Cross-Tailoring Integrative Alcohol and Risky Sex Feedback for College Students: A Hybrid Type 1 Effectiveness-Implementation Trial

项目摘要/摘要 酗酒和相关的危险性行为(RSB)是大学生中重大的公共健康问题 学生们。三分之二的学生是现在的饮酒者，至少三分之一的学生在过去的一个月里酗酒(5+饮酒 )，十分之一的人报告高强度饮酒(连续饮酒10多次)。学生饮酒量增加 而在某一天大量饮酒与性行为增加和RSB有关(例如，无保护措施的性行为， 计划外的勾搭)。这会使学生面临负面健康后果(例如，性传播感染)的风险，并是一种 性侵害和酗酒升级。大学的头几周，或者说红区，呈现出一个关键的 对酒精使用升级和相关风险进行干预的机会之窗，这可能导致 具有较高的公共卫生和临床影响力。然而，大学生个体层面的预防策略倾向于 更广泛地关注学生的饮酒模式和后果，很少或根本没有整合内容 关于酒精使用和RSB之间的关系，这是文献中的一个重要空白，也是NIAAA的一个优先领域。 我们的团队此前确定了个性化反馈干预(PFI)的短期疗效，这是一种 标准干预方法，综合了酒精和RSB的内容。我们建议延长我们的 集成的PFI包括交叉定制的动态反馈(CDF)组件，该组件利用技术来 整合对学生行为的每日评估，并为用户提供超过12周的动态反馈 几周的时间来扩大综合PFI的有效性，并在大学校园轻松实施。这个 项目利用多站点、混合类型1有效性-实施研究设计来(1)评估 针对高危大学一年级学生的CDF和(2)确定其成功的关键实施因素，以促进 未来在园区环境中进行扩展。第一个目标是进行多层次的利益相关者参与的适应 通过发展和纳入CDF，整合酒精和危险性行为的PFI。第二个目标是 进行强化干预(PFI+CDF)的随机对照试验(RCT)，样本为600人。 报告最近酗酒和性行为活跃的一年级大学生。我们的主要假设是 接受PFI+CDF干预的参与者将报告更少的酒精使用，更少的危险性行为，以及 与那些在以下时间接受补充了通用健康信息的PFI的人相比，后果更少- 上升(1、2、3、6和13个月)。我们的第三个目标是确定对实施PFI+CDF至关重要的因素 通过与来自RCT的一部分学生以及与当地和 国家系统层面的利益攸关方。这种干预具有广泛传播和传播的强大潜力 目标人群是酗酒和RSB的高危人群。

PROJECT SUMMARY/ABSTRACT Alcohol misuse and related risky sexual behavior (RSB) are significant public health concerns among college students. Two-thirds of students are current drinkers, at least 1 in 3 report past month binge drinking (5+ drinks in a row), and 1 in 10 report high intensity drinking (10+ drinks in a row). Greater student alcohol consumption and heavy drinking on a given day is linked to increased sexual activity and RSB (e.g., unprotected sex, unplanned hook-ups). This puts students at risk for negative health outcomes (e.g., STIs) and is a pathway to sexual victimization and escalated drinking. The first few weeks of college, or the ‘red zone,’ present a critical window of opportunity to intervene for escalated alcohol use and associated risks, which can result in a potentially high public health and clinical impact. However, individual-level prevention strategies for college students tend to focus on students’ alcohol use patterns and consequences more broadly, with little to no integration of content on the relationship between alcohol use and RSB, an important gap in the literature and a priority area for NIAAA. Our team previously established the short-term efficacy of a personalized feedback intervention (PFI), a gold standard intervention approach, with integrated content on alcohol and RSB. We propose to extend our integrated PFI to include a cross-tailored dynamic feedback (CDF) component, which leverages technology to incorporate daily assessments of student behavior and provide users with dynamic weekly feedback over 12 weeks to amplify the effectiveness of the integrated PFI and to be easily implemented on college campuses. The project utilizes a multisite, hybrid type 1 effectiveness-implementation study design to (1) evaluate the impact of CDF for at-risk first-year college students and (2) identify implementation factors critical to its success to facilitate future scale-up in campus settings. The first aim is to conduct a multi-level stakeholder-engaged adaptation of the integrated alcohol and risky sex PFI through the development and inclusion of CDF. The second aim is to conduct a randomized controlled trial (RCT) of the enhanced intervention (PFI+CDF) in a sample of 600 first- year college students who report recent binge drinking and are sexually active. Our primary hypothesis is that participants who receive the PFI+CDF intervention will report less alcohol use, fewer risky sexual behaviors, and fewer consequences relative to those who receive a PFI supplemented with generic health information at follow- up (1, 2, 3, 6, and 13 months). Our third aim seeks to identify factors critical to PFI+CDF implementation in campus settings through conducting focus groups with a subset of students from the RCT and with local and national systems-level stakeholders. The intervention has strong potential for widespread dissemination and targets a group at high risk for alcohol misuse and RSB.