Developing a mobile-health intervention to reduce problematic alcohol use in young adults with ADHD

项目总结/摘要 博士Traci Kennedy，拟议中的K23的PI，是一位临床科学家，其长期目标是领导一项 研究制定和测试干预措施，以减少易受伤害青年的酗酒问题 特别是患有注意力缺陷/多动障碍（ADHD）的年轻人。酗酒问题 在年轻人（18-25岁）中，艾滋病毒/艾滋病对个人和社会造成严重后果，但大多数人得不到治疗。 ADHD会显著增加风险，并限制现有治疗的有效性。抑制控制是关键 transdiagnosis和modifiable风险因素潜在的ADHD和问题的酒精使用。K23项目 旨在开发和测试一种新型的、可访问的移动健康（mHealth）的可行性和初步疗效。 干预，目标是在瞬间抑制控制，以减少年轻人的问题饮酒， 多动症。短信将促使使用行为策略，以加强抑制控制整个 在高风险的时刻，为了激励行为策略的使用，生态瞬时评估（EMA） ADHD症状和个性化的自适应反馈将提高自我意识的抑制控制缺陷。 目标1是开发可行的和可接受的行为策略提示。首先，将制定战略内容 在一项正在进行的试点研究（研究1a）的年轻成人饮酒者ADHD的子样本（n=10）。下一个是 将在一个新的青年试点样本（n=16）中对战略提示内容和提供时间和频率进行改进 患有多动症的成年人每周喝4+/5+饮料（女性/男性）（即，重度间歇性饮酒者）， 关键利益相关者小组的投入（研究1b）。目的二是研究 在患有ADHD的重度间歇性饮酒者（N=70）中进行干预，其中一半被随机分配到 干预和一半的酒精监测控制条件下3周（研究2）。被动的效用 所感测的智能手机抑制控制指数（例如，屏幕解锁率），以告知未来 个性化。目标3是测试初步干预效果，包括酒精之间的动态交易 使用、抑制控制和生活障碍。这种创新的、可扩展的干预措施满足了以下关键需求： 帮助患有ADHD的年轻人控制有问题的酒精使用。结果将导致未来的充分动力的功效 审判拟议的研究和培训（教学法、会议、导师指导培训）将使PI具备以下能力： 在酒精干预方面开展独立研究事业所需的技能： 饮酒捕获;专注于mHealth的干预科学专业知识;以及对抑制 控制Sarah Pedersen博士（导师），瞬时饮酒过程、EMA和抑制控制方面的专家，以及 博士布鲁克莫利纳（共同导师），在干预科学与多动症和成瘾的重点专家，将指导 私家侦探的训练和研究一个顾问小组将补充培训（统计分析、酒精 移动健康干预措施的制定和评估，以及被动传感）。K23有直接的公共卫生 影响和地址NIAAA优先发展酒精治疗共病条件。

PROJECT SUMMARY/ABSTRACT Dr. Traci Kennedy, PI of the proposed K23, is a clinical scientist whose long-term goal is to lead a program of research on developing and testing interventions to reduce problematic alcohol use among vulnerable young people, especially young adults with Attention Deficit/Hyperactivity Disorder (ADHD). Problematic alcohol use among young adults (ages 18-25) has severe individual and societal consequences, yet most go untreated. ADHD significantly elevates risk and limits the effectiveness of existing treatments. Inhibitory control is a key transdiagnostic and modifiable risk factor underlying both ADHD and problematic alcohol use. This K23 project aims to develop and test the feasibility and preliminary efficacy of a novel, accessible mobile-health (mHealth) intervention that targets in-the-moment inhibitory control to reduce problematic drinking among young adults with ADHD. Text messages will prompt the use of behavioral strategies to enhance inhibitory control throughout the day and in high-risk moments. To motivate behavioral strategy use, ecological momentary assessment (EMA) of ADHD symptoms and personalized, adaptive feedback will boost self-awareness of inhibitory control deficits. Aim 1 is to develop feasible and acceptable behavioral strategy prompts. First, strategy content will be developed in a subsample (n=10) of young adult drinkers with ADHD from an in-progress pilot study (Study 1a). Next, strategy prompt content and delivery timing and frequency will be refined in a new pilot sample (n=16) of young adults with ADHD who consume 4+/5+ drinks/occasion (female/male) weekly (i.e., heavy episodic drinkers) with input from a panel of key stakeholders (Study 1b). Aim 2 is to examine the feasibility and acceptability of the resulting intervention among heavy episodic drinkers (N=70) with ADHD, half randomly assigned to the intervention and half to an alcohol monitoring control condition for 3 weeks (Study 2). The utility of passively sensed smartphone indices of inhibitory control (e.g., screen unlock rate) will be explored to inform future personalization. Aim 3 is to test preliminary intervention effects, including dynamic transactions among alcohol use, inhibitory control, and life impairments. This innovative, scalable intervention addresses a critical need to help young adults with ADHD curb problematic alcohol use. Outcomes will lead to a future fully-powered efficacy trial. The proposed research and training (didactics, conferences, mentor-directed training) will equip the PI with the requisite skills to launch an independent research career in alcohol interventions: competence in momentary drinking capture; expertise in intervention science focused on mHealth; and in-depth knowledge of inhibitory control. Dr. Sarah Pedersen (mentor), expert in momentary drinking processes, EMA, and inhibitory control, and Dr. Brooke Molina (co-mentor), expert in intervention science with emphasis on ADHD and addictions, will guide the PI’s training and research. A team of consultants will complement training (statistical analysis, alcohol mHealth interventions development and evaluation, and passive sensing). This K23 has direct public health implications and addresses NIAAA priorities on developing alcohol treatments for comorbid conditions.