Informing treatment adaptation based on the interplay between behavioral undercontrol and context: an event-level study

项目总结 在美国，未成年人饮酒是一个严重的健康问题，其病因是多方面的，而且范围广泛。 各种影响，包括危险情况(机动车事故、危险性行为和暴力)和酒精 使用障碍(青少年酒精使用障碍的发病率最高)。无论是环境还是 青少年饮酒行为的发展与个体特征有关。在 环境水平、社会、地点和情景背景特征影响青少年的行为模式 喝酒。在个人层面上，对未成年人饮酒最有力的个人预测因素之一是行为。 控制不足(BU；例如冲动、寻求感觉)。成功针对BU差异的干预措施 推迟未成年饮酒者的饮酒时间并减少饮酒量。然而，研究表明， 背景特征和BU的差异对饮酒行为有意义的改变。因此，有一个 有机会调查背景效应如何因性别而不同，并受到BU的调节而产生沉重的影响 在事件层面上的间歇性饮酒；通过进行时间敏感的研究，调查BU如何预测自我 对饮酒环境的选择，以及BU随后如何缓和这些环境的影响。这个K01 题为“在青少年饮酒中使用细粒度背景数据通知治疗适应情况”的提案 建议收集可以为上下文敏感干预提供信息的细粒度数据，方法是通知 在哪里和与谁一起干预，以及适应特定于性别或特定背景的情况。相等的数字 报告至少一次酗酒的男性和女性青少年(N=120，年龄15-17岁) 在过去的两周内，将被招募进行为期17天的生态瞬时评估(EMA)调查 通过一次实验室会议。实验室课程将包括自我报告和行为评估 BU以及环境因素。EMA将包括随机用户提示以及自行发起的提示 评估酒精使用、社交、地点和情景特征的报告，以及 在饮酒前后对BU进行评估。本课题有三个具体的研究目的：1)考察 情境是否中介了BU对青少年饮酒的影响。2)检查BU是否协调角色 在预测青少年饮酒方面的背景。3)研究饮酒如何影响冲动，以及这种影响如何 预测酗酒的后果。通过根据调查结果通知上下文敏感干预措施，我们将 充分利用能够根据具体情况进行提示的技术(“及时”干预)。这个 相关培训计划将为应聘者提供独立进行EMA调查的能力 在青少年中开展活动，并协助确保未来的资金来源，成为活动一级背景下的实质性专家 使用细粒度评估工具的特征和个人特征，并通知治疗适应 以个体差异为基础的干预措施。因此，该项目在多个层面上与NIAAA的 未成年人饮酒研究倡议调查导致青少年有害饮酒的因素。

PROJECT SUMMARY Underage drinking in the United States is a serious health concern, with a multifaceted etiology and wide- ranging implications including risky situations (motor vehicle accidents, risky sex, and violence) and alcohol use disorder (adolescents have the highest rate of alcohol use disorder onset). Both environmental and individual characteristics are implicated in the development of adolescent drinking behavior. At the environmental level, social, locational, and situational context characteristics influence adolescent patterns of drinking. At the individual level, one of the strongest individual predictors of underage drinking is behavioral undercontrol (BU; e.g. impulsivity, sensation seeking). Interventions that target differences in BU successfully delay onset and reduce quantity of alcohol use in underage drinkers. However, research has shown that context characteristics, and differences in BU, meaningfully change drinking behavior. Hence, there is an opportunity to investigate how context effects differ by sex and are moderated by BU to produce heavy episodic drinking at the event level; by conducting time-sensitive research investigating how BU predicts self- selection into drinking contexts, and how BU subsequently moderates the impact of those contexts. This K01 proposal, titled “Informing treatment adaptation using fine-grained context data in adolescent alcohol use” proposes to collect fine-grained data that could inform context-sensitive interventions, by informing when, where, and with whom to intervene, along with adaptation to sex- or context-specific situations. Equal numbers of male and female adolescents (N = 120, ages 15-17 years) who report at least one heavy drinking episode in the past two weeks, will be recruited for a 17-day ecological momentary assessment (EMA) survey preceded by a single laboratory session. The laboratory session will include self-report and behavioral assessments of BU as well as environmental factors. The EMA will include random user prompts as well as self-initiated reports assessing alcohol use, social, locational, and situational context characteristics, along with assessments of BU prior to, and after, alcohol use. The project has three specific research aims: 1) Examine whether context mediates the effect of BU on adolescent drinking. 2) Examine whether BU moderates the role of context in predicting adolescent drinking. 3) Examine how drinking impacts impulsivity, and how this impact predicts alcohol consequences. By informing context-sensitive interventions based on findings, we will capitalize on technology that allows for context-appropriate prompts (“Just-in-time” interventions). The associated training plan will provide the candidate with the ability to independently conduct EMA surveys among adolescents and aid in securing future funding, becoming a substantive expert on event-level context characteristics and individual traits using fine-grained assessment tools, and informing treatment adaptations for individual-differences-based interventions. Thus, the project is aligned at multiple levels with NIAAA’s underage drinking research initiative into investigating factors that drive harmful adolescent alcohol use.