The effectiveness of text-based messaging strategies for preventing subsequent problematic alcohol use among technical trainees in the U.S. Air force

基于文本的消息传递策略对于防止美国空军技术学员随后出现酗酒问题的有效性

• 批准号: 10515810
• 负责人: Robert C Klesges
• 金额: $ 58.17万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-12 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10515810
• 关键词: Accident and Emergency department; Adult; Air; Alcohol abuse; Alcohol consumption; Alcohols; American; Automobile Driving; Cause of Death; Certificate of Confidentiality; Cessation of life; Consumption; Counseling; Effectiveness; Epidemic; Event; Feedback; Gender; Harm Reduction; Health; Health Promotion; Health behavior; Heavy Drinking; High Prevalence; Individual; Injury; Intervention; Intervention Studies; Lead; Legal; Literature; Methods; Military Personnel; Monitor; Outcome; Patient Self-Report; Population; Privileged Communications; Professional counselor; Public Health; Punishment; Randomized; Reporting; Research; Risk; Safety; Sampling; Services; Suicide; Surveys; Techniques; Testing; Text; Text Messaging; Time; Training; Treatment Efficacy; United States; Validity of Self Report; Work; alcohol abstinence; alcohol availability; alcohol involvement; alcohol misuse; alcohol research; base; binge drinking; brief alcohol intervention; college; cost; cost effective; court; data anonymization; drinking; drinking behavior; driving under influence; efficacious intervention; efficacy evaluation; experience; follow-up; group intervention; hazardous drinking; high risk; improved; innovation; intervention effect; live text; military service; motivational enhancement therapy; opioid overdose; overdose death; post intervention; prevent; programs; psychologic; recruit; sexual assault; smoking cessation; social; substance use; text messaging intervention; treatment effect; underage drinking; universal prevention; young adult

Episodic heavy or binge drinking and the associated health and social consequences are substantial public health concerns, with a high prevalence among young adults. This is particularly true among US military personnel. While alcohol consumption in the US military is very high and normative, there is zero tolerance for getting in legal trouble while drinking, and Airmen who do get in alcohol-related legal trouble (e.g., DUI, sexual assault) typically receive what is called an Alcohol Related Incident (ARI). In other populations, Brief Alcohol Interventions (BAIs) for alcohol misuse have been validated as efficacious with robust evidence for mostly college young adults who report episodic heavy drinking. Many BAI studies have targeted young adults who drink hazardously; these individuals are generally not interested in abstaining from alcohol, but are often willing to decrease the amount they drink or change the manner in which they drink in order to reduce harmful consequences. We have previously published1 the results of a BAI group- based intervention that has been shown to reduce ARIs universally (not in just high risk drinkers) in over 150,000 on average by 16%. Since we began in 2010, the BAI has been disseminated to most Airmen in Technical (Advanced) Training in the USAF. However, it is clear that additional research is needed to enhance the efficacy of our BAI intervention and to reduce the risk associated with problem drinking behavior. One such strategy that could improve health promotion outcomes is well timed and tailored automated text messages. Building on our preliminary study where text messages reduced driving after drinking as well as total drinks consumed before driving (See Previous Work), text messaging may be highly effective as the precise time that Airmen gain access to alcohol (when they are allowed off base for the first time) is known and is the same time for all Airmen. One of the challenges to conducting alcohol research in the military is the lack of privileged communication. As a result, it is difficult to obtain valid self-reports due to a tendency to deny or minimize use. Fortunately, we have recently validated a method developed by our research team for collecting anonymous data over time. We propose to conduct what is the first study in the military, as well as the first large scale, adequately powered trial, where intervention effects will be tracked out to a one year follow-up. Our findings would have strong implications for conducting research in both civilian and military populations. Thus, we propose the following Specific Aims: (1) We will randomize approximately 3000 Airmen to either the currently administered group BAI versus the BAI + Interactive Counselor Facilitated Text messages timed to occur before, during, and after Airmen have access to alcohol; and (2) To evaluate the efficacy of the intervention at a 3-, 6-, 9- and 12-month follow-up using repeated anonymous surveys with unique identifiers allowing us to match up surveys while simultaneously maintaining anonymity.

偶尔酗酒或酗酒以及相关的健康和社会后果是重大的公共卫生问题，在年轻人中发病率很高。在美国军事人员中尤其如此。虽然美国军队的饮酒量非常高且规范，但对于饮酒时陷入法律麻烦的行为是零容忍的，而确实陷入与酒精相关的法律麻烦（例如酒后驾车、性侵犯）的飞行员通常会受到所谓的“惩罚”。酒精相关事件 (ARI)。在其他人群中，针对酒精滥用的简短酒精干预措施 (BAI) 已被证实是有效的，有强有力的证据表明，对于大多数报告偶尔酗酒的大学生年轻人来说，这是有效的。 BAI 的许多研究都针对酗酒的年轻人。这些人通常对戒酒不感兴趣，但往往愿意减少饮酒量或改变饮酒方式，以减少有害后果。我们之前发表过1基于 BAI 团体的干预措施的结果，该干预措施已被证明可以使超过 150,000 人的 ARI 普遍降低（不仅仅是高风险饮酒者），平均降低 16%。自 2010 年开始以来，BAI 已分发给美国空军大多数接受技术（高级）培训的飞行员。然而，很明显，我们还需要进行更多的研究来提高 BAI 干预的效果并降低与问题饮酒行为相关的风险。一种可以改善健康促进成果的策略是适时且量身定制的自动短信。根据我们的初步研究，短信减少了酒后驾驶以及驾驶前消耗的总饮料量（参见之前的工作），短信可能非常有效，因为飞行员获得酒精的精确时间（当他们被允许离开基地时）第一次）是已知的，并且对于所有飞行员来说都是相同的时间。在军队中进行酒精研究的挑战之一是缺乏特权沟通。因此，由于倾向于否认或最小化使用，很难获得有效的自我报告。幸运的是，我们最近验证了我们的研究团队开发的一种随时间推移收集匿名数据的方法。我们建议进行首次军事研究，以及首次大规模、动力充足的试验，干预效果将在一年内进行追踪。我们的研究结果将对平民和军人的研究产生重大影响。因此，我们提出以下具体目标： (1) 我们将大约 3000 名飞行员随机分配到当前管理的 BAI 组和 BAI + 互动辅导员促进短信组，时间安排在飞行员饮酒之前、期间和之后； (2) 使用具有唯一标识符的重复匿名调查来评估干预措施在 3、6、9 和 12 个月随访中的有效性，使我们能够在保持匿名的同时匹配调查。