Development of a lifestyle physical activity intervention to reduce risk for perinatal cannabis use

摘要 近年来，产前大麻使用率(CU)急剧上升，这是一个严重的问题，因为与 产妇和婴儿的不良结局。改变CU等潜在不健康行为的动机很高 在许多孕妇中。然而，不幸的是，对这一人群的干预方法是 目前还不够。此外，许多妇女经历精神健康症状(焦虑、抑郁)和 不舒服的怀孕症状(恶心，身体不适)，这些症状对戒烟构成了挑战。 因此，帮助孕妇制定替代应对策略以应对这些问题的干预措施 症状可能在减少或预防怀孕期间和更长时间内的慢性尿毒症方面起到重要作用。 鉴于先前的研究表明，体育锻炼有助于增强对 抑郁/焦虑和怀孕症状，以及对消极情绪和大麻的急性影响 渴望，一种生活方式的体力活动(LPA)干预可能是非常有效的。我们队的R34奖 (R34DA055317-01A1；Battle)是第一个研究LPA干预是否代表 帮助减少怀孕期间的大麻使用和渴望的可行和可接受的战略。建议数 行政补充将允许我们的团队通过检查 LPA干预的潜在作用机制。我们的团队建议将补充资金用于 响应NOT-OD-22-140，将生态瞬时评估(EMA)协议添加到计划的 临床试验，将包括三次为期7天的每日EMA评估，以衡量每日水平 身体活动、母性情感、身体不适以及对大麻的渴望和使用。有了这个 额外的数据收集，其中将包括30名参与者在试点随机试验，我们将能够更多 充分评估研究干预所基于的概念模型。分析得出的结论 作为本补充资料的一部分收集的其他EMA数据将提供有关 女性心理健康与对大麻的渴望之间的关系--以及体育活动是否有帮助 减少负面情绪、身体不适和对大麻的渴望。此外，这些补充数据将 提供关于在这一人群中实施EMA的关键可行性数据，以便为未来的研究提供参考。

ABSTRACT Rates of prenatal cannabis use (CU) have risen sharply in recent years, a serioius concern given associated adverse maternal and infant outcomes. Motivation to change potentially unhealthy behaviors like CU is high among many pregnant women. However, unfortunately, intervention approaches for this population are currently lacking. In addition, many women experience mental health symptoms (anxiety, depression) and uncomfortable pregnancy symptoms (nausea, physical discomfort) that pose challenges to abstaining from CU. Thus, interventions that help pregnant women develop alternate coping strategies to cope with these symptoms may have an important role in decreasing or preventing CU during pregnancy and longer term. Given prior research demonstrating benefits of physical activity to potentiate long-term effects on depression/anxiety and pregnancy symptoms, as well as acute effects on negative affect and cannabis cravings, a lifestyle physical activity (LPA) intervention could be highly impactful. Our team’s R34 award (R34DA055317-01A1; Battle) is the first study to examine whether an LPA intervention could represent a feasible and acceptable strategy to help reduce cannabis use and cravings during pregnancy. The proposed administrative supplement would allow our team to extend the impact of this R34 study by examining the potential mechanisms of action of the LPA intervention. Our team proposes to use supplemental funding in response to NOT-OD-22-140 to add an ecological momentary assessment (EMA) protocol to the planned clinical trial, which would be comprised of three 7-day bursts of daily EMA assessment to measure daily-level physical activity, maternal affect, physical discomfort, as well as cannabis cravings and use. With this additional data collection, which will include 30 participants in the pilot randomized trial, we will be able to more fully evaluate the conceptual model on which the study intervention is based. Findings from the analysis of the additional EMA data collected as part of this supplement will provide valuable information regarding the relationship between women’s mental health and cannabis cravings -- and whether physical activity can help reduce negative affect, physical discomforts and cannabis cravings. In addition, this supplemental data will provide critical feasibility data regarding implementing an EMA with this population to inform future studies.