Daily personalized drinking feedback delivered via mobile phone

项目总结 许多年轻人酗酒，继而经历负面后果(例如，严重伤害， 服药过量)。虽然个性化反馈干预(PFI)在大学生中显示出希望，但非 大学生年轻人经常被排除在研究之外，影响的规模往往是小到中等，收获却不是 通常保持不变，需要改进参与度和潜在的覆盖范围。移动技术 可以被利用来提供干预，但许多mHealth平台没有理论基础或严格的 开发和测试。初步研究表明，饮酒后的第二天早晨可能代表着一种“可教的” 时刻“还没有被用于减少危害。我们建议对饮酒后的早晨进行检查，作为最佳选择 是时候提供重复的、个性化的反馈，以减少危险饮酒的目标。具体来说，我们 将进一步开发和中试一种新的以理论为基础的针对酗酒年轻人的PFI。创新包括 在接近饮酒的时间内以移动方式提供多剂量反馈；反馈的选择；反馈 通过对最近关键饮酒事件的日常移动评估获得信息；并使用个性化和动态目标 引导行为改变的设置。符合跨理论模式的原则(例如，开发 差异)，干预策略包括个性化反馈(例如，前夜血液酒精浓度， 结果)与基线设定的饮酒目标和纠正的规范反馈(例如，如何 昨晚的饮酒量与同龄人相比)。我们有关于这种干预的有希望的初步数据；然而，之前 试点参与者仅包括大学生。此外，他们还获得了遵守每日调查的报酬 这为他们的反馈提供了信息，但在没有金钱奖励的情况下参与是可扩展性的关键。在……里面 在拟议的研究中，我们将纳入终端用户关于如何增加参与度和操纵的反馈 支付，以确定与更具可伸缩性(即，无偿)的每日PFI的参与度。第一，精炼版 我们每天流动PFI的一部分将在一项公开试验中提供给20名酗酒的年轻人(50%非大学毕业生)。 经过四周的日常干预后，参与者将返回进行个人面谈，以了解进一步的改进 干预内容。最后，132名参与者(50%非大学毕业生)将被随机分为三组： 对日常调查有货币激励的PFI，没有货币激励的PFI，或仅进行调查评估。我们 将检查招聘率、保留率、干预内容交付/接收的确认、响应 每日调查的比率、数据质量和干预价值评级。我们将测试这些指标是否 在那些接受和不接受每日调查的金钱激励的人之间，参与度不同。此外， 基线、测试后和3个月的跟踪评估将使我们能够估计PFI与对照的效果大小 每周饮酒量、大量饮酒频率和负面后果的差异。评选结果 拟议的研究将产生一种新颖的、可扩展的年轻人酒精滥用干预措施， 有可能对高风险饮酒的公共健康问题产生重要影响。

PROJECT SUMMARY Many young adults engage in heavy drinking and in turn experience negative consequences (e.g., severe injury, overdose). While personalized feedback interventions (PFIs) show promise among college students, non- college young adults are often excluded from research, effect sizes tend to be small to medium, gains are not usually maintained, and improvements in engagement and potential for reach are needed. Mobile technology can be harnessed to deliver intervention, but many mHealth platforms are not theoretically based or rigorously developed and tested. Preliminary work suggests that the morning after drinking may represent a “teachable moment” not yet exploited for harm reduction. We propose to examine mornings after drinking as an optimal time to provide repeated, personalized feedback with the goal of reducing hazardous drinking. Specifically, we will further develop and pilot test a novel theory-based PFI for heavy drinking young adults. Innovations include mobile delivery of feedback in multiple doses that occur close in time to drinking; choice of feedback; feedback informed by daily, mobile assessment of recent key drinking events; and use of personalized and dynamic goal setting to guide behavior change. In line with principles of the transtheoretical model (e.g., developing discrepancy), intervention strategies include personalized feedback (e.g., prior night blood alcohol concentration, consequences) contrasted with both drinking goals set at baseline and corrective normative feedback (e.g., how last night’s drinking compares to peers). We have promising preliminary data on this intervention; however, prior pilot participants included only college students. Further, they were paid for compliance with the daily surveys that informed their feedback, but engagement in the absence of monetary reward is essential to scalability. In the proposed study, we will incorporate end-user feedback on ways to increase engagement, and manipulate payment in order to determine engagement with a more scalable (i.e., unpaid) daily PFI. First, a refined version of our mobile daily PFI will be delivered in an open trial to 20 heavy drinking young adults (50% non-college). After four weeks of daily intervention, participants will return for individual interviews to inform further refinement of the intervention content. Finally, 132 participants (50% non-college) will be randomized to one of three groups: PFI with monetary incentives for daily surveys, PFI without monetary incentives, or survey assessment only. We will examine recruitment rates, retention rates, confirmation of intervention content delivery/intake, response rates to daily surveys, data quality, and ratings of intervention value. We will test whether these indicators of engagement differ between those who do and do not receive monetary incentives for daily surveys. Further, baseline, post-test, and 3-month follow-up assessments will allow us to estimate effect sizes for PFI vs control differences in drinks per week, frequency of heavy drinking, and negative consequences. The results of the proposed research will result in a novel and scalable intervention for alcohol misuse among young adults, with potential to have an important impact on the public health problem of high-risk drinking.