Behavioral economic and wellness-based approaches for reducing alcohol use and consequences among diverse non-student emerging adults

基于行为经济学和健康的方法，用于减少不同非学生新兴成年人的饮酒及其后果

• 批准号: 10339445
• 负责人: JAMES G. MURPHY
• 金额: $ 35.02万
• 依托单位: UNIVERSITY OF MEMPHIS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-05 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10339445
• 关键词: Address; Affective Symptoms; African American; Age; Alcohol abuse; Alcohol consumption; Arousal; Behavioral; Behavioral Mechanisms; Belief; Black race; COVID-19 pandemic effects; Clinical Research; Communities; Coping Skills; Development; Drug usage; Education; Educational Intervention; Elements; Ethnic group; Evaluation; Feedback; Future; Goals; Health; Healthcare; Heavy Drinking; Income; Informal Social Control; Institute of Medicine (U.S.); Intervention; Laboratory Research; Marketing; Measures; Mediating; Mental Depression; Mental Health; Modality; Moods; National Institute on Alcohol Abuse and Alcoholism; Outcome; Participant; Physiological; Population; Poverty; Preventive care; Psychological reinforcement; Race; Randomized; Randomized Clinical Trials; Relaxation Therapy; Reporting; Research; Rewards; Risk; Risk Factors; Site; Stress; Stress and Coping; Suggestion; Symptoms; Testing; Woman; Workplace; active method; age group; alcohol consequences; alcohol demand; alcohol measurement; alcohol misuse; alcohol related consequences; alcohol related problem; alcohol use disorder; base; behavior change; behavioral economics; brief alcohol intervention; chronic alcohol ingestion; college; community center; comorbidity; control trial; cost effective; depressive symptoms; discounting; dissemination research; dissemination trial; drinking; economic impact; efficacy evaluation; emerging adult; experience; follow-up; heavy drinking college student; help-seeking behavior; high risk; member; negative affect; novel; post intervention; preference; psychiatric comorbidity; racial and ethnic; reduced alcohol use; reduced substance use; secondary outcome; sex; social; stress management; telehealth; tool; treatment response; university student

Brief alcohol interventions (BAI) are among the most cost-effective preventive care measures available and the evaluation of these interventions with high-risk and difficult-to-reach populations is an NIAAA priority. Although emerging adults (EAs) who attend college often have access to brief alcohol interventions (BAIs), there is a critical need to enhance both the efficacy and potential for dissemination of these approaches with high-risk non-student EAs. EAs who are not 4-year college students or graduates report higher levels of alcohol-related problems, greater levels of comorbid drug use and mental health symptoms, and higher risk for chronic alcohol use disorder compared to college graduates. Most BAIs include a single session focused explicitly on discussing risks associated with drinking and correcting normative beliefs about drinking rates without addressing the reasons why EAs may drink, including stress and limited behavioral alternatives to drinking. Because many EAs who do not graduate from college are socially and economically marginalized, an approach that encourages them to drink less without providing the tools to reduce stress and develop mood- enhancing behavioral substitutes to drinking or drug use is unlikely to be successful. The Substance-Free Activity Session (SFAS) attempts to increase engagement goal-directed activities that might provide alternatives to alcohol use and also includes strategies for coping with stress/depression. The two-session (plus booster) BAI+SFAS approach has demonstrated efficacy for reducing both alcohol use/problems and depressive symptoms in two randomized clinical trials with college EAs and may be a more promising approach than single-session BAIs for higher-risk non-student EAs. Two critical next steps are to: 1) evaluate the BAI+SFAS with non-student EAs, and 2) determine if a two-session Relaxation Training (RT) +SFAS approach, which would enhance wellness and address two synergistic risk factors for alcohol misuse, demonstrates similar efficacy as the BAI+SFAS intervention. If so, this wellness-based approach may have greater potential for dissemination than approaches that include a BAI because the session content may be more appealing to EAs (managing stress and increasing positive activities). Thus, the primary goal of the proposed study is to establish the efficacy of these novel BAI approaches with high-risk community dwelling EAs, and a secondary goal is to identify factors that may increase potential for dissemination. We will conduct a randomized 3-group (BAI+SFAS vs. RT+SFAS vs. education control) trial with 525 EAs (175 per group; estimated 50% women & 50% African American) who report recent heavy drinking and who are not students or graduates of 4-year colleges. Outcomes will be assessed at 1, 3, 6, and 12 months post-intervention. We hypothesize that at follow-up both BAI+SFAS and RT+SFAS participants will report significantly greater reductions in alcohol use and problems relative to education control participants, with no differences in outcomes between the two active treatment conditions.

简短的酒精干预措施（BAI）是可用的最具成本效益的预防措施， 对这些干预措施的评估是NIAAA的优先事项。虽然 上大学的新兴成年人（EAS）经常可以接受简短的酒精干预措施（BAI），有一个 批判性需要增强具有高风险的这些方法的疗效和潜力 非学生EAS。不是4岁的大学生或毕业生的EAS报告与酒精有关的水平更高 问题，合并药物使用和心理健康症状的水平更高，慢性酒精的风险更高 与大学毕业生相比，使用障碍。大多数Bais都会明确地集中于 讨论与饮酒和纠正关于饮酒率的规范性信念相关的风险 解决EA可能会喝酒的原因，包括压力和饮酒行为替代品有限的原因。 因为许多不从大学毕业的EA在社会和经济上被边缘化，所以 鼓励他们喝少喝酒而不提供工具来减轻压力和发展情绪的方法 - 增强饮酒或吸毒的行为替代品不太可能成功。无物质 活动会议（SFA）试图增加参与目标指导的活动， 饮酒的替代方案，还包括应对压力/抑郁症的策略。两项 （加上助推器）BAI+SFAS方法已证明减少酒精使用/问题和 在两项与大学EAS的随机临床试验中的抑郁症状，可能是一个更有前途的 对于高风险的非学生EAS而言，仅次于单课的BAI。下一步的两个关键步骤是：1）评估 带有非学生EA的BAI +SFA，以及2）确定是否进行两次休闲训练（RT） +SFA 方法可以增强健康并解决滥用酒精的两个协同风险因素， 表现出与BAI+SFAS干预相似的功效。如果是这样，这种基于健康的方法可能具有 比包括BAI的方法更大的传播潜力，因为会话内容可能是 更具吸引力的EA（管理压力和增加积极的活动）。因此， 拟议的研究是在高风险的社区住宅中确定这些新型BAI方法的功效 EAS和次要目标是确定可能增加传播潜力的因素。我们将进行 一项随机3组（BAI+SFAS与RT+SFAS与教育控制）试验的试验为525 EA（每组175； 估计有50％的女性和50％的非洲裔美国人）报告了最近的大量饮酒，而不是学生或 4年大学的毕业生。结局将在干预后1、3、6和12个月进行评估。我们 假设在随访时，BAI+SFA和RT+SFAS参与者将报告明显更大 相对于教育控制参与者的饮酒和问题的减少，没有差异 两个主动治疗条件之间的结果。