Applying Construal Level Theory to Develop and Test an Interactive Text Messaging Adjunct Intervention to Reduce Heavy Drinking and HIV Risk

项目总结/摘要 大量饮酒在与男性发生性关系的年轻成年男性中很常见，这增加了 有感染艾滋病风险的性行为。短信这种无处不在的技术开始成为 用于解决酒精/艾滋病毒的风险，但需要更多的理论为基础的工作，严格开发和测试 短信内容来优化行为改变。因此，在本MOSAIC K99/R 00中，申请人将在 K99阶段，开发和完善，然后，在R 00阶段，测试交互式短信的功效 利用控制水平理论（CL T）确定干预目标，以减少大量饮酒和艾滋病毒风险。 先前的证据和理论都为这一提议提供了依据。具体来说，CL T建议个人可以考虑 行为或行为改变（例如，喝得少）抽象（例如，为什么这个人想喝得少）或具体地说 (e.g.,如何限制自己的饮酒量）。干预和实验操作的基础上， CL T使用为什么/如何范式向参与者询问一系列为什么/如何问题，旨在诱导抽象或 具体的思考。有证据表明，抽象思维可能会增强改变的动力。 而具体的思维可能有助于有效地实施行为改变;然而，CL T在很大程度上 被应用于促进减肥和减少吸烟。尽管它的适用性和潜力，CL T还没有 用于酒精和艾滋病研究。在本提案中，申请人寻求开发和测试基于CL T的 为什么/如何短信诱导抽象/具体的思考，分别关于酒精和艾滋病毒的风险， 减少饮酒、危险性行为和饮酒的负面后果。 在K99阶段，申请人将与一个由大量饮酒的年轻男性接触者组成的咨询小组合作， 开发和完善短信协议（目标1; 1-9个月）。然后我们将进行一系列的试点测试 和离职面谈（2轮，n=12名参与者），以反复评估和提高可行性和可接受性 干预（目标2; 10-24个月）。在R 00阶段，受试者（N=240）将首先完成基线 评估和游戏计划-现有的简短酒精/艾滋病毒干预措施，以提高改变的动机， 表现出的承诺。然后将在日水平对受试者进行微随机化（即，每天随机分组） 接受（1）CLT具体信息;（2）CLT抽象信息;（3）控制信息;或（4）无 充分和传播参与者将在每天和干预结束时完成评估。 这些目标符合申请人的目标，即获得以下方面的培训：（1）开发和测试行为 干预（克里斯托弗·卡勒博士）;（2）进行微观随机试验（斯蒂芬妮·戈尔茨坦博士）;（3） 分析密集的纵向数据（詹尼弗梅里尔博士），并促进成功地过渡到独立。 该项目将使申请人能够与一个高度熟练，经验丰富的团队合作，并提供数据， 未来的R 01将在更大范围内测试干预的有效性，并提供关键的理论 关于酒精/艾滋病研究中行为改变的潜在新机制的信息。

Project Summary/Abstract Heavy drinking is common among young adult men who have sex with men (MSM), which increases likelihood of engaging in sexual behaviors with risk for HIV. Text messaging - a ubiquitous technology- is starting to be used to address alcohol/HIV risk, but more theory-based work is needed to rigorously develop and test the content of text messages to optimize behavior change. Thus, in this MOSAIC K99/R00, the applicant will, in the K99 phase, develop and refine, and then, in the R00 phase, test the efficacy of an interactive text messaging program to reduce heavy drinking and HIV risk utilizing construal level theory (CL T) to define intervention targets. Both prior evidence and theory inform this proposal. Specifically, CL T suggests that individuals can think about a behavior or behavior change (e.g., drinking less) abstractly (e.g., why the person wants to drink less) or concretely (e.g., how the person will limit their drinking). Interventions and experimental manipulations based on CL T use the why/how paradigm to ask participants a series of why/how questions intended to induce abstract or concrete thinking, respectively. Evidence suggests that abstract thinking may enhance motivation to change whereas concrete thinking may facilitate effective implementation of behavior change; however, CL T has largely been applied to facilitate weight loss and reduced smoking. Despite its applicability and potential, CL T has yet to be applied to alcohol and HIV research. In this proposal, the applicant seeks to develop and test CL T-based why/how text messages to induce abstract/concrete thinking, respectively, about alcohol and HIV risk and in turn reduce alcohol use, risky sexual behaviors, and negative consequences of drinking, at the day-level. During the K99 phase, the applicant, working with an advisory panel of young adult heavy drinking MSM, will develop and refine the text messaging protocol (Aim 1; months 1-9). We will then conduct a series of pilot tests and exit interviews (2 rounds of n=12 participants) to iteratively assess and improve feasibility and acceptability of the intervention (Aim 2; months 10-24). During the R00 phase, participants (N=240) will first complete baseline assessment and GamePlan - an existing brief alcohol/HIV intervention to enhance motivation to change with demonstrated promise. Participants will then be micro-randomized at the day-level (i.e., randomized every day) for 8 weeks to receive (1) CLT-concrete messages; (2) CLT-abstract messages; (3) control messages; or (4) no messages. Participants will complete assessments daily and at the end of the intervention. These aims are in line with the applicant's goals to acquire training in (1) developing and testing behavioral interventions (Dr. Christopher Kahler); (2) conducting micro-randomized trials (Dr. Stephanie Goldstein), and (3) analyzing intensive longitudinal data (Dr. Jennifer Merrill}, and to facilitate a successful transition to independence. This project will enable the applicant to work with a highly skilled, experienced team, and provide data for a future R01 to test the effectiveness of the intervention on a larger scale, as well as provide critical theoretical information regarding potentially novel mechanisms of behavior change in alcohol/HIV research.