个弱势群体，有很高的未满足的需求。酒精滥用是在滥用和依赖之前出现的问题饮酒的一个阶段，使服务人员的伴侣和家庭面临严重后果的风险。不幸的是，现有的军事报告政策可能会阻止服务人员寻求帮助，因为担心负面的职业后果。服务成员报告鼓励他们的合作伙伴作为最普遍的促进者寻求照顾和个人谁改变他们的饮酒模式最经常引用合作伙伴的支持作为最有帮助的机制，在支持变化。因此，针对服务人员的伴侣采取预防性干预措施，可以成为防止发展成滥用和依赖的重要手段。我们提出了一个为期3年的研究，以适应和试点测试的基于网络的干预（WBI），旨在帮助有关合作伙伴（CP）提供支持，服务成员与酒精滥用和开始开发一个服务成员模块的基础上服务成员的输入。我们将首先采用一种基于证据的干预措施，即社区强化和家庭培训（CRAFT）干预措施，以帮助克服与保密问题和访问相关的障碍。我们的建议有三个具体目标。目标1：开发一个4节网络干预（WBI）原型，并根据15 - 20名CP的反馈进行迭代修订。目标二：对最终WBI（n = 50）与延迟WBI（n = 50）进行随机对照试验，并评估WBI对CP报告的服务人员求助（例如，咨询、自助、初级保健、治疗）和饮酒，以及干预后三个月的CP幸福感和关系满意度。目标3：开始为服务成员开发基于服务成员输入和内容评估的后续WBI模块。我们将探索服务成员的干预偏好，并获得他们对建议的WBI的反馈。我们的项目意义重大，因为它有可能使大量的军人受益，他们可能受到当前OEF/OIF/OND冲突的不成比例的影响，否则他们的饮酒滥用将不会被发现和治疗。它还开发了一种新的预防模式，不依赖于服务成员或合作伙伴参加医院或临床设施获得护理。拟议的研究是创新的，因为没有基于CP的预防性干预措施来解决滥用问题。这项试点研究将为R01试验的开发提供信息，该试验评价了一项针对CP的WBI大型随机研究，并对服务人员进行了后续干预。

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.