Pilot test of an mHealth Intervention for Reducing Alcohol Use among Rural Adolescent and Young Adult Cancer Survivors

摘要 青少年和青壮年(Aya)癌症幸存者比他们的同龄人健康状况更差 被诊断为癌症的人更有可能死于与癌症无关的原因。研究人员呼吁 健康促进干预，以改善结果并减少该人群中的危险行为； 然而，一个关键的风险因素--饮酒--在很大程度上还没有得到研究。大多数阿雅幸存者都是 目前饮酒者，超过三分之一的报告参与了狂欢饮酒。生活在农村地区的幸存者可能会扯平 风险更大，因为他们获得保健和心理护理的机会有限，而且这些地区的许多青年 报告称，他们比城市同龄人更频繁地饮酒。鉴于酒精的使用与 随着癌症复发风险的增加、存活率的降低和其他并发症的出现，探索 减少农村阿亚幸存者这种行为的干预措施。这项拟议的研究将测试一款手机 减少酒精使用的健康(MHealth)干预，称为TRAC：跟踪和减少酒精 消费。这项干预措施目前正在一批与艾滋病相关的患者中实施 艾滋病毒/艾滋病，是基于激励性访谈原则。它利用每周的电话交谈，与 为期8周的干预者，每天两次使用移动设备自我监控酒精消费 调查和蓝牙呼吸测定仪。这项干预措施有很强的潜力让农村地区的农民协会接受 鉴于这些人口的高数字素养，还将减少农村地区的人在护理方面的障碍 他们经常要长途跋涉才能亲自去看供应商。通过关键线人的采访， 核心预算资源调拨目标的干预措施将针对农村的阿亚幸存者进行调整和完善。然后，它将通过飞行员进行测试 随机对照试验，设监测教育对照组。这项试点试验将评估 干预保留率、依从性和可接受性，并提供有关对酒精影响的初步数据 使用。总体而言，拟议的研究将产生有价值的可行性数据，为最终的随机 对这一干预措施进行对照试验，以在更大样本的农村阿亚幸存者中测试疗效。如果TRAC是 在这一人群中被证明是成功的，它可以在全国各地的农村癌症诊所实施 并在美国200多万年鉴中减少高风险的酒精消费。

ABSTRACT Adolescent and young adult (AYA) survivors of cancer have poorer health than their peers who have not been diagnosed with cancer and are more likely to die from non-cancer related causes. Researchers have called for health promotion interventions to improve outcomes and reduce risk behaviors among this population; however, one key risk factor—alcohol consumption—has been largely unstudied. Most AYA survivors are current drinkers, and over a third report engaging in binge drinking. Survivors living in rural areas may be even more at risk, as they have limited access to health and psychological care and many youth in these areas report more frequent alcohol consumption than their urban counterparts. Given that alcohol use is associated with increased risk of cancer recurrence, poorer survival, and other comorbidities, it is important to explore interventions for reducing this behavior among rural AYA survivors. The proposed research will test a mobile health (mHealth) intervention for reducing alcohol use, called TRAC: Tracking and Reducing Alcohol Consumption. This intervention, which is currently being implemented among a sample of people living with HIV/AIDS, is based on principles of motivational interviewing. It utilizes weekly phone conversations with an interventionist over an 8-week period and twice-daily self-monitoring of alcohol consumption using mobile surveys and Bluetooth breathalyzers. The intervention has strong potential for acceptability among rural AYAs given this populations’ high digital literacy, and will also reduce barriers to care experienced by those in rural areas, who often have to travel long distances to see providers in-person. Through key informant interviews, the TRAC intervention will be adapted and refined for rural AYA survivors. Then, it will be tested through a pilot randomized controlled trial with a monitoring and education comparison group. This pilot trial will assess intervention retention, adherence, and acceptability, and provide preliminary data regarding impact on alcohol use. Overall, the proposed research will yield valuable feasibility data to inform a definitive randomized controlled trial of this intervention to test efficacy among a larger sample of rural AYA survivors. If TRAC is shown to be successful in this population, it could be implemented in rural cancer clinics across the country and reduce risky alcohol consumption among the over 2 million AYAs in the United States.