Technology-Supported Physical Activity Intervention for Depressed Alcoholic Women

 描述（由申请人提供）：酒精使用障碍（AUD）是美国第三大可预防的死亡原因，并与重大经济负担和健康相关的负面后果相关。虽然女性可能不太可能发展AUDs，但她们比男性经历更多的酒精使用的负面健康后果。由于耻辱，羞耻和儿童保育问题;妇女不太可能接受专业成瘾治疗。抑郁症和AUD的共病率在女性中要高得多，与男性相比，女性抑郁症通常在AUD之前暂时发作。男性和女性的复发率都很高，但复发的预测因素存在显著的性别差异。女性更容易陷入不愉快的、消极的情绪状态和抑郁症状，消极情绪介导了这些压力源和饮酒结果之间的关系。与男性相比，患有AUD的女性报告说，饮酒是为了应对负面情绪。因此，帮助女性制定替代应对策略的干预方法可以在减少患有AUD的抑郁女性酒精复发方面发挥重要作用。考虑到运动对减少抑郁，负面影响和饮酒冲动的好处，帮助女性参与灵活和可接受的生活方式体育活动（LPA）干预可能会为他们提供一种工具，他们可以利用“当下”来应对复发风险最高的早期恢复期间的负面情绪状态和酒精渴望。令人兴奋的新数字健身技术（例如，具有网络和移动的应用的Fitbit活动监测器）近年来已经出现，其包括能够进一步增强用于增加身体活动的关键组件的特征-目标设定和自我监测。我们建议为酒精治疗中的抑郁症女性开发为期12周的LPA + Fitbit干预。这将包括：1）一个面对面的身体活动（PA）咨询定向会议2）4个简短的，基于电话的PA咨询会议，重点是增加PA和战略性地使用PA来应对影响和酒精渴望; 3）使用Fitbit健身跟踪器进行身体活动目标设定和日常自我监测;和4）每周通过电子邮件提供支持信息。本申请的总体目标是开发此LPA + Fitbit干预，根据初始开放试验（n = 20）和反馈进行修改，以确保其可行性 和可接受性的抑郁症妇女与AUDs在早期恢复，提出潜在的机制，并获得其疗效的初步数据，在一个小的随机临床试验（n = 50）。本申请中提出的LPA + Fitbit干预简单、成本低，并且易于运输到接受治疗的AUD女性的各种临床环境中。如果患有AUD的女性发现LPA + Fitbit干预在早期恢复期间是可行的，可接受的和有帮助的，那么他们可以获得急需的替代应对策略，这将降低复发风险并减少酒精使用对其健康和福祉的整体负面影响。

 DESCRIPTION (provided by applicant): Alcohol use disorders (AUDs) are the 3rd leading preventable cause of death in the U.S. and are associated with significant economic burden and health-related negative consequences. While women may be less likely to develop AUDs, they experience more significant negative health consequences of alcohol use than men. Due to stigma, shame, and child care issues; women are less likely to receive specialty addiction treatment. The comorbidity of depression and AUDs is much higher in women, and compared to men, women depression often has a temporal onset prior to an AUD. Relapse rates are very high in both men and women but significant gender differences emerge in the predictors of relapse. Women are more likely to relapse in unpleasant, negative emotional states and depressive symptoms and negative affect mediate the relationship between these stressors and drinking outcomes. More so than men, women with AUDs report drinking to cope with negative emotions. Therefore, intervention approaches that help women develop alternate coping strategies can have an important role in decreasing alcohol relapse among depressed women with AUDs. Given the demonstrated benefits of exercise for decreasing depression, negative affect, and urges to drink, helping women engage in a flexible and acceptable lifestyle physical activity (LPA) intervention may provide them a tool they can utilizing "in the moment" to cope with negative emotional states and alcohol craving during early recovery when relapse risk is highest. Exciting new digital fitness technologies (e.g., Fitbit activity monitor with web and mobile applications) have emerged in recent years that include features able to further enhance critical components for increasing physical activity - goal setting and self-monitoring. We propose to develop a 12-week LPA+Fitbit intervention for depressed women in alcohol treatment. This will include: 1) an in-person physical activity (PA) counseling orientation session 2) 4 brief, phone-based PA counseling sessions focused on increasing PA and strategically using bouts of PA to cope with affect and alcohol cravings; 3) use of the Fitbit fitness tracker fo physical activity goal-setting and daily self-monitoring; and 4) weekly supportive messages delivered by email. The overall objective of this application is to develop this LPA+Fitbit intervention, modify it based on a initial open pilot (n=20) and feedback to ensure its feasibility and acceptability for depressed women with AUDs in early recovery, propose potential mechanisms, and to obtain preliminary data on its efficacy in a small randomized clinical trial (n=50). The LPA+Fitbit intervention proposed in this application is simple, low-cost, and easily transportable to the varied clinical settings women with AUDs receive treatment. If women with AUDs find the LPA+Fitbit intervention feasible, acceptable, and helpful during early recovery, they could be afforded with a much needed alternate coping strategy that would reduce relapse risk and decrease the overall negative impact of alcohol use on their health and well-being.