A digital intervention to prevent the initiation of opioid misuse in adolescents in school-based health centers

防止学校保健中心青少年滥用阿片类药物的数字干预措施

• 批准号: 10408897
• 负责人: Lynn Elizabeth Fiellin
• 金额: $ 273.53万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2023-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10408897
• 关键词: 19 year old; Address; Adolescence; Adolescent; Age; Alcohols; American; Attention; Attitude; Behavioral; Cause of Death; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Cities; Computer software; Conflict (Psychology); Control Groups; Country; Data; Decision Making; Development; Dose; Effectiveness; Enrollment; Evaluation; Female Adolescents; Focus Groups; Foundations; Future; Goals; HIV; Health; Health Alliance; Health Promotion; Health behavior; High Prevalence; Human Resources; Intervention; Knowledge; Life; Male Adolescents; Marijuana; Methods; National Institute of Drug Abuse; Nature; Opioid; Outcome; Overdose; Participant; Perception; Pharmaceutical Preparations; Phase; Planning Theory; Play; Population; Prevention; Prevention program; Randomized Controlled Trials; Reporting; Research; Research Personnel; Resources; Risk; Risk Behaviors; Risk Factors; Schools; Self Efficacy; Smoking; Strategic Planning; Technology; Teenagers; Testing; Time; Tobacco; Translating; Video Games; Vulnerable Populations; Work; Youth; aged; base; cost; cost-effectiveness evaluation; design; digital intervention; experience; game development; heroin use; high risk; high-risk adolescents; implementation cost; implementation framework; implementation strategy; improved; improved outcome; innovation; intervention cost; meetings; mortality; novel; opioid misuse; opioid mortality; opioid overdose; prescription opioid misuse; prevent; preventive intervention; programs; risk perception; skills; social learning; social media; substance use; substance use prevention; therapy design; videogame intervention; young adult

Most opioid misuse begins during adolescence and young adulthood. Adolescence is the time to intervene with prevention interventions in settings like school-based health centers (HCs), yet few exist that prevent initiation of opioid misuse. “Serious videogame” interventions can improve health behaviors. They meet adolescents “where they are,” and compared to standard interventions, they can reach large populations, with consistent fidelity, place limited demands on personnel/resources, facilitate rapid sustainable distribution, all at a potentially lower cost. This proposal harnesses the power of videogame interventions and incorporates components of effective substance use prevention programs to develop an evidence-informed intervention to prevent the initiation of opioid misuse in adolescents. Building on our experience developing videogame interventions and in partnership with the national School-Based Health Alliance (SBHA), we will develop and test a new videogame intervention, PlaySmart. PlaySmart will build upon our PlayForward videogame intervention platform that has demonstrated efficacy in improving attitudes and knowledge related to risk behaviors. Through rigorous formative work and with input from adolescents, and our SBHA and game development partners, we will create the PlaySmart videogame intervention. PlaySmart will be designed to provide players with behavioral skills and knowledge through repetitive and engaging videogame play to target adolescent perception of risk of harm from initiating opioid misuse. The specific aims of this proposal are to: 1) Phase 1 (UG3): Develop and pilot-test the PlaySmart game and, working with SBHA stakeholders, develop implementation strategies and partners; and 2) Phase 2 (UH3): Conduct a randomized controlled trial (RCT) with 532 high-risk 16-19 year old adolescents, in 10 local school-based (HCs), comparing the PlaySmart game to attention/time control games, and work with the SBHA to examine strategies for implementing PlaySmart in school-based HCs nationally. The main outcomes for the RCT will be the proportion of participants who report a perception of great risk of harm from misuse of opioids, intentions to misuse opioids, self-efficacy for refusing opioids, and initiation of opioid misuse. We hypothesize that participants in the PlaySmart group, compared to the control group, will have improved outcomes at 6 weeks (completion of gameplay), and at 3, 6 and 12 months. During the trial, we will collect implementation data from participants and school-based HCs and from the videogame software (e.g. dose). We will use an implementation framework to examine barriers and facilitators to implementing PlaySmart in school-based HCs nationally, and evaluate the cost-effectiveness of the intervention and the cost of the implementation strategies. This research, conducted by an experienced team of videogame intervention researchers and the national SBHA, holds the promise of creating an effective, engaging, and tailored intervention for preventing initiation of opioid misuse. This work has considerable potential for wide implementation, reach, and impact on high-risk adolescents through school-based HCs.

