Development and Initial Testing of a Multi-Component Breath Alcohol-Focused Intervention for Young Adults

项目摘要/摘要 近1/4的年轻人符合酒精使用障碍标准。目前的干预措施往往只产生很小的效果 缺乏有效的、即时的行为干预措施。技术和智能手机 应用程序前景看好，但没有证据表明适度饮酒的应用程序对年轻人有效。 血液酒精浓度(BAC)是一个重要的即时干预指标，但估计 没有技术的BAC和实施适度饮酒策略都是具有挑战性的。最近推出的R21 (AA023368，PI：Leeman)测试了3种适度饮酒技术作为单独干预。年轻的成年人是 随机使用这些技术中的一项-1)智能手机呼气酒精设备和应用程序；2)BAC-估计器 APP，或3)自发短信，饮酒清点程序--在实验室酒精自我管理会议上。虽然当时有 基于技术的酒精自我给药没有显著差异，参与者随后开放 获得这3项技术的2周时间。与基线相比，参与者报告说几乎喝了一杯 在两周的时间里，平均每天饮酒的次数减少了。72%的受访者使用了至少一种形式的技术 饮酒天数，平均是总共的9倍，尽管只因使用每种技术一次而获得补偿。 参与者经常在饮酒时使用一种以上的技术，并描述了以下障碍 在某些情况下忘记和使用某些技术，但不在其他情况下使用。基于这些发现，最佳的 方法是将三种适度饮酒技术作为联合干预进行开发和测试。 在开发促进适度饮酒技术使用的方法时，我们将探索“高技术”和“低技术”。 选择。其他技术可能会优化这3项技术的使用。一款新的应用程序可以帮助用户切换 使用地理空间位置等工具，可以轻松地在各种技术之间进行选择，并根据当前环境进行选择。 然而，这3种技术不需要太多技能或蜂窝数据，有些人在 互联网接入或蜂窝数据，因此“较低技术”的选择(例如，电话警报作为提醒)也很有吸引力。 鉴于R21测试了3种适度饮酒技术，作为单独的干预措施，作为组合 干预，我们缺乏可行性数据；与对照条件相比的初步疗效数据；阴性 结果数据与基线的对比；以及关于可能机制的数据。因此，我们需要R34支持才能正式 开发一种组合的、多模式的干预措施，为R01做准备。我们提出一个分三个阶段的项目，从 形成性研究(N=25)测试简介，基于MI的咨询修订自我们的R21研究，外加开放使用 在3种适度饮酒技术中，进行为期2周的“低技术”促进和形成性访谈。在……里面 第二阶段，我们将打造一个APP，作为一种高科技的促进方式，并设计一个多通道的注意控制条件。 在第三阶段，我们将进行一项试验性随机对照试验，以评估 一种综合的、多模式的干预。实施科技含量较高、技术含量较低的便利化。这项研究 将解决缺乏精确药物和对年轻人进行有效的即时干预所造成的差距。

PROJECT SUMMARY/ABSTRACT Nearly 1 in 4 young adults meet Alcohol Use Disorder criteria. Current interventions tend to yield small effects and there is a lack of efficacious, in-the-moment behavioral interventions. Technology and smartphone apps have great promise but there are no moderate drinking apps with evidence of efficacy for young adults. Blood alcohol concentration (BAC) is an important in-the-moment intervention target but estimating BAC without technology and implementing moderate drinking strategies are both challenging. A recent R21 (AA023368, PI: Leeman) tested 3 moderate drinking technologies as solo interventions. Young adults were randomized to use 1 of these technologies—1) smartphone breath alcohol device and app; 2) BAC-estimator app, or 3) self-texting, drink counting procedure—in a lab alcohol self-administration session. While there were no significant differences in alcohol self-administration based on technology, participants then had open access to the 3 technologies for a 2-week period. Compared to baseline, participants reported nearly a drink per drinking day less, on average, in the 2-week period. They used at least 1 form of technology on 72% of drinking days, and 9 times total, on average, despite only being compensated for using each technology once. Participants often used more than 1 form of technology in a drinking episode and described barriers like forgetting and using certain technologies in some contexts but not others. Based on these findings, the optimal approach is for the 3 moderate drinking technologies to be developed and tested as a combined intervention. In developing ways to facilitate moderate drinking technology use, we will explore “higher” and “lower tech” options. Additional technology may optimize use of the 3 technologies. A new app could help users switch easily among technologies and facilitate selection based on current context using tools like geospatial location. However, these 3 technologies do not require much skill or cellular data and some people have limitations with internet access or cellular data, thus “lower tech” options (e.g., phone alarms as reminders) are also appealing. Given the R21 tested the 3 moderate drinking technologies as solo interventions, as a combined intervention, we lack feasibility data; preliminary efficacy data compared to a control condition; negative consequence data versus baseline; and data on possible mechanisms. Thus, we need R34 support to formally develop a combined, multi-modal intervention to prepare for an R01. We propose a 3-stage project, beginning with formative research (N=25) testing brief, MI-based counseling revised from our R21 study, plus open use of the 3 moderate drinking technologies for 2 weeks with “lower tech” facilitation and a formative interview. In Stage 2, we will create an app as “higher-tech” facilitation and design a multi-modal attention control condition. In Stage 3, we will conduct a pilot RCT to evaluate feasibility, acceptability, usability and preliminary efficacy of a combined, multi-modal intervention. “Higher” and “lower tech” facilitation will be implemented. This research will address gaps from lack of precision medicine and efficacious in-the moment intervention for young adults.