Efficacy and Mechanisms of Technology-Based Behavioral Interventions

 描述(由申请人提供)：大学生饮酒是一个主要的公共卫生问题(NIAAA，2002b)。大规模调查表明，约68%的大学生每月饮酒(Johnston et al.，2006)，40%的大学生有大量间歇性饮酒(NIAAA，2004)。尽管采取了预防/干预措施，但大学生中有问题的饮酒仍然每年导致约1800人死亡和60万人受伤(Hingson，Za和Weitzman，2009)，流行病学研究表明，大学生中的风险没有明显下降(例如，Johnston等人，2006)。建议研究的目的是通过改进传播方法和干预内容来改进现有的大学饮酒干预(具体目标1)。作为方法的改进，移动计算的快速发展使生态瞬时干预(EMIS)变得越来越可行(Heron等人，2012年)。教育管理信息系统指的是可以多次、“在当下”实施的干预措施。EMIS可以优化干预的时机和地点，同时还可以增加干预的剂量。提高干预水平 内容，我们的研究重点是保护行为策略(PBS)，以减少酒精问题，而不仅仅是酒精的使用。PBS是指在饮酒前、饮酒期间和饮酒后立即进行的限制饮酒、酒精中毒和/或与酒精相关的伤害的行为(Pearson，2013)。在多项研究和调查人员中，研究表明，PBS的使用可以保护个人免受酒精问题的影响，而不是它对减少酒精使用的影响(Marten等人，2005、2007、2009、2011；Pearson，Kite&Henson，2012a；Pearson，Kite，&Henson，2012b；Pearson，Kite，&Henson；2013)。这项研究的主要目的是通过使用基于技术的干预方法(即，EMI)来更有效地测试PBS干预对酒精相关后果的影响。参与者将按性别随机进入完全交叉的3(标准BMI，有PBS成分的BMI，对照)×2(基于PBS的EMI，仅生态评估[EMA])设计。我们选择了这6个条件来回答几个关键的研究问题(具体目标2)：a)增加PBS成分是否提高了标准BMI的有效性；b)基于PBS的EMI是否比标准的单次BMI提高了有效性；c)基于动机的干预(BMI)和基于技能的干预(EMI)的结合是否产生了更大的后果减少(即，适度)。这项研究的最终目的是确定行为改变的机制，以优化干预发展。具体地说，我们将研究公共广播服务规范、公共广播服务感知的有效性以及改变公共广播服务使用的动机，作为改进干预措施的新中介。结果可以用来传播更有效的大学饮酒干预措施，这些干预措施在减少酒精问题方面更便宜、更有效，而不仅仅是使用。

 DESCRIPTION (provided by applicant): College student alcohol use is a major public health concern (NIAAA, 2002b). Large scale surveys indicate that approximately 68% of college students drink alcohol every month (Johnston et al., 2006) and 40% of college students engage in heavy episodic drinking (NIAAA, 2004). Despite prevention/intervention efforts, problematic alcohol consumption among college students continues to result in an estimated 1,800 deaths and 600,000 injuries annually (Hingson, Zha, & Weitzman, 2009), and epidemiological studies demonstrate no appreciable decrease in risk among college students (e.g., Johnston et al., 2006). The purpose of the proposed research is to improve extant college-drinking interventions by advancing the dissemination methodology and the intervention content (Specific Aim 1). As a methodological improvement, rapid advances in mobile computing makes ecological momentary interventions (EMIs) increasingly feasible (Heron et al., 2012). EMIs refer to interventions that can be delivered multiple times and "in the moment". EMIs can optimize the timing and location of the intervention while also increasing the dose of the intervention. To improve the intervention content, we focus our research on protective behavioral strategies (PBS) to reduce alcohol problems, not just alcohol use. PBS are behaviors that one can engage in immediately prior to, during, and immediately following alcohol use that limit alcohol use, alcohol intoxication, and/or alcohol-related harm (Pearson, 2013). Across multiple studies and investigators, research suggests that PBS use can protect individuals from alcohol problems above and beyond its effect on reducing alcohol use (Martens et al., 2005, 2007, 2009, 2011; Pearson, Kite, & Henson, 2012a; Pearson, Kite, & Henson, 2012b; Pearson, Kite, & Henson; 2013). The primary purpose of this research is to provide a more powerful test of a PBS intervention's effects on alcohol- related consequences by using a technology-based intervention methodology (i.e., EMI). Participants will be randomized by gender into to a fully crossed, 3 (Standard BMI, BMI with a PBS component, control) X 2 (PBS- based EMI, Ecological Assessment Only [EMA]) design. We selected these 6 conditions to answer several critically important research questions (Specific Aim 2): a) does the addition of a PBS component improve the efficacy of a standard BMI, b) does a PBS-based EMI improve efficacy over the standard, single session BMI, c) does the combination of motivation-based intervention (BMI) with a skills-based intervention (EMI) yield even greater decreases in consequences (i.e., moderation). A final purpose of this research is to identify mechanisms of behavior change to optimize intervention development. Specifically, we will be examining PBS norms, PBS perceived effectiveness, and motivation to change PBS use as novel mediators of the improved interventions. Results can be used to disseminate more effective college drinking interventions that are cheaper and more efficacious at reducing alcohol problems, not just use.