Mobile adaptive intervention to reduce negative consequences associated with simultaneous alcohol and marijuana use in young adults in primary care

移动适应性干预，以减少初级保健中的年轻人同时使用酒精和大麻带来的负面后果

• 批准号: 10508958
• 负责人: Kristina T. Phillips
• 金额: $ 24.87万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 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 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10508958
• 关键词: Academic achievement; Address; Alcohol consumption; Alcohols; Behavioral; Brain; Cellular Phone; Clinic; Communities; Development; Ecological momentary assessment; Environment; Experimental Designs; Feedback; Frequencies; Future; Goals; Harm Reduction; Hawaii; Health; Health system; Individual; Individuation; Informal Social Control; Injury; Intervention; Intervention Studies; Lead; Mental Health; Methodology; Methods; Nature; Outcome; Participant; Persons; Population; Primary Health Care; Process; Randomized; Randomized Controlled Trials; Reporting; Research; Risk; Site; Substance Use Disorder; System; Technology; Testing; Time; Treatment Efficacy; Work; adaptive intervention; addiction; base; binge drinking; brief intervention; college; craving; efficacious intervention; emerging adulthood; experience; feasibility testing; handheld mobile device; impaired driving performance; implementation intervention; improved; improved outcome; interest; marijuana use; multiphase optimization strategy; pilot test; post intervention; prevent; preventive intervention; primary care setting; programs; psychoeducation; recruit; response; satisfaction; smartphone Application; social cognitive theory; substance use treatment; therapy design; therapy development; usability; young adult

Project Summary Up to one-third of young adults report use of marijuana or alcohol in the past month, with 8% reporting daily marijuana use and 32% engaging in heavy episodic drinking. Marijuana and alcohol use peak during emerging adulthood and can still have an impact on the developing brain. Both substances are associated with lower academic achievement, negative health effects, addiction, and driving impairment and injury. Simultaneous alcohol and marijuana (SAM) use, defined as use of both substances at the same time or in close proximation of each other with overlapping effects, is common among young adults. Past research has shown that SAM use occurs in almost one-fourth of young adults and can lead to more negative consequences than use of either substance alone. Though brief interventions have been developed for alcohol and marijuana use independently, many are targeted to college populations. Young adults in the community who are at risk for developing substance use disorders (SUDs) often have more limited options. Targeting protective behavioral strategies (PBS), such as setting limits on the frequency of SAM use, may help reduce negative consequences and prevent development of SUD. No current intervention addresses SAM use and few leverage new technological methods (e.g., smartphones) or strategies (e.g., PBS) to engage young adults. Ecological momentary interventions (EMIs) and just-in-time adaptive interventions (JITAIs) offer opportunity for interventions on SAM use by delivering intervention components in real-time, in a person's natural environment, using mobile devices. Technological advances afford increased adaptability to support an individual as his/her context changes, when the individual is receptive and in need of assistance. The goal of this treatment development project is to develop an adaptive EMI (a-EMI) that is grounded in self-regulation and social cognitive theories. To determine the most efficacious intervention strategies, we will utilize the Multiphase Optimization Strategy (MOST) framework. Historically, most interventions are built initially as a package of strategies, from which it is difficult to determine the most effective components. As an alternative, the MOST framework allows for successive testing of intervention components to identify the best combination. Following pilot testing, we will assess the feasibility and efficacy of intervention components on two outcomes (negative consequences and PBS) using a fractional factorial experimental design, with post-assessment and one- and three-month follow-ups. 136 diverse young adults recruited from primary care clinics who report current SAM use will be randomly assigned to one of eight groups, representing experimental conditions that include or do not include intervention strategies focused on craving reduction and PBS. As a result of this process, individual and/or combined components that lead to improved outcomes will be retained in a subsequent randomized controlled trial, while ineffective components will be eliminated.

项目概要 多达三分之一的年轻人报告在过去一个月吸食过大麻或酗酒，其中 8% 的人每天报告 吸食大麻，32% 的人偶尔酗酒。新兴时期大麻和酒精使用高峰 成年后仍然会对发育中的大脑产生影响。这两种物质都与较低的 学业成就、负面健康影响、成瘾以及驾驶障碍和伤害。同时 酒精和大麻 (SAM) 使用，定义为同时或非常接近地使用两种物质 相互影响重叠的现象在年轻人中很常见。过去的研究表明 SAM 几乎四分之一的年轻人都使用这种药物，并且比使用这种药物可能导致更多的负面后果 单独的任何一种物质。尽管已经针对酒精和大麻的使用制定了简短的干预措施 独立而言，许多都是针对大学人群的。社区中面临以下风险的年轻人 正在发生物质使用障碍 (SUD) 的选择通常更为有限。针对保护性行为 策略 (PBS)，例如限制 SAM 使用频率，可能有助于减少负面后果 并防止 SUD 的发展。当前没有干预措施解决 SAM 的使用问题，而且很少利用新的干预措施 吸引年轻人参与的技术方法（例如智能手机）或策略（例如 PBS）。生态的 瞬时干预（EMI）和及时适应性干预（JITAI）为 通过以人的自然方式实时提供干预组件，对 SAM 使用进行干预 环境，使用移动设备。技术进步提高了适应性，以支持 当个人愿意接受并需要帮助时，他/她的环境发生变化。目标是 该治疗开发项目旨在开发一种基于自我调节的自适应 EMI (a-EMI) 和社会认知理论。为了确定最有效的干预策略，我们将利用 多阶段优化策略 (MOST) 框架。从历史上看，大多数干预措施最初都是作为 一揽子战略，很难从中确定最有效的组成部分。作为替代方案， MOST 框架允许对干预组件进行连续测试，以确定最佳组合。 经过试点测试，我们将评估干预措施对两种结果的可行性和有效性 （负面后果和 PBS）使用部分因子实验设计，并进行事后评估和 一个月和三个月的随访。从初级保健诊所招募的 136 名不同的年轻人报告 当前 SAM 使用将被随机分配到八组之一，代表实验条件 包括或不包括以减少渴望和 PBS 为重点的干预策略。结果是 导致改善结果的过程、单个和/或组合组件将保留在 随后进行随机对照试验，而无效成分将被淘汰。