Couple-Based Motivational Interviewing with Technology to Reduce Alcohol Consumption in HIV+ South African Couples

基于夫妇的动机访谈，利用技术减少艾滋病毒南非夫妇的饮酒量

• 批准号: 10491329
• 负责人: Amy Anne Conroy
• 金额: $ 24.85万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 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 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10491329
• 关键词: Address; Adherence; Affect; Africa South of the Sahara; African; Alcohol consumption; Awareness; Blood alcohol level measurement; Clinical Services; Communication; Couples; Data; Data Collection; Enrollment; Feedback; Fire - disasters; Focus Groups; Frequencies; Future; Gender; Goals; HIV; Health; Heavy Drinking; Individual; Intervention; Interview; Knowledge; Manuals; Methods; Monitor; Outcome; Patients; Persons; Pilot Projects; Problem Solving; Procedures; Process; Professional counselor; Public Health; Randomized; Randomized Controlled Trials; Research; Role; Social support; South Africa; South African; Structure; Technology; Testing; Time; Training; Treatment outcome; Viral; Visit; Work; acceptability and feasibility; alcohol intervention; alcohol misuse; alcohol monitoring; alcohol testing; antiretroviral therapy; arm; base; cost; design; drinking; effectiveness evaluation; efficacy trial; improved; instrument; mobile application; mobile computing; motivational enhancement therapy; pilot test; reduced alcohol use; reduced substance use; retention rate; satisfaction; scale up; skills; success; tool; treatment as usual; treatment program

Project Summary/Abstract In sub-Saharan Africa (SSA), our research suggests that primary partners should be involved in alcohol interventions given their critical role in helping drinkers reduce alcohol use and the couple dynamics that intersect with alcohol use. Motivational interviewing (MI) is a proven intervention for reducing alcohol use among individuals living with HIV, and emerging evidence suggests that MI is a promising option for couples. Correct knowledge of drinking levels in real-time is critical for triggering couple communication and timely and tailored support to help drinkers reduce their alcohol use. Mobile breathalyzer technology could help to achieve this goal by providing real-time and objective feedback to couples and current apps already have this built-in dyadic functionality. In this study, we propose to develop and test an alcohol intervention using couple-based MI and mobile breathalyzers to build dyadic support around drinking in HIV-affected couples in South Africa. We posit that by motivating the couple to work together to reduce drinking, and using mobile breathalyzers as a tool to increase partner knowledge and trigger couple communication and timely support, we will reduce heavy alcohol use and improve HIV treatment outcomes. The specific aims are to: (1) to adapt a couple-based MI intervention to reduce alcohol use in HIV-affected South African couples and incorporate a breathalyzer with mobile app to deliver real-time feedback on blood alcohol content (BAC) levels to both partners; (2) to develop and pilot test the study procedures for a future randomized controlled trial (RCT) of the couple-based intervention; and (3) to assess the feasibility and acceptability (F&A) of a couple-based MI intervention with and without mobile breathalyzers for real-time feedback. For Aim 1, we will adapt a couple-based MI framework and interventions (We Test and the Couples Health Project) to address alcohol use in South African couples and incorporate the breathalyzer component. For Aim 2, we will develop the intervention manuals, study procedures, and data collection instruments to be pilot tested. For Aim 3, we will implement a three-arm RCT with 30 couples randomized to the following arms (90 couples total): 1) an enhanced usual care control condition; 2) couple-based MI; and 3) couple-based MI with mobile breathalyzers for feedback. For arm 2 and 3, couples will receive several monthly MI sessions with a lay counselor to help couples strengthen communication and problem-solving skills around alcohol use. For Arm 3, couples will use the mobile breathalyzers and app for 60 days and receive the same MI sessions, which will also incorporate feedback on BAC levels (prior 30 days) and teach couples how to effectively engage with the breathalyzers. We will conduct exit interviews with a subset of 30 couples to contextualize F&A data, and will analyze the mixed-methods data to refine the intervention for a future efficacy trial. Our long-term goal is to implement a couple-based MI intervention that leverages the mobile breathalyzer technology for real-time feedback and support, and can be scaled-up to reduce alcohol use, strengthen couple support, and improve HIV treatment outcomes in SSA.

项目摘要/摘要 在撒哈拉以南非洲（SSA）中，我们的研究表明，主要伴侣应参与酒精 干预措施在帮助饮酒者减少酒精饮酒和夫妻动态方面的关键作用 与饮酒相交。动机访谈（MI）是减少酒精使用的事实干预 在患有艾滋病毒的人中，以及新兴的证据表明，MI是夫妻的有前途选择。 正确了解饮酒水平的实时知识对于触发夫妇的交流至关重要 量身定制的支持，以帮助饮酒者减少饮酒。移动呼气技术可以帮助实现 通过向夫妻和当前应用程序提供实时和客观的反馈，这一目标已经具有此内置 二元功能。在这项研究中，我们建议使用基于夫妇的 在南非，MI和流动呼吸分析仪为艾滋病毒影响的夫妇饮酒而建立二元支持。 我们认为，通过激励夫妻共同努力减少饮酒，并将移动呼吸器作为 一种增加合作伙伴知识并触发夫妇沟通和及时支持的工具，我们将减少 大量饮酒并改善HIV治疗结果。具体目的是：（1）适应一对基于夫妇的 MI干预以减少受艾滋病毒影响的南非夫妇的饮酒并纳入呼吸分析仪 使用移动应用程序，向双方提供有关血液酒精含量（BAC）水平的实时反馈； （2）至 开发和试点测试这对夫妇的未来随机对照试验（RCT）的研究程序 干涉; （3）评估基于夫妇的MI干预的可行性和可接受性（F＆A） 并且没有移动呼吸分析仪可实现实时反馈。对于AIM 1，我们将调整基于夫妇的MI 框架和干预措施（我们测试和夫妻健康项目）以解决南非的酒精使用 夫妻并结合呼吸分析仪组件。对于AIM 2，我们将制定干预手册， 研究程序和数据收集工具进行试点测试。对于AIM 3，我们将实施三臂 RCT与30对夫妇随机分配到以下臂（总共90对夫妇）：1）增强的常规护理控制 健康）状况; 2）基于夫妇的MI； 3）基于夫妇的MI与移动呼吸分析仪可供反馈。对于手臂2和 3，夫妇将与外行辅导员每月进行几次MI会议，以帮助夫妻加强 围绕酒精使用的沟通和解决问题的技能。对于手臂3，夫妻将使用手机 呼气和应用程序已有60天，并接受相同的MI会议，这也将包含反馈 BAC水平（前30天），并教夫妻如何有效地与呼吸分析仪互动。我们将进行 退出30对夫妇的子集的访谈，以将F＆A数据背景化，并将分析混合方法数据 为了完善未来疗效试验的干预措施。我们的长期目标是实施基于夫妇的MI 利用移动呼吸分析仪技术以获得实时反馈和支持的干预措施，并且可以是 扩大规模以减少饮酒，增强夫妇的支持并改善SSA中的HIV治疗结果。