Action Plans & Memory Consolidation: Reducing HIV Risk in Drug Users

行动计划

• 批准号: 8541668
• 负责人: Alan W Stacy
• 金额: $ 55.43万
• 依托单位: CLAREMONT GRADUATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-15 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8541668
• 关键词: AIDS/HIV problem; Address; Adult; Applied Research; Area; Basic Science; Behavior; Behavioral; Caring; Communities; Complex; Cues; Decision Making; Diversion Program; Drug usage; Drug user; Education; Enrollment; Ensure; Evidence based program; Future; Goals; HIV; HIV Infections; HIV risk; Habits; Health; Health education; Hepatitis; Hepatitis B; Hepatitis B Virus; Hepatitis C; Hepatitis C Transmission; Hepatitis C virus; Human immunodeficiency virus test; Imprisonment; Individual; Infection; Intention; Intervention; Link; Long-Term Effects; Mediation; Memory; Mind; Multiple Partners; NIH Program Announcements; Participant; Pharmaceutical Preparations; Population; Populations at Risk; Prevention; Prevention program; Preventive; Procedures; Process; Protocols documentation; Public Health; Randomized; Randomized Controlled Trials; Research; Research Personnel; Risk; Risk Behaviors; Risk Reduction; Science; Services; Short-Term Memory; System; Target Populations; Testing; Time; Translating; Translations; Work; cognitive neuroscience; condoms; court; design; drug offender; evidence base; follow-up; improved; innovation; intervention effect; memory process; operation; prevent; programs; prospective; public health relevance; relating to nervous system; sound; standard care; success; theories; therapy design; transmission process

DESCRIPTION (provided by applicant): A large body of basic research on memory, decision-making, and neural systems has accumulated with major implications for improving prevention effects through new strategies. One of the most promising avenues suggests ways to turn new preventive action plans into long-lasting habits. This can be accomplished by harnessing multiple processes, known to engage divergent neural systems, in ways that: a) consolidate action plans in memory at multiple levels; b) thoroughly link these plans to the situations that precede risk behaviors; and c) ensure action plans readily come to mind. The action plans then become highly accessible -- more spontaneously activated by situational cues. Although mere formation of action plans can be powerful in some behaviors and populations, memory consolidation of cue-linked action plans and specific forms of memory practice have a strong potential for long term effects on complex behaviors in at-risk populations. The present project applies, for the first time, this promising general strategy from basic research to the promotion o behaviors that reduce the risk of HIV [and hepatitis (HBV/HCV)] transmission: condom use and [testing of HIV/HBV/HCV]. These preventive behaviors are addressed in a population of adult drug offenders enrolled in "drug diversion" (educational) programs in lieu of incarceration. This growing population of mostly non-injection drug users is relatively easy to engage in preventive efforts on sexual risk and testing yet is documented at-risk for these infections. Indeed, they constitute one of the most readily available at-risk populations suitable for these preventive efforts, though evidence-based prevention programs have not yet been developed and evaluated for them. Preliminary studies reveal that specific strategies focusing on new preventive action plans, linkage of plans to risk situations, and consolidation in memory are promising in this population: a) participants are amenable to the strategies and actively engage in them; and b) the strategies show significant effects on formation and memory accessibility of action plans. The proposed study experimentally evaluates short-term prospective effects of action plan formation, memory consolidation, and memory practice on preventive behaviors (condom use and testing) and underlying basic processes. It is hypothesized that memory consolidation and practice will show superior effects on preventive behavior over effects of creating action plans alone or "standard care" health education. The study is conducted with drug diversion participants in existing drug education facilities. Thus, the intervention components can later be readily disseminated, since they are already tailored to the population and field setting. The investigators have repeatedly shown that carefully tailored basic research protocols are acceptable, feasible, and effective in this context. Community programs, such as drug diversion, are in urgent need of evidence-based, powerful interventions on [HIV/HBV/HCV] risk prevention. This project will experimentally evaluate theoretically sound, practical interventions with strong potential for improving public health.

描述（由申请人提供）：关于记忆、决策和神经系统的大量基础研究已经积累，对于通过新策略提高预防效果具有重大意义。最有希望的途径之一是提出将新的预防行动计划转化为持久习惯的方法。这可以通过利用已知会参与不同神经系统的多个过程来实现，方法是：a）在多个级别上巩固记忆中的行动计划； b) 将这些计划与风险行为发生之前的情况彻底联系起来； c) 确保行动计划容易浮现在脑海中。然后，行动计划变得更容易理解——更容易被情境线索自发激活。尽管仅仅形成行动计划对于某些行为和人群来说可能很有效，但与提示相关的行动计划的记忆巩固和特定形式的记忆练习对于高危人群的复杂行为具有强大的长期影响潜力。本项目首次应用这一有前途的总体战略，从基础研究到促进降低艾滋病毒[和肝炎(HBV/HCV)]传播风险的行为：使用安全套和[艾滋病毒/乙型肝炎/丙型肝炎病毒检测] ]。这些预防行为在参加“毒品转移”（教育）计划而不是监禁的成年毒品犯罪者中得到解决。不断增长的人口（大多数为非注射吸毒者）相对容易参与性风险和检测的预防工作，但有记录表明他们面临这些感染的风险。事实上，他们是最容易获得的适合这些预防工作的高危人群之一，尽管尚未为他们制定和评估基于证据的预防计划。初步研究表明，侧重于新的预防行动计划、计划与风险情况的联系以及记忆巩固的具体策略对该人群来说是有希望的： a) 参与者愿意接受这些策略并积极参与； b) 这些策略对行动计划的形成和记忆可及性具有显着影响。拟议的研究通过实验评估了行动计划形成、记忆巩固和记忆练习对预防行为（安全套使用和测试）和潜在基本过程的短期预期影响。据推测，记忆巩固和实践对预防行为的效果将优于单独制定行动计划或“标准护理”健康教育的效果。该研究是在现有毒品教育设施中对毒品转移参与者进行的。因此，干预措施随后可以很容易地传播，因为它们已经针对人群和现场环境进行了定制。研究人员一再表明，在这种情况下，精心定制的基础研究方案是可以接受的、可行的和有效的。药物转移等社区计划迫切需要基于证据的强有力的干预措施来预防 [HIV/HBV/HCV] 风险。该项目将通过实验评估理论上合理、实用的干预措施，这些干预措施具有改善公共卫生的巨大潜力。