A SMART evaluation of an adaptive web-based AUD treatment for service members and their partners

针对服务成员及其合作伙伴的基于网络的自适应 AUD 治疗的 SMART 评估

基本信息

批准号：
10705674
负责人：
Karen Chan Osilla
金额：
$ 72.8万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-20 至 2027-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10705674
关键词：
Absenteeism Address Alcohol abuse Anxiety Behavioral Mechanisms Caring Communication Communities Coping Skills Disease Domestic Violence Educational process of instructing Ethnic Origin Evaluation Family Goals Heavy Drinking Impairment Intervention Interview Mediating Mediator Mental Depression Mental Health Mental disorders Military Personnel Modeling Online Systems Outcome Partner Communications Pilot Projects Policies Probability Psychological reinforcement Race Randomized Reduce health disparities Reporting Resources Risk Rural Sampling Self Care Sequential Multiple Assignment Randomized Trial Services Social support Spouses Suicide Surveys Symptoms Telephone Testing Training Unmarried Waiting Lists Work adaptive intervention alcohol measurement alcohol misuse alcohol risk alcohol seeking behavior alcohol use disorder binge drinking brief intervention care seeking comparison control demographics depressive symptoms design deter alcohol use drinking efficacy evaluation experience fitness follow-up generalized anxiety help-seeking behavior high risk drinking improved innovation meetings military service novel peer personalized normative feedback prevent programs recruit rural area service gap service member sexual violence skills social treatment planning treatment services trial design web site web-based intervention

项目摘要

PROJECT ABSTRACT Military spouses in relationships with a heavy drinking service member partner report high levels of depression symptoms, drinking, and social impairment, and a heightened risk for domestic violence compared to spouses who are not in a relationship with a heavy drinking partner, and these consequences are compounded when both partners drink heavily. Yet, spouses often do not seek care for their own or their partner’s problems due to multiple barriers preventing pursuit of care. Military spouses and partners —termed “concerned partners” (CPs)—may be an important gateway for motivating service members to seek care. However, CPs may first need to reduce their own drinking and improve their communication to effectively support and encourage changes for their service member partner. The proposed study builds off our pilot work with Partners Connect, a 4-session web-based intervention (WBI) for military CPs. In Aim 1, we propose a Sequential Multiple Assignment Randomized Trial (SMART) design to evaluate the efficacy of an adaptive CP intervention on CP drinking and SM help-seeking. In Aim 2, we will examine how and for whom the adaptive intervention is most efficacious by looking at moderators and mediators of service-member help-seeking and supplementing these quantitative analyses with qualitative CP and service member interviews on the reasons and drivers of service member help-seeking. We will conduct a two-stage SMART design. In stage one, we will randomize CPs to either Partners Connect or communication resources from the Gottman Institute website. CPs will be considered a ‘”responder” at stage one if their service member completes their personalized normative feedback (PNF) session. CPs who are non-responders to stage one (service member has not completed PNF) will be re-randomized to receive additional communication interventions in stage two. The purpose of the stage two randomization is to test what helps stage one non-responders. We expect that by further treating those that do not respond initially to Partners Connect, we can improve CP communication and drinking, and ultimately help service members access a brief, effective PNF intervention for their drinking. Our goal is to reduce health disparities in the military by first intervening with the service member’s spouse and improving their outcomes to better equip them to engage their service member in services. In doing so, we develop a model that increases treatment accessibility and appeal among a group that may not otherwise seek care. The optimal package for CPs is the one that improves the CP’s drinking, mental health, and communication and that ultimately engages the service member in PNF. Thus, Partners Connect is a novel “two-in-one” intervention that fills service gaps for CPs and service members.

项目摘要与酗酒的军人伴侣有关系的军人配偶报告患有高度抑郁症与配偶相比，症状、饮酒和社交障碍以及家庭暴力的沉重风险没有与酗酒伴侣发生关系的人，当这些后果变得更加复杂时然而，夫妻双方都酗酒，通常不会因为自己或伴侣的问题而寻求照顾。多重阻碍寻求照顾的军人配偶和伴侣——被称为“有关伙伴”的障碍。 (CP)——可能是激励服役人员寻求护理的重要途径，但是，CP 可能首先。需要减少自己的饮酒量并改善沟通以有效支持和鼓励拟议的研究以我们与 Partners Connect 的试点工作为基础，针对军事 CP 的 4 次网络干预 (WBI) 在目标 1 中，我们提出了连续多重干预。分配随机试验 (SMART) 设计评估适应性 CP 干预对 CP 的疗效在目标 2 中，我们将研究适应性干预最有效的方式和对象。通过查看服役人员寻求帮助的主持人和调解员并补充这些内容，是有效的通过定性 CP 和服务成员访谈进行定量分析，了解服务的原因和驱动因素我们将进行两阶段的 SMART 设计在第一阶段，我们将随机分配 CP。 Partners Connect 或来自 Gottman Institute 网站的通信资源将是。如果他们的服役人员完成了个性化规范，则在第一阶段被视为“响应者” 对第一阶段没有反应的 CP（服役人员尚未完成 PNF）。将被重新随机分配以在第二阶段接受额外的沟通干预。两个进一步的随机化是为了测试对第一阶段无反应者有什么帮助，我们希望通过治疗这些人来做到这一点。最初没有对 Partners Connect 做出回应的人，我们可以改善 CP 沟通和饮酒，以及最终帮助军人获得简短、有效的 PNF 饮酒干预措施。通过首先对军人的配偶进行干预并改善健康状况，减少军队中的健康差距他们的成果是为了更好地让他们的服役人员参与服务。为此，我们开发了一个这种模式可以提高治疗的可及性和对可能不会寻求治疗的群体的吸引力。对于 CP 来说，最佳的方案是改善 CP 的饮酒、心理健康和沟通能力，并且最终让服务成员参与 PNF 因此，Partners Connect 是一种新颖的“二合一”。填补 CP 和军人服务空白的干预措施。