A social media intervention for high-intensity drinking in a national sample of emerging adults

项目摘要 防止高强度饮酒(HID；女性饮用8+标准饮品，男性10+标准饮品) 新兴成年人(EA)是一个重要的公共卫生问题；HID增加了短期风险(例如， 伤害)和饮酒的长期后果。在发展方面，EAS报告的发病率最高 酗酒和误用。约11%的EA报告超过两周的HID，三分之一的酗酒者(5+ 饮酒)报告在过去两周内隐藏，七分之一的高中生遵循持续的隐藏模式 即将进入成年期。HID增加了停电的风险，可能导致进一步的健康后果，如 就像受伤一样。虽然有一些有希望的干预措施可以减少EAs的酒精消费，但干预措施 影响的规模通常不大，不会随着时间的推移产生持续的影响，到目前为止干预措施还没有 具体解决了HID，这可能不太可能因之前的干预而改变。引人入胜 使用社交媒体(SM)现在是经常使用私人移动消息应用程序的EA的日常规范，例如 约80%的EA使用Snapchat。25岁以下的用户每天在Snapchat上花费的时间M=40分钟。这些高水平的 与SM内容的接触提供了一个动态平台，让EA参与干预，从而提供访问 与传统干预相比，同行式的健康教练在日常生活中隐藏的问题更接近实时。 拟议研究的具体目标是：1)反复开发和集中测试由同伴促成的8周 以SM为基础的EAS HID干预，以及2)测试干预的初步效果。 关于HID和酒精后果的控制条件。我们将迭代地开发一个对等促进的私有SM 通过Snapchat提供消息传递干预。与之前的工作一样，我们将首先开发吸引人的、用户- 通过与EA和国家众包的参与式方法生成内容，然后进行迭代 对全国招募的患有HID的EA参与者进行焦点测试。这种干预将把同伴作为健康的杠杆。 教练以促进融洽和联系(这是可扩展的，因为有机会在卫生领域的学生培训) 并将重点放在“为什么，如何”的激励性采访模式，以及针对“为什么”的内容进行量身定做 改变(例如，引出改变的理由、审查负面后果、关于HID的规范反馈等) 以及“如何”改变(例如，获得保护性战略的好处、解决预期和动机问题、使用 动机、目标设定等的认知行为应对策略)。我们将测试已开发的干预措施 过去一个月100名18-25岁EAS的试点随机对照试验 藏起来了。结果将在2个月的测试后和4个月的跟踪(基线后)进行测量。这个 开发一种可适应的、可扩展的和有效的干预措施是为EAS中的HID量身定做的关键步骤 在公共卫生工作中对高风险饮酒和相关后果的关注。这项研究可能会产生重大影响 通过改变EAs之间的HID轨迹，防止健康和社会后果以及发展 酒精使用障碍，以及为未来行为健康的SM干预提供信息。

Project Summary Preventing high intensity drinking episodes (HID; consuming 8+ standard drinks for women and 10+ for men) among emerging adults (EAs) is an important public health concern; HID increases risk for both short (e.g., injury) and long-term consequences of alcohol use. Developmentally, EAs report the highest prevalence of alcohol use and misuse. Approximately 11% of EAs report past 2-week HID, 1/3 of those who binge drink (5+ drinks) report HID in the past 2 weeks, and 1 in 7 high school seniors follow a sustained HID pattern through emerging adulthood. HID increases risk for blackouts, potentially leading to further health consequences such as injury. Although there are promising interventions that reduce alcohol consumption among EAs, intervention effects are typically modest in size without sustained effects over time, and interventions to date have not addressed HID specifically, which may be less likely to change as a result of previous interventions. Engaging with social media (SM) is now a daily norm for EAs with regular use of private mobile-messaging apps like Snapchat among ~80% of EAs. Users under age 25 spend an M=40min/day on Snapchat. These high levels of engagement with SM content provide a dynamic platform to engage EAs in interventions providing access to peer-like health coaches to address HID in their daily lives closer to in real-time than traditional interventions. The specific aims of the proposed study are to: 1) iteratively develop and focus test a peer-facilitated 8-week SM-based intervention for HID among EAs, and 2) test the preliminary efficacy of the intervention versus a control condition on HID and alcohol consequences. We will iteratively develop a peer-facilitated private SM messaging intervention delivered via Snapchat. As in prior work, we will initially develop engaging, user- generated content via a participatory approach with EAs and national crowdsourcing, followed by iterative focus testing with nationally recruited EA participants with HID. The intervention will leverage peers as health coaches to promote rapport and connection (which is scalable given access to student trainees in health fields) and will focus on the “Why, How” model of motivational interviewing with tailoring of content addressing “why” change (e.g., elicit reasons for change, review of negative consequences, normative feedback on HID, etc.) and “how” change (e.g., elicit benefits of protective strategies, addressing expectancies and motives, use of cognitive behavioral coping strategies for motives, goal setting, etc.). We will test the developed intervention in a pilot randomized controlled trial versus a control condition among 100 18-25 year-old EAs with past-month HID. Outcomes will be measured at a 2-month post-test and 4-month follow-up (post-baseline). The development of an adaptable, scalable and efficacious intervention tailored for HID among EAs is a critical step in public health efforts to high-risk drinking and related consequences. This study could have significant impact by altering HID trajectories among EAs, preventing health and social consequences and the development of alcohol use disorders, as well as informing future SM interventions for behavioral health.