Alcohol Use & HIV: Developing Computerized Interventions

饮酒

• 批准号: 6947115
• 负责人: Joseph Conigliaro
• 金额: $ 2.2万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-06-10 至 2005-10-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6947115
• 关键词: HIV infections; alcoholism /alcohol abuse therapy; behavior therapy; behavioral /social science research tag; clinical research; computer assisted medical decision making; counseling; diagnosis design /evaluation; human subject; patient care planning; patient oriented research; therapy design /development

DESCRIPTION (provided by applicant): Alcohol use and hazardous drinking have significant implications for the clinical management and health outcomes of HIV positive patients. Alcohol use in HIV positive patients is believed to be associated with increased morbidity and mortality, more rapid disease progression, poorer adherence to antiretroviral regimens, and greater risk of viral resistance. Despite this risk, HIV providers do not accurately identify alcohol use and hazardous drinking. The long-term objective of this developmental R21 proposal is to improve the detection and management of hazardous drinking in HIV clinical settings, thereby reducing long term health and economic consequences. One (1) method to achieve this objective is through brief interventions (BIs). BIs are simple treatments that vary from brief advice to a short motivational interview and persuade drinkers to reduce their alcohol intake to low risk levels and consequently reduce medical complications and resource use. Computer technology offers a promising and understudied method of delivering Bis in the healthcare setting. This application will combine Bis with state-of-the-art computer technology to deliver patient-specific recommendations based on clinical guidelines. The specific aims of this developmental project are: 1) To adapt and test a computer alcohol screening and Bl prototype ("the prototype") using an iterative, qualitative process of user testing, focus groups, and face-to-face interviews with providers and HIV positive patients; 2) To test the feasibility of implementing the prototype, assess potential barriers to alcohol screening and intervention (e.g., complexity of medication regimen, social issues, etc.) and gather data on enrollment rates in two Department of Veterans Affairs HIV clinics; 3) To test whether the intervention is associated with a decrease in alcohol consumption 90 days post-BI in HIV positive patients who screen positive for hazardous drinking. This exploratory/developmental proposal will produce a field-tested intervention and dependable estimates for sample size, recruitment rate, and number of sites needed for a randomized clinical trial.

描述（由申请人提供）：饮酒和危险饮酒对 HIV 阳性患者的临床管理和健康结果具有重大影响。 HIV阳性患者饮酒被认为与发病率和死亡率增加、疾病进展更快、抗逆转录病毒治疗依从性较差以及病毒耐药风险增加有关。尽管存在这种风险，艾滋病毒提供者仍无法准确识别饮酒和危险饮酒。这项开发 R21 提案的长期目标是改善 HIV 临床环境中危险饮酒的检测和管理，从而减少长期健康和经济后果。实现这一目标的一 (1) 种方法是通过简短干预 (BI)。 BI 是简单的治疗方法，从简短的建议到简短的动机性访谈，说服饮酒者将酒精摄入量减少到低风险水平，从而减少医疗并发症和资源使用。计算机技术提供了一种在医疗保健环境中提供 Bis 的有前景且尚未得到充分研究的方法。 该应用程序将 Bis 与最先进的计算机技术相结合，根据临床指南提供针对患者的具体建议。该开发项目的具体目标是： 1) 使用用户测试、焦点小组以及与提供者和 HIV 阳性患者面对面访谈的迭代定性过程来调整和测试计算机酒精筛查和 BI 原型（“原型”）； 2) 测试实施原型的可行性，评估酒精筛查和干预的潜在障碍（例如，药物治疗方案的复杂性、社会问题等），并收集退伍军人事务部两个艾滋病毒诊所的入学率数据； 3) 测试干预措施是否与危险饮酒筛查呈阳性的 HIV 阳性患者 BI 后 90 天饮酒量减少相关。该探索性/开发性提案将产生经过现场测试的干预措施，并对随机临床试验所需的样本量、招募率和站点数量进行可靠的估计。