Feasibility and Effectiveness of Gamified Digital Intervention to Prevent Alcohol and Mental Health Risks

项目摘要 性少数族裔女性饮酒，经历与酒精有关的问题，并患有精神疾病 健康问题的发生率比他们的异性恋同龄人更高。尽管有几个临床项目正在进行 为寻求治疗这些问题的性少数族裔妇女(SMW)开发的，只有一小部分 有需要的SMW曾寻求治疗。与此同时，能够通过以下方式避免这些问题的预防性干预措施 未寻求治疗的SMW在减少饮酒和改善心理健康方面进展缓慢 才能出现。建议的研究建立在R21AA025767的基础上，建立了初步的可行性和 在一年内向SMW提供关于饮酒和应对行为的个性化规范反馈的有效性 更广泛的基于应用的社交竞争，旨在挑战关于这一群体的有害刻板印象 培育一个支持性的虚拟社区。在我们的试点试验中，性少数族裔妇女热情地参与到 APP在缺乏参与激励的情况下这样做。此外，相对于接收到PnF子样本 在比赛中的控制话题上，那些接受了关于饮酒和应对的PNF的人大大减少了 在4个月的时间里，他们的消费和负面影响。此外，质量反馈 表明否定PNF和社交媒体的负面刻板印象激发了社区特征(目前 在不同情况下)也可能提供了酒精和应对PNF之外的心理益处 已评估。为了建立在这些有希望的发现和弥补局限性的基础上，这项研究建议首先优化 该应用程序基于参与者在试点试验(AIM1)中的反馈，然后进行大型、复杂、 第一类实施-有效性试验，以同时检查功能齐全的应用程序对 饮酒、酒精相关问题和心理健康相对有限的心理教育功能 控制版的应用程序(AIM2)，识别与完全相关的解释心理机制 精选APP的有效性(AIM3)，阐明人口统计和性别少数族裔污名相关的主持人 (AIM4)，并检查在现实世界条件下使用的参与度、接受性和可持续性 缺乏激励、功能齐全的应用程序用户的子样本(AIM 5)。

Project Abstract Sexual minority women consume alcohol, experience alcohol-related problems, and suffer from mental health problems at higher rates than do their heterosexual peers. Although several clinical programs are being developed for sexual minority women (SMW) seeking treatment for these problems, only a small proportion of SMW needing it ever seek treatment. Meanwhile, preventive interventions able to avoid these problems by reducing drinking and improving psychological well-being among non-treatment seeking SMW have been slow to emerge. The proposed research builds on R21AA025767, which established the preliminary feasibility and effectiveness of delivering personalized normative feedback on drinking and coping behaviors to SMW within a broader app-based social competition designed to challenge harmful stereotypes about this population and foster a supportive virtual community. In our pilot trial, sexual minority women enthusiastically engaged with the app in the absence of participation incentives for doing so. Further, relative to a sub-sample that received PNF on control topics within the competition, those who received PNF on drinking and coping substantially reduced their consumption and negative consequences over a 4-month period. Moreover, qualitative feedback suggested that negative stereotype disconfirming PNF and social media inspired community features (present across conditions) may have also provided psychological benefits beyond the alcohol and coping PNF evaluated. To build on these promising findings and remedy limitations, this research proposes to first optimize the app based on feedback from participants in the pilot trial (AIM1) and then conduct a large, sophisticated, Type I implementation-effectiveness trial to simultaneously examine the effects of the fully featured app on drinking, alcohol-related problems, and psychological well-being relative to a limited feature psychoeducational control version of the app (AIM2), identify explanatory psychological mechanisms associated with the fully featured app’s effectiveness (AIM3), elucidate demographic and sexual minority stigma-related moderators (AIM4), and examine engagement, acceptability, and sustainability of use under real world conditions among a sub-sample of unincentivized, fully featured app users (AIM 5).