Evaluation of a Combined Motivational Interviewing and Ecological Momentary Intervention to Reduce Risky Alcohol Use among Sexual Minority Males and Transgender Individuals

动机访谈和生态瞬时干预相结合以减少性少数男性和跨性别者危险饮酒的评估

• 批准号: 10542291
• 负责人: Trace S Kershaw
• 金额: $ 73.57万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10542291
• 关键词: Address; Adherence; Affect; Alcohol consumption; Alcohols; Behavior; Behavioral; Biological; Bisexual; Cancer Survivor; Car Phone; Cellular Phone; Clinic; Communities; Connecticut; Data; Effectiveness; Elderly; Evaluation; Event; Gays; Goals; HIV; HIV Seronegativity; HIV risk; Harm Reduction; Health; Heterosexuals; Individual; Intervention; Kentucky; Literature; Location; Methods; Motivation; Outcome; Participant; Patient Self-Report; Persons; Population; Randomized Controlled Trials; Reading; Reporting; Research; Research Personnel; Risk Behaviors; Self Efficacy; Sex Behavior; Sexual Partners; Sexual and Gender Minorities; Surveys; Technology; Testing; Time; Unsafe Sex; Visit; Vulnerable Populations; Work; aged; alcohol behavior; alcohol monitoring; alcohol use disorder; arm; base; behavior change; binge drinking; cisgender; comparison group; drinking; emerging adult; evidence base; experience; gender minority group; group intervention; hazardous drinking; high risk; high risk drinking; high risk population; innovation; intervention effect; literacy; meetings; men; mobile application; motivational enhancement therapy; pre-exposure prophylaxis; precision medicine; prevent; primary endpoint; primary outcome; recruit; reduced alcohol use; remote delivery; secondary endpoint; secondary outcome; sex; sexual minority male; substance use; therapy design; transgender; trend; young adult

ABSTRACT Sexual and gender minority individuals are more likely to report hazardous drinking and have alcohol use disorders (AUDs) compared to cisgender and heterosexual people. Emerging adult (aged 18-34) sexual and gender minorities are at especially high risk for AUDs compared to older adults, with up to 44% meeting AUD criteria. These trends are concerning, as studies have found that alcohol use increases HIV risk behaviors, and HIV disproportionately affects emerging adult sexual minority male and transgender (SMMT) individuals. Thus, it is essential to test interventions for reducing alcohol use among SMMT individuals as a means of preventing HIV among this vulnerable population. One potential evidence-based method of reducing alcohol use is motivational interviewing, which incorporates a goal-oriented approach for changing behavior and has been shown to be effective among various populations in prior literature and the investigators’ pilot research. However, there are opportunities to use technology to extend the impact of this approach by delivering messaging to prevent risk behaviors in real time (i.e., outside of intervention sessions). The proposed study will conduct a 3-arm randomized controlled trial that assesses the efficacy of two interventions as compared to a control: 1) An 8-week motivational interviewing intervention (TRAC) delivered remotely via cell phones and 2) TRAC combined with an ecological momentary intervention designed to deliver messages reinforcing drinking reduction strategies discussed during TRAC sessions when individuals visit risky locations (GeoTRAC). All participants will also complete monitoring of alcohol use and sexual behavior by completing daily surveys and twice-daily mobile breathalyzer readings. GeoTRAC will use an existing app developed in the investigators’ ongoing research that uses GPS tracking to determine when individuals visit “risky” locations. Participants will receive messages upon arrival at these locations reminding them of strategies to address triggers for drinking, and will also complete mobile surveys and breathalyzer readings when they leave these locations to determine what alcohol and/or risk behaviors they engaged in. If they reported drinking, they will receive harm reduction messaging to encourage them to avoid subsequent risk behavior (e.g., unprotected sex). Breathalyzer results and daily self-reports will be used to assess the primary and secondary outcomes of drinking days, drinks/drinking day, binge drinking episodes, and HIV risk behaviors, and additional assessments at baseline, 8 weeks, 6 months, and 12 months will evaluate exploratory long-term outcomes. Participants will be recruited from Kentucky and Connecticut through community-based recruitment and health clinics that serve SMMT individuals. Overall, there is a strong need to determine optimal methods of reducing alcohol use among emerging adult SMMT individuals given its relationship to increased HIV risk behaviors. The proposed work will draw upon the high technological literacy of emerging adults by using mobile phones and will test an innovative precision medicine approach that offers comprehensive support in reducing hazardous alcohol consumption.

抽象的 性别和性别少数人更有可能报告危险饮酒并使用酒精 与Cisgender和异性恋者相比，疾病（AUDS）。新兴成人（18-34岁）性和 与老年人相比，性别少数群体的aud风险尤其高，最多44％的会议 标准。这些趋势涉及到研究，因为研究发现酒精使用会增加艾滋病毒的风险行为，并且 艾滋病毒不成比例地影响新兴的成年性少数族裔男性和变性人（SMMT）个体。那， 必须测试减少SMMT个人酒精使用的干预措施，以防止 艾滋病毒在这个脆弱的人群中。减少酒精使用的一种潜在基于证据的方法是 动机访谈，结合了一种面向目标的改变行为的方法，并且一直是 在先前的文献和研究人员的试点研究中，在各个人群中都有效。 但是，有机会通过提供技术来扩展这种方法的影响 消息传递以实时预防风险行为（即在干预会议之外）。拟议的研究将 进行3臂随机对照试验，该试验评估了两种干预措施的效率 控制：1）通过手机远程交付的8周动机访谈干预（TRAC）和2 TRAC结合了旨在传递信息加强饮酒的消息的生态瞬时干预措施 当个人参观有风险的位置（GEOTRAC）时，讨论的减少策略。全部 参与者还将通过完成每日调查和 每天两次移动braathalyzer读数。 GeotRac将使用研究人员中开发的现有应用 正在进行的研究使用GPS跟踪来确定个人何时访问“风险”地点。参与者会 到达这些地点时接收消息，提醒他们解决诱因以饮酒的策略 并将在离开这些位置确定时完成移动调查和Breedalyzer读数 他们从事什么酒精和/或风险行为。如果他们报告饮酒，他们会减少伤害 发出消息，以鼓励他们避免随后的风险行为（例如，不受保护的性行为）。呼吸分析仪结果 每天的自我报告将用于评估饮酒日的主要和次要结果， 饮料/饮酒日，bbinge饮酒事件和艾滋病毒风险行为以及基线时的其他评估， 8周，6个月和12个月将评估探索性的长期结果。参与者将被招募 从肯塔基州和康涅狄格州到为SMMT服务的社区招聘和健康诊所 个人。总体而言，非常需要确定减少酒精使用的最佳方法 新兴的成年SMMT个人与增加的HIV风险行为有关。拟议的工作将 利用新兴成年人的高技术素养，并将测试创新的 精密医学方法可为减少危险饮酒提供全面支持。