Piloting Signs of Safety: A Deaf-Accessible Therapy Toolkit for Alcohol Use Disorder and Trauma

安全试点：针对酒精使用障碍和创伤的聋人无障碍治疗工具包

基本信息

批准号：
9761412
负责人：
Melissa Lee Anderson
金额：
$ 24.08万
依托单位：
UNIV OF MASSACHUSETTS MED SCH WORCESTER
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-10 至 2021-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9761412
关键词：
Address Adherence Adult Aftercare Alcohol abuse Alcohol consumption American American Sign Language Behavior Therapy Client Clinical Cognitive Communities Comorbidity Companions Compassion Coping Skills Data Educational process of instructing Employment Enrollment Evidence based treatment Family Feedback Film Frequencies Future General Population Health Health Personnel Hearing Impairment Individual Integrative Therapy Language Development Learning Linguistics Mediator of activation protein Modeling Motivation National Institute on Alcohol Abuse and Alcoholism Outcome Parents Participant Pilot Projects Population Post-Traumatic Stress Disorders Problem Solving Process Assessment Program Development Protocols documentation Psychotherapy Radio Randomized Randomized Controlled Trials Reading Recovery Reporting Research Personnel Research Training Safety Services Severities Socialization Symptoms Text Therapeutic Studies Time Training Training Programs Translations Trauma Visual Work addiction alcohol abuse therapy alcohol comorbidity alcohol craving alcohol related problem alcohol use disorder arm artist base behavioral health cultural competence deaf design digital disorder risk drinking behavior efficacy testing evidence base experience falls follow up assessment follow-up fourth grade health literacy high risk improved peer physical conditioning primary outcome programs prototype recruit response satisfaction screening social norm trauma exposure

项目摘要

PROJECT SUMMARY/ABSTRACT The U.S. Deaf community – a group of more than 500,000 Americans who communicate using American Sign Language (ASL) – experiences nearly three times the rate of lifetime problem drinking and twice the rate of trauma exposure compared to the general population. Although there are validated treatments for alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) in hearing populations, there are no evidence-based treatments for any behavioral health condition for use with Deaf clients. Current evidence-based treatments fail to meet Deaf clients’ unique linguistic and cultural needs. To address these barriers, the PI led a team of Deaf and hearing researchers, clinicians, filmmakers, actors, artists, and Deaf people with AUD to develop a prototype of “Signs of Safety,” a Deaf-accessible toolkit to be used with an existing, widely-disseminated protocol for AUD/trauma – Seeking Safety. The Signs of Safety toolkit, as designed thus far, includes a therapist guide and population-specific client materials (e.g., visual handouts; ASL teaching stories on digital video, which present key learning points). It is designed for use by clinicians who are Deaf themselves, hearing signers, or hearing non-signers working with ASL interpreters. The aims of the proposed study are: (1) to generate a final, professional version of Signs of Safety to be used in future research and train three study clinicians in Signs of Safety and Seeking Safety; (2) to conduct a two- arm pilot randomized controlled trial (RCT) of Seeking Safety + Signs of Safety toolkit versus unsupplemented Seeking Safety, collecting data on feasibility outcomes (screening, recruitment, retention, satisfaction, fidelity, adherence, assessment process) and preliminary clinical outcomes (i.e., reduction in alcohol use frequency and quantity, alcohol craving, alcohol-related problems, severity of PTSD symptoms); and, (3) to examine potential mediators and moderators of outcome (e.g., motivation for treatment, provider cultural competency, coping skills, self-compassion, understanding of health information). The proposed aims will provide feasibility and preliminary efficacy data necessary to support a NIAAA R01 for a full-scale RCT to test the efficacy of Signs of Safety, as well as a participatory action model for conducting RCTs within the Deaf community.

项目概要/摘要美国聋人社区——由超过 500,000 名使用美国手语进行交流的美国人组成的群体语言 (ASL) – 一生中酗酒问题的发生率几乎是其三倍，是酗酒问题发生率的两倍与一般人群相比，虽然有有效的饮酒治疗方法。听力障碍（AUD）和创伤后应激障碍（PTSD），目前尚无证据支持目前针对聋人客户的任何行为健康状况的治疗均失败。满足聋人客户独特的语言和文化需求。为了解决这些障碍，PI 领导了一个由聋人和听力研究人员、叛逆者、电影制作人、演员、艺术家和聋人用澳元开发“安全标志”原型，这是一个聋人可用的工具包与现有的、广泛传播的 AUD/创伤协议一起使用 - 寻求安全的迹象。迄今为止设计的工具包包括治疗师指南和针对特定人群的客户材料（例如，视觉讲义；关于数字视频的 ASL 教学故事，其中介绍了学习要点）。本身是聋人的战士、听力手语者或听力非手语者与 ASL 口译员一起工作。拟议研究的目的是：(1) 生成要使用的安全标志的最终专业版本 (2) 进行两次寻求安全 + 安全标志工具包与未补充药物的手臂试点随机对照试验 (RCT) 寻求安全，收集可行性结果的数据（筛选、招聘、保留、满意度、忠诚度、依从性、评估过程）和初步临床结果（即减少饮酒频率）和数量、酒精渴望、酒精相关问题、创伤后应激障碍 (PTSD) 症状的严重程度）；以及 (3) 检查结果的潜在中介因素和调节因素（例如治疗动机、提供者文化能力、应对技巧、自我同情、对健康信息的理解）。拟议的目标将提供支持 NIAAA R01 所需的可行性和初步功效数据用于测试安全标志有效性的全面随机对照试验，以及用于进行的参与行动模型聋人社区内的随机对照试验。