大多数阿片类药物滥用始于青春期，青春期是干预的时期。 学校保健中心 (HC) 等环境中存在预防干预措施，但很少有阻止启动的措施 “严肃的电子游戏”干预措施可以改善青少年的健康行为。 “他们在哪里”，与标准干预措施相比，它们可以覆盖大量人群，并且具有一致的效果 保真度，对人员/资源的要求有限，促进快速可持续分配，所有这些都在 该提案利用了视频游戏干预的力量并纳入了潜在的较低成本。 有效的药物使用预防计划的组成部分，以制定循证干预措施 基于我们开发视频游戏的经验，防止青少年滥用阿片类药物。 干预措施并与国家校本健康联盟 (SBHA) 合作，我们将制定和 测试新的视频游戏干预，PlaySmart 将基于我们的 PlayForward 视频游戏。 已证明在改善与风险相关的态度和知识方面有效的干预平台 通过严格的正式工作和青少年的投入以及我们的 SBHA 和游戏。 开发合作伙伴，我们将创建 PlaySmart 视频游戏干预，旨在。 通过重复且引人入胜的视频游戏来达到目标​​，为玩家提供行为技能和知识 青少年对滥用阿片类药物造成伤害的风险的认识 该提案的具体目的是： 1) 第 1 阶段 (UG3)：开发和试点 PlaySmart 游戏，并与 SBHA 利益相关者合作，开发 实施策略和合作伙伴；2) 第 2 阶段 (UH3)：进行随机对照试验 (RCT) 在 10 个当地学校 (HC) 中，对 532 名 16-19 岁高风险青少年进行了 PlaySmart 游戏的比较 注意力/时间控制游戏，并与 SBHA 合作研究在以下领域实施 PlaySmart 的策略： 全国校本 HC 的主要结果是报告参与者的比例。 认为滥用阿片类药物造成巨大伤害风险、滥用阿片类药物的意图、拒绝的自我效能 我们勇敢地表示，与 PlaySmart 组的参与者相比，阿片类药物和阿片类药物滥用的开始。 对照组将在第 6 周（完成游戏）以及第 3、6 和 12 周时取得更好的结果 在试验期间，我们将从参与者和校本 HC 以及来自的地方收集实施数据。 我们将使用一个实施框架来检查障碍和电子游戏软件（例如剂量）。 促进者在全国校本 HC 中实施 PlaySmart，并评估其成本效益 这项研究由经验丰富的专家进行。 由视频游戏干预研究人员和国家 SBHA 组成的团队有望创建一个有效的、 这项工作对于防止阿片类药物滥用具有一定的吸引力和针对性。 通过学校健康中心对高危青少年进行广泛实施、影响和影响的潜力。

项目成果

A Video Game Intervention to Prevent Opioid Misuse Among Older Adolescents: Development and Preimplementation Study.

防止老年青少年滥用阿片类药物的视频游戏干预措施：开发和实施前研究。

• 发表时间: 2023-11-03
• 影响因子: 4
• 作者: Aneni, Kammarauche;Fernandes, Claudia;Hoerner, Lily A;Szapary, Claire;Pendergrass Boomer, Tyra M;Fiellin, Lynn E
• 通讯作者: Fiellin, Lynn E

A digital health game to prevent opioid misuse and promote mental health in adolescents in school-based health settings: Protocol for the PlaySmart game randomized controlled trial.

一种数字健康游戏，旨在防止阿片类药物滥用并促进学校健康环境中青少年的心理健康：PlaySmart 游戏随机对照试验方案。

• 发表时间: 2023
• 影响因子: 3.7
• 作者: Pendergrass Boomer, Tyra M;Hoerner, Lily A;Fernandes, Claudia;Maslar, Amber;Aiudi, Sherry;Kyriakides, Tassos C;Fiellin, Lynn E
• 通讯作者: Fiellin, Lynn E