Latinx Hazardous Drinkers with Clinical Anxiety: Effectiveness Trial of a Personalized Normative Feedback Intervention

患有临床焦虑的拉丁裔危险饮酒者：个性化规范反馈干预的有效性试验

• 批准号: 10369165
• 负责人: MICHAEL J. ZVOLENSKY
• 金额: $ 14.65万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-20 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10369165
• 关键词: Address; Alcohol consumption; Alcohols; Anxiety; Area; Attitude; Basic Science; Behavior Therapy; COVID-19; Caring; Clinic; Clinical Trials Design; Community Health; Computers; Data; Development; Disease; Effectiveness; Expectancy; Feedback; Female; Focus Groups; Frequencies; Goals; Guidelines; Happiness; Health; Health Services Accessibility; Impairment; Individual; Intention; Intervention; Knowledge; Latinx; Literature; Mediating; Mediator of activation protein; Modeling; Motivation; National Institute on Alcohol Abuse and Alcoholism; Outcome; Participant; Persons; Phase; Population; Populations at Risk; Prevalence; Public Health; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Reporting; Research; Research Project Grants; Research Support; Sampling; Severities; Standardization; Strategic Planning; Symptoms; Testing; Translating; Treatment Cost; Underserved Population; United States; United States National Institutes of Health; Work; acceptability and feasibility; alcohol abuse therapy; alcohol misuse; alcohol misuse prevention; alcohol related consequences; alcohol use disorder; anxiety management; anxiety symptoms; base; biobehavior; brief intervention; clinical anxiety; comorbidity; compare effectiveness; coping; cost; demographics; design; drinking; effectiveness testing; effectiveness trial; ethnic discrimination; experience; follow-up; hazardous drinking; health care settings; health disparity; health inequalities; improved; innovation; intervention effect; male; novel; personalized normative feedback; point of care; psychoeducation; public health priorities; recruit; therapy design; therapy development

Project Summary/Abstract Despite being one of the largest and fastest-growing demographics in the United States (US), Latinx persons experience striking health disparities, particularly in terms of hazardous drinking and co-occurring clinical anxiety. No interventions to date have targeted hazardous drinking in the context of clinical anxiety among Latinx persons. The current R01 proposal builds upon our past work by developing a brief, single-session, computer-based, personalized feedback intervention (PFI) designed to enhance knowledge regarding adverse anxiety-alcohol interrelations, increase motivation and intention to reduce hazardous drinking, and reduce positive attitudes and intentions regarding the use of alcohol for anxiety. Specifically, we propose to develop a low-cost, highly disseminatable, integrated PFI for Latinx hazardous drinkers with clinical anxiety (AA-PFI 1.0) that will be implemented and tested for effectiveness in community-based health clinics. Our approach will follow a staged model consistent with National Institutes of Health (NIH) guidelines for developing and standardizing behavioral interventions. Phase IA activities will involve collecting qualitative and quantitative feedback from three iterative focus groups (N = 21) to refine intervention content and evaluate treatment acceptability and feasibility. Phase IB activities will include a rigorous randomized clinical trial designed to compare the effectiveness of AA-PFI 2.0 to a control PFI (C-PFI) among a sample of 250 Latinx hazardous drinkers with clinical anxiety who receive care within community-based health clinics. This study represents an important and pivotal step in the larger landscape of translating basic research to more efficacious strategies for reducing hazardous drinking in underserved populations with biobehavioral comorbidities. The proposed research project supports the 2017-2021 strategic plan of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) by advancing research in two of the key areas. First, the current proposal has the end goal of improving strategies to prevent alcohol misuse, alcohol use disorder, and alcohol-related consequences among an ‘at-risk’ population for these conditions (goal 3). Second, it enhances the public health impact of NIAAA-supported research by focusing on one of the fastest-growing and largest demographics in the US who demonstrate disparities in hazardous drinking (goal 5). The current application aligns with the goals of RFA- AA-21-001 by proposing to examine the effectiveness of a low cost, highly disseminatable, personalized, culturally adapted PFI for Latinx hazardous drinkers with clinical anxiety within community-based health clinics. Given the collective public health impact of concurrent anxiety and alcohol use, we believe the proposed study will yield findings that enhance scientific knowledge, advance our understanding of mechanisms in anxiety- alcohol use relations, and inform the development of novel treatments for hazardous drinkers with clinical anxiety that are adaptable and easily implemented across a variety of healthcare settings.

项目概要/摘要 尽管拉丁裔是美国人口规模最大、增长最快的群体之一，但 经历显着的健康差异，特别是在危险饮酒和同时发生的临床症状方面 迄今为止，还没有针对临床焦虑背景下的危险饮酒的干预措施。 当前的 R01 提案以我们过去的工作为基础，制定了一个简短的、单次会议的、 基于计算机的个性化反馈干预（PFI），旨在增强有关不良反应的知识 焦虑与酒精的相互作用，增加减少有害饮酒的动机和意图，并减少 具体来说，我们建议制定一个关于使用酒精治疗焦虑的积极态度和意图。 针对具有临床焦虑的拉丁裔危险饮酒者的低成本、高度传播的综合 PFI（AA-PFI 1.0） 我们的方法将在社区卫生诊所中实施并测试其有效性。 遵循符合美国国立卫生研究院 (NIH) 指南的分阶段模型来开发和 标准化行为干预措施将涉及收集定性和定量的信息。 来自三个迭代焦点小组 (N = 21) 的反馈，以完善干预内容并评估治疗 IB 期活动将包括严格的随机临床试验，旨在 在 250 个拉丁裔危险样本中比较 AA-PFI 2.0 与对照 PFI (C-PFI) 的有效性 这项研究代表了在社区健康诊所接受护理的患有临床焦虑症的饮酒者。 将基础研究转化为更有效策略的大格局中重要且关键的一步 减少患有生物行为合并症的服务不足人群的危险饮酒。 研究项目支持国家酒精滥用研究所 2017-2021 年战略计划 酒精中毒（NIAAA）通过推进两个关键领域的研究首先，当前的提案有最终目标。 改进酒精预防滥用、酒精使用障碍和酒精相关后果的策略 其次，它增强了这些疾病的“高危”人群（目标 3）。 NIAAA 支持的研究重点关注美国增长最快和最大的人口统计数据之一 展示危险饮酒的差异（目标 5）。当前的应用与 RFA 的目标一致。 AA-21-001 提议检查低成本、高度传播、个性化、 针对社区卫生诊所内患有临床焦虑症的拉丁裔危险饮酒者进行文化适应的 PFI。 考虑到同时焦虑和饮酒对公共健康的集体影响，我们认为拟议的研究 将产生增强科学知识、增进我们对焦虑机制的理解的发现 酒精使用关系，并通过临床为有害饮酒者开发新的治疗方法提供信息 焦虑症具有适应性，并且可以在各种医疗保健环境中轻松实施。