Leveraging Ecological Momentary Assessment to Examine Peer Affiliations as a Mechanism of Behavior Change in Youth Alcohol Use Treatment

利用生态瞬时评估来检查同伴关系作为青少年酒精使用治疗中行为改变的机制

• 批准号: 10205943
• 负责人: Samuel Noah Meisel
• 金额: $ 7.05万
• 依托单位: EMMA PENDLETON BRADLEY HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10205943
• 关键词: Abstinence; Address; Adolescence; Adolescent; Adult; Adverse effects; Affect; Aftercare; Age; Alcohol consumption; Alcohols; Applications Grants; Attenuated; Behavioral Mechanisms; Biological; Biological Process; Clinical; Clinical Research; Clinical Treatment; Clinical Trials; Cognitive Therapy; Complex; Critiques; Data; Data Analyses; Data Collection; Data Set; Development; Dose; Ecological momentary assessment; Etiology; Excitatory Amino Acid Antagonists; Failure; Family; Friends; Future; GABA Agonists; Goals; Gold; Heavy Drinking; Hospitals; Iatrogenesis; International; Intervention; Lead; Mentors; Mentorship; Modeling; Motivation; National Institute on Alcohol Abuse and Alcoholism; Outcome; Parents; Participant; Pharmaceutical Preparations; Pharmacotherapy; Placebos; Population; Process; Psychotherapy; Public Health; Publications; Randomized; Randomized Clinical Trials; Research; Research Priority; Risk; Role; Social Development; Social Environment; Social Network; Social Processes; Substance Use Disorder; Testing; Time; Titrations; Training; Treatment outcome; Universities; Work; Youth; addiction; alcohol abuse therapy; alcohol effect; alcohol intervention; alcohol measurement; alcohol misuse; alcohol risk; alcohol use disorder; alcohol-related death; base; behavior change; bullying; cigarette smoking; craving; design; drinking; efficacy testing; emerging adult; emerging adulthood; evidence base; improved; neglect; notch protein; peer; post intervention; pre-doctoral; primary outcome; programs; psychosocial; relapse risk; secondary analysis; sobriety; social; statistics; theories; topiramate; treatment research; underage drinking; virtual

PROJECT SUMMARY/ABSTRACT BACKGROUND. Alcohol use (AU) and misuse, including the onset of alcohol use disorder (AUD), peak during adolescence and emerging adulthood. Despite the adverse effects of AU among youth, such as increased risk for the development of substance use disorders and increased risk of alcohol-related deaths, the best available psychosocial interventions for AUD yield only modest short term benefits among youth. One way to improve treatments for AUD and reduce the public health burden associated with youth AU is to advance our understanding of how interventions work. Virtually all evidence-based psychosocial interventions emphasize shifting from alcohol using peers to non-using peers because youth AU predominantly occurs in the presence of peers, and affiliating with AU using peers is consistently associated with increased risk for relapse and worse treatment outcomes. To date, AUD treatment research has largely neglected the peer context of adolescents and emerging adults and this is particularly concerning because failure to consider the centrality of peer relationships in adolescent AU interventions leads to diminished and, in some cases, iatrogenic effects. SPECIFIC AIMS. This F32 supports the first study, to our knowledge, to use ecological momentary assessment (EMA) to examine whether daily level shifts from alcohol using to non-using peers over the course of AUD treatment leads to reductions in drinking and identify when these shifts occur. METHODS. Using an existing data set of a clinical trial examining the effects of medication (topiramate) and motivational enhancement and cognitive behavioral therapies (MET-CBT) relative to placebo plus MET-CBT using EMA (N =82; ages 14-24 years), the project will examine 1) the amount of time youth spend with alcohol-using and non-using peers from pre to post intervention in topiramate and placebo conditions, 2) whether topiramate leads to reductions in AU by attenuating the relationship between being in the presence of alcohol using peers and subsequent AU, and 3) whether lower levels of alcohol use, resulting from the attenuated relationship between being in the presence of alcohol-using peers and subsequent AU in the topiramate condition, in turn, leads to greater time spent with non-alcohol using peers. LONG-TERM GOAL. This research plan provides the opportunity for mentored training in identifying mechanisms of behavior change for youth AUD treatments and advanced training in collecting and analyzing complex EMA data. The identified mentorship team includes experts in the fields of adolescent addiction treatment, mechanisms of behavior change research, clinical trials research, and EMA data collection and analysis., and is housed in internationally recognized clinical and addiction research centers. The current F32 project will facilitate a successful transition to research independence and will support future grant applications that will investigate how social and biological processes impact AUD treatment leveraging EMA designs. Thus, this F32 aids the NIAAA's research priorities of identifying mechanisms of action for pharmacotherapy and reducing youth AU.

项目摘要/摘要 背景。饮酒（AU）和滥用，包括酒精使用障碍的发作（AUD），在 青春期和成年。尽管AU在青年中产生不利影响，例如增加风险 为了发展药物使用障碍和与酒精相关死亡的风险增加，最好的 AUD的社会心理干预措施仅在青年人中产生适度的短期益处。改进的一种方法 AUD治疗和减轻与青年AU相关的公共卫生负担是为了促进我们的 了解干预措施的工作方式。几乎所有基于证据的社会心理干预措施都强调 从同龄人使用酒精转移到非使用同龄人，因为青年人主要发生在存在下 同龄人的同龄人和同行的盟友都始终与复发风险增加有关 较差的治疗结果。迄今为止，AUD治疗研究在很大程度上忽略了 青少年和新兴的成年人，这尤其令人担忧，因为未能考虑 青少年AU干预措施中的同伴关系会导致减少，在某些情况下会减少医源性作用。 具体目标。据我们所知，该F32支持首次研究生态瞬间 评估（EMA）检查课程中是否从酒精使用到非使用同行的每日水平是否转变 AUD治疗的大量导致饮酒减少，并确定何时发生这些转移。方法。使用一个 现有的临床试验数据集检查药物（托吡酯）和动机的影响 使用EMA相对于安慰剂加Met-CBT的增强和认知行为疗法（MET-CBT）（n = 82; 14-24岁），该项目将检查1）青年在饮酒和 从托吡酯和安慰剂条件下干预前的不使用同龄人，2）托吡酯是否是否 通过减少使用同龄人在酒精存在下的关系，导致AU减少的降低 以及随后的AU，以及3）降低的关系是否降低了饮酒水平 在存在饮酒的同龄人的存在与后来的AU之间 通过使用同龄人，可以花费更多的时间。长期目标。该研究计划提供了 有指导培训的机会，以识别青年澳元治疗的行为改变机制和 收集和分析复杂EMA数据的高级培训。确定的指导团队包括 青少年成瘾治疗领域的专家，行为改变的机制，临床试验 研究和EMA数据收集和分析。 成瘾研究中心。当前的F32项目将有助于成功过渡到研究 独立，并将支持未来的赠款应用，这些应用将调查社会和生物学 过程影响AUD处理利用EMA设计。因此，该F32有助于NIAAA的研究重点 确定药物疗法的作用机制和减少青年AU。