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.

短期酒精干预 (BAI) 是现有的最具成本效益的预防性护理措施之一， 对高风险和难以接触人群的这些干预措施进行评估是 NIAAA 的优先事项。虽然 上大学的新兴成年人 (EA) 通常可以获得短暂的酒精干预 (BAI)，有一个 迫切需要提高这些高风险方法的有效性和传播潜力 非学生 EA。非四年制大学生或毕业生的 EA 报告与酒精相关的水平较高 问题、合并用药和心理健康症状的水平更高，以及慢性酗酒的风险更高 与大学毕业生相比，使用障碍。大多数 BAI 都包含一个明确重点关注的会议 讨论与饮酒相关的风险并纠正有关饮酒率的规范观念，而无需 解决 EA 可能饮酒的原因，包括压力和有限的饮酒替代行为。 因为许多没有大学毕业的 EA 在社会和经济上都处于边缘地位， 鼓励他们少喝酒的方法，但没有提供减轻压力和培养情绪的工具- 加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 (SFAS) 尝试增加以目标为导向的活动，这些活动可能会提供 饮酒的替代方案，还包括应对压力/抑郁的策略。两届会议 （加上加强剂）BAI+SFAS 方法已证明可以有效减少酒精使用/问题和 大学 EA 的两项随机临床试验中的抑郁症状可能是更有希望的 对于高风险非学生 EA，这种方法比单次 BAI 更好。接下来的两个关键步骤是：1) 评估 BAI+SFAS 与非学生 EA，以及 2) 确定是否进行两节放松训练 (RT) +SFAS 方法，这将增强健康并解决酗酒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会 比包含 BAI 的方法具有更大的传播潜力，因为会话内容可能是 对 EA 更具吸引力（管理压力和增加积极活动）。因此，该项目的首要目标是 拟议的研究旨在确定这些新颖的 BAI 方法对高风险社区住宅的有效性 EA 的第二个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 对比 RT+SFAS 对比教育对照）试验，有 525 个 EA（每组 175 个； 据估计，有 50% 的女性和 50% 的非裔美国人）最近酗酒且不是学生或 四年制大学的毕业生。将在干预后 1、3、6 和 12 个月评估结果。我们 假设在后续阶段，BAI+SFAS 和 RT+SFAS 参与者都会报告显着更高的 与教育控制参与者相比，酒精使用和问题的减少，没有差异 两种积极治疗条件之间的结果。